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Arterial stiffness is associated with left ventricular diastolic dysfunction (DD), which can lead to heart failure with preserved ejection fraction. However, longitudinal data on their relationship in the general population are limited. This study aimed to evaluate the association between arterial stiffness, assessed by brachial-ankle pulse wave velocity (baPWV), and the prevalence and progression of DD, as well as long-term outcomes in a large, community-based cohort. This retrospective cohort study enrolled 16 476 adults (≥ 18 years) who underwent health screening, including echocardiography and baPWV measurements, between 2010 and 2019. Participants were categorized into normal (< 1400cm/s), borderline (1400-1799cm/s), and elevated (≥ 1800cm/s) baPWV groups. Multivariable regression was conducted to analyze the association between baPWV, DD progression, and all-cause mortality during long-term follow-up. At baseline, the prevalence of definite DD was significantly higher in the borderline baPWV group (PR, 1.73; 95%CI, 1.23-2.23) and the elevated baPWV group (PR, 3.25; 95%CI, 2.16-4.33) compared with the normal group. Participants with borderline or elevated baPWV had a faster increase in left ventricular filling pressure (E/e') over a mean follow-up of 4 years. Elevated baPWV was independently associated with an increased risk of incident DD (HR, 2.61; 95%CI, 1.73-3.95) and higher all-cause mortality during follow-up (HR, 3.91; 95%CI, 1.68-9.10), even after adjustment for traditional cardiovascular risk factors. Borderline and elevated baPWV were significantly associated with a higher prevalence and faster DD progression, as well as an increased mortality risk in the general population, suggesting that baPWV is an important factor in DD pathophysiology and a useful noninvasive tool for cardiovascular risk stratification. Clinical neurological examination remains the gold standard to detect, diagnose, and follow-up responses to treatment in acute neurological conditions in the critical care setting. However, in patients with severe neurological deficits at baseline or those requiring sedatives, detecting neurological deterioration can be challenging. In this scenario, noninvasive bedside neuromonitoring as a part of multimodal strategies can be useful in the avoidance of secondary brain injury and in the selection of which patient with acute brain injury would benefit from invasive neuromonitorization. Serum vascular endothelial growth factor (VEGF) levels correlate with structural alterations in Rheumatoid Arthritis (RA). Since P wave dispersion (PWD) is associated with atrial ischemic-related fibrotic changes, it was conceived that there may be a correlation between altered PWD and increased VEGF levels in RA. In this prospective observational study, we evaluated patients with RA, and compared them to control subjects. PWD was considered as the difference between the maximum and minimum duration of the P wave. An altered PWD was considered one that had dispersion≥38ms. Measurements of VEGF serum levels were performed using enzyme-ligand, immunosorbent measurement ELISA kits. A total of 99 patients with RA, and 48 control subjects were evaluated. The PWD was 25.3±4.9ms in the control group vs. 57±14.9ms (p<0.0001) in the RA group. No patient in the control group had altered PWD, while 94 (95%) patients in the RA group presented it (p<0.0001). The value of VEGF in the control group was 15.2±15.1pg/ml vs 51.1±55.5pg/ml (p<0.001) in RA. The value of VEGF in RA without altered PWD was 20±12pg/ml vs 56±57pg/ml in RA with altered PWD (p<0.02). An elevated VEGF value had a specificity of 80%, and a positive predictive accuracy of 95% in predicting altered PWD in RA. This study establishes for the first time that RA patients who possess significantly higher serum levels of VEGF have an altered PWD. The presence of an elevated VEGF serum value has a high specificity, and high positive predictive accuracy of the existence of altered PWD in RA. A renal biopsy represents the gold standard in the diagnosis, prognosis and management of patients with chronic kidney disease and glomerulonephritis. Strain wave elastography (SE) is a developing technique to assess tissue elasticity. The aim of this study was to correlate between the strain index value of renal parenchyma and degree of renal fibrosis detected with renal biopsy. For 68 patients who were referred for a kidney biopsy, SE test was performed. The Banff scoring system was utilized to classify the IFTA grading of kidney fibrosis that assigns a severity level of mild, moderate, or severe. Receiver operating characteristic curve (ROC) was utilized to correlate between the severity of renal fibrosis and the grade of renal elasticity determined by SE. In total, 38 males and 30 females, the