Background/Objectives: Red cell distribution width, platelet distribution width, and mean platelet volume are hematological indices derived from complete blood counts that have been increasingly investigated as potential cardiovascular biomarkers. This study aimed to assess the association between these indices and the extent of coronary artery disease, quantified by the Gensini score. Methods: We conducted a retrospective observational study of 240 patients hospitalized with typical angina who underwent elective coronary angiography at the Institute of Cardiovascular Diseases in Timișoara (January 2023–April 2024). Patients with hematological disorders, prior revascularization, or severe comorbidities were excluded. CAD severity was assessed by the Gensini score, with patients stratified into a low-score group (<50) and a high-score group (≥50). Laboratory and echocardiographic data were collected. Correlation analyses, ROC curve analysis, and multivariate regression were performed to evaluate predictors of CAD complexity. Results: Among 240 patients (81% male), 161 (67%) were in the high-score group. Compared with the low-score group, these patients had higher RDW (12.43 ± 0.68 vs. 12.70 ± 1.01, 95%CI: −0.52 to −0.02, p = 0.03), MPV (9.20 ± 0.88 vs. 9.45 ± 0.84, 95%CI: −0.48 to −0.02, p = 0.03), serum creatinine (p = 0.01), and potassium (p = 0.02), and lower ejection fraction (p < 0.001). RDW correlated positively with the Gensini score (rho = 0.28, 95%CI: 0.16–0.39, p = 0.001). Multivariate analysis identified RDW, MPV, and diastolic dysfunction as independent predictors. RDW showed weak discrimination for high Gensini burden (AUC = 0.57, 95% CI: 0.49–0.65, p > 0.05), consistent with a borderline, non-significant result. Conclusions: Elevated RDW and MPV are independently associated with greater coronary lesion burden. These routinely available indices may serve as novel, cost-effective markers for CAD risk stratification, warranting validation in prospective studies.

Oxidative stress contributes to heart failure (HF) progression by mechanisms that go beyond hemodynamic overload, including mitochondrial dysfunction, endothelial injury, inflammation, and fibrotic remodeling. This review evaluates the relationship between redox imbalance, Galectin-3 (Gal-3), fibrosis, and imaging findings in HF. Reactive oxygen species (ROS) generated by mitochondria, nicotinamide adenine dinucleotide phosphate (NADPH) oxidases, and xanthine oxidase may disturb calcium handling, impair mitochondrial function, activate fibroblasts, and promote ferroptosis. Biomarkers of oxidative injury and antioxidant reserve, including malondialdehyde (MDA), 8-hydroxy-2′-deoxyguanosine (8-OHdG), and circulating thiols, provide information complementary to natriuretic peptides. Experimental evidence supports a context-dependent role of Gal-3 in fibro-inflammatory remodeling, whereas circulating Gal-3 should be regarded as a complementary biomarker rather than as a direct measure of myocardial fibrosis. Echocardiography assesses functional remodeling through diastolic indices, myocardial deformation, and right ventricular–pulmonary arterial (RV–PA) coupling, while cardiac magnetic resonance characterizes focal scar and diffuse interstitial remodeling using late gadolinium enhancement, native T1 mapping, and extracellular volume fraction. Therapeutic strategies are increasingly shifting from nonspecific antioxidant supplementation toward targeting ROS sources and downstream pathways, with SGLT2 inhibitors emerging as clinically relevant agents with indirect redox-modulating effects. Integrated redox, fibro-inflammatory, hemodynamic, and imaging phenotyping may refine risk stratification, although prospective validation is required before routine implementation.

BACKGROUND The COVID-19 pandemic prompted rapid changes in medical education, accelerating the adoption of online and distance learning methods as alternatives to traditional teaching. While these approaches offered logistical advantages, students worldwide reported significant limitations, particularly in terms of motivation, clinical exposure, and hands-on skill acquisition. Despite the increased use of digital teaching during the pandemic, core educational objectives and the mission of medical training remained unchanged, emphasizing the continued importance of practical experience. OBJECTIVE This study aims to investigate the impact of the COVID-19 pandemic on current teaching methods in medical education and to explore students’ perceptions of online learning, telemedicine, artificial intelligence, and other modern educational alternatives. METHODS This observational, cross-sectional multicentric study surveyed a cohort of Romanian medical students using a self-developed 48-item online questionnaire distributed via social media. Data were collected over 6 weeks (February-March), yielding 451 responses, of which eligible participants included students in clinical years or preclinical students interested in surgical or orthopedic careers, with a heavy representation of the Medicine and Pharmacy University of Timisoara. Statistical analysis was performed using Microsoft Excel and JASP (University of Amsterdam; version 0.95.4). RESULTS A total of 436 responses were analyzed, with students favoring online or hybrid formats for lectures but preferring on-site teaching for practical training. Reduced patient interaction and limited skill acquisition were the main drawbacks of online practical education. Acceptance of hybrid learning correlated with more positive perceptions of teaching methods and a lower perceived desire to cheat. CONCLUSIONS The COVID-19 pandemic brought significant changes to the way medicine is being taught in Romania, but it also brought a clearer picture for students and medical staff on how they want medical education to be done. Online cheating remains a significant challenge, but it is being tackled at the moment with different algorithms being tested.

