nitroglycerin (Millisrol Tape)

Comment on "Nano-enabled targeted transdermal therapy for pain management in cervical cancer".

Kamble Shubham S, Gurunani Gulshan G, Bodhankar Mitali M

Response to the Letter Regarding "Nano-enabled Targeted Transdermal Therapy for Pain Management in Cervical Cancer".

Odei-Mensah Beatrice B, Adeyemi Samson A SA, Choonara Yahya Essop YE

"Microneedles in breast cancer therapy: navigating treatment innovation amid biological and technological challenges".

Pachipala Mokshitha M, Ruby J Joysa JJ, Puttegowda Venkatesh Dinnekere VD

Breast cancer remains a leading cause of cancer-related morbidity and mortality worldwide, with conventional treatments frequently limited by systemic toxicity, multidrug resistance, and high recurrence rates, particularly in triple-negative and metastatic subtypes. Microneedle (MN)- based drug delivery systems have emerged as a minimally invasive platform that bypasses the stratum corneum to enable targeted transdermal and intradermal delivery of chemotherapeutics, nanocarriers, and immunotherapeutics, with reduced systemic exposure. This review critically examines the design principles, fabrication materials, and functional types of microneedles (MNs) as applied to breast cancer therapy. The integration of MNs with nanocarriers, immunotherapy, and stimuli-responsive materials to improve tumor penetration, remodel the immunosuppressive tumor microenvironment, and amplify anticancer immune responses is discussed, along with key biological, safety, and regulatory challenges relevant to clinical translation. Microneedles offer great promise as a versatile platform to increase the effectiveness and safety of breast cancer therapies.

Case Report: Spontaneous coronary artery dissection presenting as MINOCA in uncontrolled Graves' disease.

Pan Yunfeng Y, Han Hao H, Chen Jijie J, Zhang Shiyi S

Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction with non-obstructive coronary arteries (MINOCA). Although Graves' disease is a well-established cause of coronary vasospasm, its potential association with structural coronary arterial injury remains incompletely understood. We report a case of hyperthyroidism-associated SCAD that provides clinical insight into a possible link between severe thyrotoxicosis and coronary arterial vulnerability. We report a 56-year-old female with uncontrolled Graves' disease presenting with an acute ST-segment elevation myocardial infarction (STEMI). Despite prominent inferior ST-segment elevations, emergent coronary angiography revealed a long narrowing extending from the mid to the distal tip of the left anterior descending (LAD) artery with preserved TIMI 3 flow. The lesion's lack of response to intracoronary nitroglycerin supported a working diagnosis of MINOCA. Given the concurrent severe thyrotoxicosis and the substantial risk of precipitating thyroid storm during invasive evaluation, a staged diagnostic approach was adopted: acute-phase management prioritized conservative cardiovascular and antithyroid therapy, while definitive intravascular imaging was deferred. Follow-up intravascular ultrasound (IVUS) at three months demonstrated a persistent intramural hematoma, confirming the diagnosis of SCAD. The patient remained asymptomatic at the one-year follow-up. This case suggests that severe thyrotoxicosis may contribute to coronary arterial vulnerability and the development of SCAD. It also highlights the diagnostic challenges of complex MINOCA presentations in patients with uncontrolled hyperthyroidism. In selected cases, a staged diagnostic strategy with deferred intracoronary imaging after endocrinological stabilization may provide a safe and effective approach to diagnostic confirmation while minimizing procedural risk.