Coronary Microvascular Disease in Women: Epidemiology, Mechanisms, Evaluation, and Treatment.

Coronary microvascular dysfunction (CMD) involves functional or structural abnormalities of the coronary microvasculature resulting in dysregulation of coronary blood flow (CBF) in response to myocardial oxygen demand. This perfusion mismatch causes myocardial ischemia, which manifests in patients as microvascular angina (MVA). CMD can be diagnosed non-invasively via multiple imaging techniques or invasively using coronary function testing (CFT), which assists in determining the specific mechanisms involving endothelium-independent and dependent epicardial and microcirculation domains. Unlike traditional coronary artery disease (CAD), CMD can often occur in patients without obstructive atherosclerotic epicardial disease, which can make the diagnosis of CMD difficult. Moreover, MVA due to CMD is more prevalent in women and carries increased risk of future cardiovascular events. Successful treatment of symptomatic CMD is often patient-specific risk factor and endotype targeted. This article aims to review newly identified mechanisms and novel treatment strategies for managing CMD, and outline sex-specific differences in the presentation and pathophysiology of the disease.

Electrochemical Rapid Detection of Methamphetamine from Confiscated Samples Using a Graphene-Based Printed Platform.

Methamphetamine (MAP) is a highly addictive and illegal stimulant drug that has a significant impact on the central nervous system. Its detection in biological and street samples is crucial for various organizations involved in forensic medicine, anti-drug efforts, and clinical diagnosis. In recent years, nanotechnology and nanomaterials have played a significant role in the development of analytical sensors for MAP detection. In this study, a fast, simple, and cost-effective electrochemical sensor is presented that is used for the sensitive detection of MAP in confiscated street samples with a complex matrix. The optimized screen-printed sensor based on a carbon working electrode modified with graphene demonstrated an excellent limit of detection, good sensitivity, and a wide dynamic range (1-500 µM) for the target illicit drug both for standard solutions and real samples (seized samples, tap water, and wastewater samples). It can detect MAP at concentrations as low as 300 nM in real samples. This limit of detection is suitable for the rapid preliminary screening of suspicious samples in customs, ports, airports, and on the street. Furthermore, the sensor exhibits a good recovery rate, indicating its reliability and repeatability. This quality is crucial for ensuring consistent and accurate results during screening processes.

Retinal Nerve Fiber Layer Imaging with Two Different Spectral Domain Optical Coherence Tomographs: Normative Data for Romanian Children.

The purpose of this study is to analyze and compare pediatric normative data for the retinal nerve fiber layer of Romanian children using two different spectral domain optical coherence tomographs. Due to different scanning speeds and axial and transverse resolution, the results of the measurements of scans cannot be transposed. A total of 140 healthy children aged 4 to 18 were enrolled in the study. Overall, 140 eyes were scanned with a Spectralis SD-OCT (Heidelberg Technology), and the other 140 eyes were imaged with a Copernicus REVO SOCT (Optopol Technology (Zawiercie, Poland)). The mean global RNFL thickness and average RNFL thickness for the four quadrants were measured and compared. The average peripapillary RNFL thickness measured with the Spectralis was 104.03 ± 11.42 (range 81 to 126 µm), while the one measured with the Revo 80 was 127.05 ± 15.6 (range 111.43-158.28). The RNFL thickness measurements taken with the Spectralis in the superior, inferior, nasal, and temporal quadrants were 132 ±19.1, 133.5 ± 21.77, 74 ± 16.48, and 73 ± 11.95 µm, respectively, while those taken with the Revo 80 were 144.44 ± 9.25, 144.86 ±23.12, 96.49 ± 19.41, and 77 ± 11.4 µm, respectively. Multivariate analysis showed that the average RNFL thickness was not influenced by gender or eye laterality and was negatively correlated with age when we used the Spectralis device. This study provides normative data for SD-OCT peripapillary RNFL in healthy Romanian children for two different tomographs. These data help the clinician evaluate and interpret the results of optical coherence tomography for a child, taking into consideration all the technical and individual parameters.

Investigating the electrochemical profile of methamphetamine to enable fast on-site detection in forensic analysis.