Background: The COVID-19 pandemic prompted rapid changes in medical education, accelerating the adoption of online and distance learning methods as alternatives to traditional teaching. While these approaches offered logistical advantages, students worldwide reported significant limitations, particularly in terms of motivation, clinical exposure, and hands-on skill acquisition. Despite the increased use of digital teaching during the pandemic, core educational objectives and the mission of medical training remained unchanged, emphasizing the continued importance of practical experience. Objective: This study aims to investigate the impact of the COVID-19 pandemic on current teaching methods in medical education and to explore students’ perceptions of online learning, telemedicine, artificial intelligence, and other modern educational alternatives. Methods: This observational, cross-sectional multicentric study surveyed a cohort of Romanian medical students using a self-developed 48-item online questionnaire distributed via social media. Data were collected over 6 weeks (February-March), yielding 451 responses, of which eligible participants included students in clinical years or preclinical students interested in surgical or orthopedic careers, with a heavy representation of the Medicine and Pharmacy University of Timisoara. Statistical analysis was performed using Microsoft Excel and JASP (University of Amsterdam; version 0.95.4). Results: A total of 436 responses were analyzed, with students favoring online or hybrid formats for lectures but preferring on-site teaching for practical training. Reduced patient interaction and limited skill acquisition were the main drawbacks of online practical education. Acceptance of hybrid learning correlated with more positive perceptions of teaching methods and a lower perceived desire to cheat. Conclusions: The COVID-19 pandemic brought significant changes to the way medicine is being taught in Romania, but it also brought a clearer picture for students and medical staff on how they want medical education to be done. Online cheating remains a significant challenge, but it is being tackled at the moment with different algorithms being tested.

Background/Objectives: Oxidative stress and galectin-3-related fibro-inflammatory processes contribute to heart failure pathophysiology, but their concurrent relationships with natriuretic peptides and structural/cardiorenal parameters remain incompletely characterized. We evaluated baseline associations of serum peroxide burden and galectin-3 with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and related phenotypic parameters in chronic heart failure. Methods: This cross-sectional analysis included 57 patients from a prospective single-center cohort. Serum peroxides were quantified using the ferrous oxidation–xylenol orange assay and expressed as nmol H₂O₂ equivalents/mL. Associations were assessed using Spearman correlation and linear regression with ln-transformed NT-proBNP. Benjamini–Hochberg correction was applied to eight secondary/exploratory correlations. Results: Serum peroxide burden correlated with NT-proBNP (ρ = 0.387, p = 0.0095; n = 44) and remained significantly associated after adjustment for age, sex, and left ventricular ejection fraction (B = 0.1756, p = 0.0420; n = 43). After additional estimated glomerular filtration rate (eGFR) adjustment, the effect estimate remained similar, although statistical significance was not reached (B = 0.1646, p = 0.0525; n = 39). Galectin-3 correlated with NT-proBNP, left ventricular end-diastolic volume index (LVEDVi), and serum uric acid; all associations remained significant after false-discovery-rate correction. Serum peroxide burden and galectin-3 were not significantly correlated. In an exploratory joint model (n = 29), both biomarkers remained significantly associated with ln(NT-proBNP) (adjusted R² = 0.4294). Conclusions: Serum peroxide burden and galectin-3 showed different cross-sectional association patterns with NT-proBNP and selected structural/cardiorenal parameters. Given the limited sample size, missing data, and exploratory nature of the joint model, these findings should be considered hypothesis-generating and do not establish biological independence or incremental clinical value.

Background and Objectives: Coronary artery disease may be difficult to detect by resting echocardiography when left ventricular ejection fraction is preserved and regional wall motion abnormalities are absent. This study aimed to assess whether resting Tissue Doppler Imaging-derived mitral annular velocities can help identify CAD in patients with suspected angina pectoris. Materials and Methods: We conducted a cross-sectional observational study of 92 patients hospitalized with suspected angina pectoris who underwent elective coronary angiography at the Institute of Cardiovascular Diseases in Timișoara (January 2025–February 2026). Patients with conditions known to affect TDI-derived parameters were excluded, including previous acute coronary syndrome or myocardial revascularization, significant valvular disease, cardiomyopathies, relevant arrhythmias or conduction abnormalities, permanent pacing, reduced ejection fraction, and pericardial disease. Laboratory and echocardiographic data were collected. ROC curve analysis, univariable logistic regression and multivariable logistic regression were performed to evaluate the diagnostic performance of TDI-derived parameters and their independent association with coronary artery disease. Results: Patients with CAD had significantly lower average E′ values (7.4 ± 1.9 vs. 8.9 ± 1.8 cm/s, p < 0.001) and average S′ values [7.0 (IQR 6.0–7.5) vs. 9.0 (IQR 8.1–10.0) cm/s, p < 0.001], together with higher E/E′ ratios [9.33 (IQR 8.23–11.15) vs. 7.87 (IQR 5.93–9.51), p = 0.002]. Average S′ showed the highest discriminative ability for coronary artery disease, with an AUC of 0.899 (95% CI: 0.819–0.952, p < 0.0001). The optimal Youden-derived cut-off was ≤7.5 cm/s, yielding 77.42% sensitivity and 93.33% specificity. After adjustment for age, male sex, body mass index, diabetes, smoking status, hypertension and LVEF, dichotomized S′ remained an independent predictor of coronary artery disease (OR = 45.49, 95% CI: 8.03–257.68, p < 0.0001), with an adjusted model AUC of 0.92 and 88.04% correct classification. Conclusions: TDI, particularly S′ velocity, may be a useful resting echocardiographic parameter for identifying CAD in selected patients with preserved LVEF and no resting regional wall motion abnormalities. Rather than serving as a universal diagnostic marker, S′ should be considered a complementary, easily obtainable parameter that may improve non-invasive assessment in this specific clinical setting.