echogenicity, qualitative and semiquantitative elastography showed significant positive correlation with serum creatinine, percentage of fibrosis, G score and tubular atrophy and significant negative correlation with eGFR. ROC curve of SE for diagnosis of interstitial fibrosis shown that echogenicity has sensitivity 100.0%, specificity 62.5%, positive predictive value (PPV) 75.0%, negative predictive value (NPV) 100.0% with area under curve (AUC) 0.906, while qualitative elastography has sensitivity 77.8%, specificity 75.0%, PPV 77.8%, NPV 75.0%, AUC 0.833, semi quantitative elastography has sensitivity 83.3%, specificity 93.8%, PPV 93.8%, NPV 83.3% with AUC 0.915. SE approach is simple to use, and can differentiate between varying stages of renal fibrosis. However, further research is required before it can be frequently used in clinical practice. The body contour market has grown rapidly in recent years, due to persistent requests for noninvasive treatments for localized fat adiposities, cellulite, and skin laxity. A variety of different methods are now available to improve body shaping. This review aims to provide an exhaustive compendium of the main recommendations for the optimal use of an innovative device delivering microwaves (MWs) for unwanted fat and cellulite reduction (Onda Coolwaves, DEKA, Florence, Italy), resulting from the experiences of the most expert international users. The availability of this new technology has led to an increasing number of treated patients and clinical studies. However, what is still missing, to the best of our knowledge, is an evaluation of the long-term efficacy and safety of this method. Based on the most recent data available, this compendium focuses on the ideal parameters, patient selection, and treatment methodology for providing safe and effective treatment protocols. Future research findings may suggest changes to the conclusions or recommendations in this report. The progression of chronic kidney disease (CKD) involves the development of alterations in mineral metabolism that are closely related to cardiovascular outcomes and bone disease. Hypomagnesemia is associated with more rapid progression of CKD and other comorbidities. Our objective was to analyze in CKD patients stages 3-4 the impact of the administration of magnesium (Mg) carbonate on bone mineral density (BMD) and hemodynamic changes associated with by vascular calcification (VC). Patients with CKD stages 3-4 were randomized into controls (n=12) or intervention (n=7) group receiving 360mg of Mg carbonate daily during a 15-month period. Parameters related to mineral metabolism, BMD, VC, and pulse wave velocity (PWV) were evaluated. Supplementation with Mg produced an increase in the urinary excretion of Mg while serum Mg levels remained stable and no episodes of hypermagnesemia were reported. In addition, no significant changes were found in the degree of VC assessed by Adragao index, however, both serum and urine Mg were significantly associated with a decrease in PWV, suggesting an increase in vascular compliance. Likewise, BMD did not change fol

Breast ultrasound is widely used for cancer screening, but data scarcity and annotation challenges hinder deep learning adoption. Synthetic image generation offers a promising solution to enhance training datasets while preserving patient privacy. However, problems such as inadequate quality of synthesized images and the need for large amounts of data to train the synthesis models remain significant. We propose a three-stage latent diffusion model (LDM) workflow-enhanced by Vision Transformers and fine-tuned with low-rank adaptation-that synthesizes realistic malignant and benign breast ultrasound images directly from healthy samples while simultaneously generating accurate segmentation masks. Stage division significantly reduces the task complexity of a single synthesis model. Applied to the BUSI dataset (133 healthy, 487 benign, and 210 malignant images), the method generates synthetic cases of each tumor type. A ResNet101 classifier could not reliably distinguish synthetic from real images (AUC = 0.563), indicating high visual plausibility. Quantitative metrics confirmed strong fidelity: Fréchet inception distance = 15.2 and inception score = 1.79, indicating low distributional divergence in feature space and high similarity to real data. When used for training a U-Net segmentation model, the augmented dataset improved the F 1 -score from 0.870 to 0.896, demonstrating substantial gains in diagnostic accuracy. These results show that the proposed three-stage LDM can generate high-quality, anatomically coherent breast cancer images from healthy controls, effectively alleviating data scarcity and enabling more robust training of medical AI systems without compromising clinical realism. Delayed wound healing in diabetes mellitus (DM) is