Methamphetamine (MA) is a synthetic psychoactive drug which is consumed both licitly and illicitly. In some countries it is prescribed for attention-deficit and hyperactivity disorder, and short-term treatment of obesity. More often though, it is abused for its psychostimulant properties. Unfortunately, the spread and abuse of this synthetic drug have increased globally, being reported as the most widely consumed synthetic psychoactive drug in the world in 2019. Attempting to overcome the shortcomings of the currently used on-site methods for MA detection in suspected cargos, the present study explores the potential of electrochemical identification of MA by means of square wave voltammetry on disposable graphite screen-printed electrodes. Hence, the analytical characterization of the method was evaluated under optimal conditions exhibiting a linear range between 50 µM and 2.5 mM MA, a LOD of 16.7 µM, a LOQ of 50.0 µM and a sensitivity of 5.3 µA mM-1. Interestingly, two zones in the potential window were identified for the detection of MA, depending on its concentration in solution. Furthermore, the oxidative pathway of MA was elucidated employing liquid chromatography - mass spectrometry to understand the change in the electrochemical profile. Thereafter, the selectivity of the method towards MA in mixtures with other drugs of abuse as well as common adulterants/cutting agents was evaluated. Finally, the described method was employed for the analysis of MA in confiscated samples and compared with forensic methods, displaying its potential as a fast and easy-to-use method for on-site analysis.

The Use of Xpert MTB/RIF Ultra Testing for Early Diagnosis of Tuberculosis: A Retrospective Study from a Single-Center Database.

Tuberculosis (TB) is a multisystemic contagious disease produced by Mycobacterium tuberculosis complex bacteria (MTBC), with a prevalence of 65:100,000 inhabitants in Romania (six times higher than the European average). The diagnosis usually relies on the detection of MTBC in culture. Although this is a sensitive method of detection and remains the "gold standard", the results are obtained after several weeks. Nucleic acid amplification tests (NAATs), being a quick and sensitive method, represent progress in the diagnosis of TB. The aim of this study is to assess the assumption that NAAT using Xpert MTB/RIF is an efficient method of TB diagnosis and has the capacity to reduce false-positive results. Pathological samples from 862 patients with TB suspicion were tested using microscopic examination, molecular testing and bacterial culture. The results show that the Xpert MTB/RIF Ultra test has a sensitivity of 95% and a specificity of 96.4% compared with 54.8% sensitivity and 99.5% specificity for Ziehl-Neelsen stain microscopy, and an average of 30 days gained in the diagnosis of TB compared with bacterial culture. The implementation of molecular testing in TB laboratories leads to an important increase in early diagnostics of the disease and the prompter isolation and treatment of infected patients.

Design of smart nanoparticles for the electrochemical detection of 3,4-methylenedioxymethamphetamine to allow in field screening by law enforcement officers.

A portable and highly sensitive sensor was designed for the specific detection of 3,4-methyl-enedioxy-methamphetamine (MDMA), in a range of field-testing situations. The sensor can detect MDMA in street samples, even when other controlled substances drugs, or adulterants are present. In this work, we report for the first time a sensor using electroactive molecularly imprinted polymer nanoparticles computationally designed to recognize MDMA and then produced using solid phase synthesis. A composite comprising chitosan, reduced graphene oxide, and molecularly imprinted polymer nanoparticles synthesized for MDMA for the first time was immobilized on screen-printed carbon electrodes. The sensors displayed a satisfactory sensitivity (106.8 nA × µM-1 ), limit of detection (1.6 nM; 0.31 ng/mL), and recoveries (92-99%). The accuracy of the results was confirmed through validation using Ultra-High Performance Liquid Chromatography coupled with tandem Mass Spectrometry (UPLC-MS/MS). This technology could be used in forensic analysis and make it possible to selectively detect MDMA in street samples.

Forensic Analysis of Synthetic Cathinones on Nanomaterials-Based Platforms: Chemometric-Assisted Voltametric and UPLC-MS/MS Investigation.

