The discovery of a “new” psychoactive substance is a relatively exceptional event, while the regulatory response usually involved the assessment of risks to public health and inclusion of the novel substance in the national list of controlled substances. However, in recent years we have witnessed the rapid emergence of new chemical substances, which elude international control and pose a challenge to existing processes and a threat to the credibility of control systems. We currently review and present characteristics of these legal and illegal new substances and issues regarding their global monitoring and regulatory measures already taken, or in the process of being taken, for their control. The concept of prohibition applied in active substance-related legislation is rather hazard ridden as balance is required between the ban on substances of potential therapeutic use and the access on the market of high-risk substances. Current and future laws regarding psychoactive compounds.
Obesity is associated with endothelial dysfunction and this relationship is probably mediated in part by inflammation. Objective: The current study evaluated the effects of etanercept, a tumor necrosis factor-alpha (TNF-α) inhibitor, on endothelial and vascular reactivity, endothelial nitric oxide synthase (eNOS) immunoreactivity, and serum and aortic concentrations of TNF-α in a diet-induced rat model. Design and results: Male weanling Wistar rats were exposed to a standard diet and cafeteria diet (CD) for 12 weeks and etanercept was administered during CD treatment. Isolated aortas of the rats were used for isometric tension recording. Carbachol-induced relaxant responses were impaired in CD-fed rats, while etanercept treatment improved these endothelium-dependent relaxations. No significant change was observed in papaverine- and sodium nitroprusside (SNP)-induced relaxant responses. eNOS expression decreased in CD-fed rats, but no change was observed between etanercept-treated CD-fed rats and control rats. CD significantly increased both the serum and the aortic levels of TNF-α, while etanercept treatment suppressed these elevated levels. CD resulted in a significant increase in the body weight of the rats. Etanercept-treated (ETA) CD-fed rats gained less weight than both CD-fed and control rats.
Tramadol is a centrally acting analgesic, atypical opioid, and although it is generally considered as a medicinal drug with a low potential for dependence, there is growing evidence of tramadol abuse in some countries. The ultraviolet detection is not suitable for analysis of tramadol in plasma, due to the lack of sensitivity and selectivity. However, it was shown that tramadol has a weak fluorescence, and the latest techniques for determination of tramadol in plasma include liquid chromatographic methods with fluorescence detection (FL). The objective of the paper was to develop a HPLC-FL method applicable for quantification of tramadol in human plasma.The separation was achieved by reverse phase HPLC method, using as stationary phase C18 – Kromasil® column and a mobile phase consisted of acetonitrile: 0.1% formic acid (20:80). The fluorescence detection has been applied with λex/em = 280/310 nm. A solid phase extraction procedure using C18 cartridge was carried out. The linearity of the method has been demonstrated in the range of both therapeutic and toxic plasma tramadol levels (concentrations of 0.100 – 1 μg/mL). The selectivity, precision, and accuracy of the method have been demonstrated. The limit of detection (LOD = 0.010 μg/mL) and the limit of quantification (LOQ = 0.100 μg/mL) have been established.The proposed method can be used to assess tramadol levels in human plasma in pharmacokinetic studies, as well as in overdose cases. The utility of the method for the quantification of therapeutic levels of tramadol has been shown on the plasma samples from the patients with tramadol treatment as analgesic (doses ranging from 100 mg to 400 mg/day).The developed method is rapid, using simple experimental conditions and an accurate and short extraction procedure.
Despite being rare, the incidence of pregnancy-related cancer is expected to rise as women continue to delay childbearing and give birth later in their reproductive years. In this broad category, tumors like breast cancer, dermatological neoplasia and cervical cancer are most common and tend to arise in women of childbearing age. All pregnant women with clinical and cytologic suspicion of cervical cancer, except for squamous atypia or low-grade squamous intraepithelial lesions, should undergo colposcopy, with or without biopsy, the latter being avoided if possible due to possible complications which, although rare, may involve preterm labor initiation. Some studies have attempted to assimilate comparable results of USG with MRI during the gestational period by determining the sensitivity, specificity, and accuracy of trans-rectal ultrasound (TRUS) in comparison to magnetic resonance imaging (MRI). In order to identify the proper way to diagnose and treat the disease, because of the complexity due to pregnancy, a multidisciplinary team consisting of a gynecologist, medical and surgical oncologist, and radiologist should be assembled. Both maternal and fetal wellbeing should be taken into consideration when the medical team must choose among termination of pregnancy, delay of maternal treatment, and iatrogenic preterm delivery. Psychological counseling also plays an important role and due to the sensitivity of the issue, should continue through gestation and the postpartum. In order to develop optimal guidelines for diagnosis, treatment, and outcome issues, large scale prospective studies are needed, but feasibility may be limited due to the scarcity of cervical cancer cases associated with pregnancy.
The cesarean operation represents a major surgery, with a higher risk of postoperative complications and longer postoperative recovery than vaginal delivery. Due to the increasing frequency of cesarean sections, the ultrasound imaging of the uterine scar has become a particularly useful tool in identifying its potential long-term complications. This should be done pre-conceptively and quarterly or whenever necessary during pregnancy. Currently, there are only few histopathological studies on the uterine scar, trying to assess the myometrial repair and certain factors that influence the quality of the scar. The study was performed on a batch of 123 patients with previous C-sections, with multiple ultrasound exams during pregnancy and post-operative pathologic evaluation of the uterine scar in order to assess the possibility of a new prognostic score by correlating these two factors. Our study found solid evidence related to possible correlations between histopathological and ultrasound data on the cesarean section scar, which could lead to a possible predictive algorithm with implications for both prognostic and therapeutic fields.