closely associated with endothelial mitochondrial dysfunction and impaired mitophagy. We therefore developed a liquid dermal matrix (LDM) and investigated its therapeutic efficacy and underlying mechanisms in diabetic wound repair. The release behavior and biocompatibility of LDM were characterized. Its therapeutic effects were evaluated in a streptozotocin (STZ)-induced diabetic mouse full-thickness wound model, and mechanistic studies were conducted in high glucose (HG)-treated human umbilical vein endothelial cells (HUVECs). LDM exhibited sustained protein release over 96 h. In STZ-diabetic mice, topical application of Gel + LDM markedly accelerated wound closure; the wound closure rate at day 12 increased from 68.87 ± 3.98% in the Gel group to 94.80 ± 1.35% in the Gel + LDM group (P < 0.001). Laser speckle imaging confirmed enhanced wound perfusion at day 12, with perfusion units increasing from 489.96 ± 33.74 (Gel) to 707.21 ± 24.21 (Gel + LDM) (P < 0.001). Histological analyses revealed improved re-epithelialization and collagen remodeling, alongside increased angiogenesis as indicated by elevated CD31 and VEGFA staining. Mechanistically, in HG-treated HUVECs, LDM restored autophagic flux, evidenced by increased LC3-II and reduced P62 accumulation, and promoted PINK1/Parkin-dependent mitophagy. This was accompanied by attenuated mitochondrial fragmentation, reduced mtROS, and improved mitochondrial membrane potential (ΔΨm). Functionally, LDM improved endothelial proliferation, migration, and tube formation, while these protective effects were largely attenuated by 3-MA, MG-149, or PINK1 knockdown, supporting a mitophagy-dependent mechanism. LDM accelerates diabetic wound healing and improves wound perfusion by restoring mitophagy and mitochondrial homeostasis in endothelial cells, highlighting LDM as a promising therapeutic strategy for DM-associated chronic wounds. Yttrium-90 resin microspheres selective internal radiation therapy ( 90 $$ {}^{90} $$ Y-SIRT) has been increasingly adopted worldwide as a locoregional treatment option for appropriately selected patients with liver malignancies. The key to ensuring that the tumor receives an adequate radiation dose while minimizing the dose to normal tissues is to optimize the trade-off between tumor control and the probability of normal tissue complications. To accurately determine a patient's internal radiation dose, pre-treatment dose planning and post-treatment dose verification using dosimetric methods are recommended and increasingly considered best practice in 90 $$ {}^{90} $$ Y-SIRT, where feasible. Due to the increased demand for personalized treatment and dose accuracy in clinical practice, 90 $$ {}^{90} $$ Y-SIRT dosimetry has transitioned from organ-level to voxel-level dosimetry. This paper introduces the relevant principles and development history of 90 $$ {}^{90} $$ Y-SIRT dosimetry for resin microspheres. It also discusses the clinical performance, influencing factors and practical applications of relevant dosimetry methods. These include body surface area (BSA) method, MIRD multi-compartment model method, and partition model method; voxel-S-value (VSV); local deposition method (LDM); and Monte Carlo (MC) method. Finally, it covers the subsequent development of resin microsphere 90 $$ {}^{90} $$ Y-SIRT dosimetry. We address computed tomography (CT) metal artifacts reduction (MAR) using a generative deep-learning model in the imaging physics framework. Existing deep learning-based MAR methods, though promising, generally lack explicit physical modeling of artifact formation and rely heavily on data-driven mappings. The absence of physics priors not only limits scalability, as they often require paired or task-specific datasets, but also makes such methods prone to hallucination, anatomical distortion, and unstable artifact suppression. We propose a novel self-supervised framework for CT MAR, integrating a lightweight multi-layer perceptron (MLP)-based beam-hardening correction with a conditional latent diffusion model (LDM). By incorporating a physics-informed correction step and an artifact-reproducing simulation technique, the framework aims to enhance scalability across diverse scenarios, reduce hallucination effects, and improve structural fidelity in the reconstructed images. The proposed MLP performs physics-driven polynomial correction, serving as a simplified but efficient alternative to existing approaches. Also, the proposed MLP implicitly incorporates sinogram consistency into its optimization objective, allowing case-specific adaptation and convergence toward the desired solution. Additionally, the learned MLP parameters are reused to simulate artifact-contaminated images from artifact-free scans, generating pseudo paired data for self-supervised training without requiring real paired datasets. A conditional