Synthetic cathinones (SCs) are a group of new psychoactive substances often referred to as "legal highs" or "bath salts", being characterized by a dynamic change, new compounds continuously emerging on the market. This creates a lack of fast screening tests, making SCs a constant concern for law enforcement agencies. Herein, we present a fast and simple method for the detection of four SCs (alpha-pyrrolidinovalerophenone, N-ethylhexedrone, 4-chloroethcathinone, and 3-chloromethcathinone) based on their electrochemical profiles in a decentralized manner. In this regard, the voltametric characterization of the SCs was performed by cyclic and square wave voltammetry. The elucidation of the SCs redox pathways was successfully achieved using liquid chromatography coupled to (tandem) mass spectrometry. For the rational identification of the ideal experimental conditions, chemometric data processing was employed, considering two critical qualitative and quantitative variables: the type of the electrochemical platform and the pH of the electrolyte. The analytical figures of merit were determined on standard working solutions using the optimized method, which exhibited wide linear ranges and LODs suitable for confiscated sample screening. Finally, the performance of the method was evaluated on real confiscated samples, the resulting validation parameters being similar to those obtained with another portable device (i.e., Raman spectrometer).

Electrochemical Fingerprints of Illicit Drugs on Graphene and Multi-Walled Carbon Nanotubes.

Illicit drugs use and abuse remains an increasing challenge for worldwide authorities and, therefore, it is important to have accurate methods to detect them in seized samples, biological fluids and wastewaters. They are recently classified as the latest group of emerging pollutants as their consumption increased tremendously in recent years. Nanomaterials have gained much attention over the last decade in the development of sensors for a myriad of applications. The applicability of these nanomaterials, functionalized or not, significantly increases and it is therefore highly suitable for use in the detection of illicit drugs. We have assessed the suitability of various nanoplatforms, such as graphene (GPH), multi-walled carbon nanotubes (MWCNTs), gold nanoparticles (AuNPs) and platinum nanoparticles (PtNPs) for the electrochemical detection of illicit drugs. GPH and MWCNTs were chosen as the most suitable platforms and cocaine, 3,4-methylendioxymethamfetamine (MDMA), 3-methylmethcathinone (MMC) and α-pyrrolidinovalerophenone (PVP) were tested. Due to the hydrophobicity of the nanomaterials-based platforms which led to low signals, two strategies were followed namely, pretreatment of the electrodes in sulfuric acid by cyclic voltammetry and addition of Tween 20 to the detection buffer. Both strategies led to an increase in the oxidation signal of illicit drugs. Binary mixtures of illicit drugs with common adulterants found in street samples were also investigated. The proposed strategies allowed the sensitive detection of illicit drugs in the presence of most adulterants. The suitability of the proposed sensors for the detection of illicit drugs in spiked wastewaters was finally assessed.

Endometrial stromal sarcoma developed on outer endometriosis foci.

INTRODUCTION: Endometrial stromal tumor is a rare mesenchymal uterine tumor. Endometriosis, an affection of the women during her fertile period, is reported in the pertinent literature to have an incidence varying from 1% to 53%, which shows a wide difference from one study to another. The pathology that grafts onto the endometriosis foci is rare, and the malignant tumoral pathology is extremely rare. The most frequent malignant tumors quoted in the pertinent literature are of the adenocarcinoma type, on the endometriosis, and the alterations of the sarcomatous type can appear extremely rarely. Most sarcomas appear on the foci of the rectosigmoid endometriosis. These rare tumors should not be taken for the mesenchymal gastrointestinal tumors. The recurrence of the malignant alterations of the endometriosis foci is estimated at about 0.7-1% in the pertinent literature. MATERIALS AND METHODS: We are presenting a case of endometrial stromal sarcoma, developed on foci of outer endometriosis (sigmoid and appendicular endometriosis), diagnosed in our laboratory on two operatory pieces taken from the same woman, at a 2-month interval. The macroscopic and microscopic study was done on operatory pieces, with the routine procedure, macroscopic examination, fixing in 10% formalin, embedding in paraffin and staining with Hematoxylin-Eosin and than we used immunohistochemical markers, for endometrial stroma. RESULTS: The endometrial stromal sarcoma developed on foci of endometriosis is very rare, has an incidence of 6% within the endometrial malignant tumors, with various degrees of malignancy, low malignancy, or high malignancy. CONCLUSIONS: We do not exclude the appearance of the endometrial sarcoma on the outer endometriosis foci. Moreover, the endometriosis foci can be considered as pre-malignant conditions.