LDM is trained on these synthetic pairs to remove residual artifacts. By operating in a low-dimensional latent space, the LDM significantly reduces inference time while maintaining high-quality reconstructions. The proposed method is evaluated on both the SynDeepLesion dataset and real clinical data, demonstrating superior artifact removal and structural preservation compared to the existing state-of-the-art MAR techniques. We particularly highlight the robustness, generalizability, and clinical applicability of the proposed framework. We proposed a self-supervised metal artifact reduction framework that combines MLP-based beam-hardening correction with a conditional latent diffusion model in the imaging physics framework. The MLP module provides physics motivated beam-hardening corrected CT images, while the residual artifact simulation strategy enables fully self-supervised training without the need for paired data. The proposed method demonstrated superior artifact suppression and structural preservation on both synthetic and clinical datasets, outperforming existing approaches. Injury to articular cartilage remains a major clinical challenge owing to its limited se

Arterial stiffness is associated with left ventricular diastolic dysfunction (DD), which can lead to heart failure with preserved ejection fraction. However, longitudinal data on their relationship in the general population are limited. This study aimed to evaluate the association between arterial stiffness, assessed by brachial-ankle pulse wave velocity (baPWV), and the prevalence and progression of DD, as well as long-term outcomes in a large, community-based cohort. This retrospective cohort study enrolled 16 476 adults (≥ 18 years) who underwent health screening, including echocardiography and baPWV measurements, between 2010 and 2019. Participants were categorized into normal (< 1400cm/s), borderline (1400-1799cm/s), and elevated (≥ 1800cm/s) baPWV groups. Multivariable regression was conducted to analyze the association between baPWV, DD progression, and all-cause mortality during long-term follow-up. At baseline, the prevalence of definite DD was significantly higher in the borderline baPWV group (PR, 1.73; 95%CI, 1.23-2.23) and the elevated baPWV group (PR, 3.25; 95%CI, 2.16-4.33) compared with the normal group. Participants with borderline or elevated baPWV had a faster increase in left ventricular filling pressure (E/e') over a mean follow-up of 4 years. Elevated baPWV was independently associated with an increased risk of incident DD (HR, 2.61; 95%CI, 1.73-3.95) and higher all-cause mortality during follow-up (HR, 3.91; 95%CI, 1.68-9.10), even after adjustment for traditional cardiovascular risk factors. Borderline and elevated baPWV were significantly associated with a higher prevalence and faster DD progression, as well as an increased mortality risk in the general population, suggesting that baPWV is an important factor in DD pathophysiology and a useful noninvasive tool for cardiovascular risk stratification. Clinical neurological examination remains the gold standard to detect, diagnose, and follow-up responses to treatment in acute neurological conditions in the critical care setting. However, in patients with severe neurological deficits at baseline or those requiring sedatives, detecting neurological deterioration can be challenging. In this scenario, noninvasive bedside neuromonitoring as a part of multimodal strategies can be useful in the avoidance of secondary brain injury and in the selection of which patient with acute brain injury would benefit from invasive neuromonitorization. Serum vascular endothelial growth factor (VEGF) levels correlate with structural alterations in Rheumatoid Arthritis (RA). Since P wave dispersion (PWD) is associated with atrial ischemic-related fibrotic changes, it was conceived that there may be a correlation between altered PWD and increased VEGF levels in RA. In this prospective observational study, we evaluated patients with RA, and compared them to control subjects. PWD was considered as the difference between the maximum and minimum duration of the P wave. An altered PWD was considered one that had dispersion≥38ms. Measurements of VEGF serum levels were performed using enzyme-ligand, immunosorbent measurement ELISA kits. A total of 99 patients with RA, and 48 control subjects were evaluated. The PWD was 25.3±4.9ms in the control group vs. 57±14.9ms (p<0.0001) in the RA group. No patient in the control group had altered PWD, while 94 (95%) patients in the RA group presented it (p<0.0001). The value of VEGF in the control group was 15.2±15.1pg/ml vs 51.1±55.5pg/ml (p<0.001) in RA. The value of VEGF in RA without altered PWD was 20±12pg/ml vs 56±57pg/ml in RA with altered PWD (p<0.02). An elevated VEGF value had a specificity of 80%, and a positive predictive accuracy of 95% in predicting altered PWD in RA. This study establishes for the first time that RA patients who possess significantly higher serum levels of VEGF have an altered PWD. The presence of an elevated VEGF serum value has a high specificity, and high positive predictive accuracy of the existence of altered PWD in RA. A renal biopsy represents the gold standard in the diagnosis, prognosis and management of patients with chronic kidney disease and glomerulonephritis. Strain wave elastography (SE) is a developing technique to assess tissue elasticity. The aim of this study was to correlate between the strain index value of renal parenchyma and degree of renal fibrosis detected with renal biopsy. For 68 patients who were referred for a kidney biopsy, SE test was performed. The Banff scoring system was utilized to classify the IFTA grading of kidney fibrosis that assigns a severity level of mild, moderate, or severe. Receiver operating characteristic curve (ROC) was utilized to correlate between the severity of renal fibrosis and the grade of renal elasticity determined by SE. In total, 38 males and 30 females, the echogenicity, qualitative and semiquantitative elastography showed significant positive correlation with serum creatinine, percentage of fibrosis, G score and tubular atrophy and significant negative correlation with eGFR. ROC curve of SE for diagnosis of interstitial fibrosis shown that echogenicity has sensitivity 100.0%, specificity 62.5%, positive predictive value (PPV) 75.0%, negative predictive value (NPV) 100.0% with area under curve (AUC) 0.906, while qualitative elastography has sensitivity 77.8%, specificity 75.0%, PPV 77.8%, NPV 75.0%, AUC 0.833, semi quantitative elastography has sensitivity 83.3%, specificity 93.8%, PPV 93.8%, NPV 83.3% with AUC 0.915. SE approach is simple to use, and can differentiate between varying stages of renal fibrosis. However, further research is required before it can be frequently used in clinical practice. The body contour market has grown rapidly in recent years, due to persistent requests for noninvasive treatments for localized fat adiposities, cellulite, and skin laxity. A variety of different methods are now available to improve body shaping. This review aims to provide an exhaustive compendium of the main recommendations for the optimal use of an innovative device delivering microwaves (MWs) for unwanted fat and cellulite reduction (Onda Coolwaves, DEKA, Florence, Italy), resulting from the experiences of the most expert international users. The availability of this new technology has led to an increasing number of treated patients and clinical studies. However, what is still missing, to the best of our knowledge, is an evaluation of the long-term efficacy and safety of this method. Based on the most recent data available, this compendium focuses on the ideal parameters, patient selection, and treatment methodology for providing safe and effective treatment protocols. Future research findings may suggest changes to the conclusions or recommendations in this report. The progression of chronic kidney disease (CKD) involves the development of alterations in mineral metabolism that are closely related to cardiovascular outcomes and bone disease. Hypomagnesemia is associated with more rapid progression of CKD and other comorbidities. Our objective was to analyze in CKD patients stages 3-4 the impact of the administration of magnesium (Mg) carbonate on bone mineral density (BMD) and hemodynamic changes associated with by vascular calcification (VC). Patients with CKD stages 3-4 were randomized into controls (n=12) or intervention (n=7) group receiving 360mg of Mg carbonate daily during a 15-month period. Parameters related to mineral metabolism, BMD, VC, and pulse wave velocity (PWV) were evaluated. Supplementation with Mg produced an increase in the urinary excretion of Mg while serum Mg levels remained stable and no episodes of hypermagnesemia were reported. In addition, no significant changes were found in the degree of VC assessed by Adragao index, however, both serum and urine Mg were significantly associated with a decrease in PWV, suggesting an increase in vascular compliance. Likewise, BMD did not change fol

Arterial stiffness is associated with left ventricular diastolic dysfunction (DD), which can lead to heart failure with preserved ejection fraction. However, longitudinal data on their relationship in the general population are limited. This study aimed to evaluate the association between arterial stiffness, assessed by brachial-ankle pulse wave velocity (baPWV), and the prevalence and progression of DD, as well as long-term outcomes in a large, community-based cohort. This retrospective cohort study enrolled 16 476 adults (≥ 18 years) who underwent health screening, including echocardiography and baPWV measurements, between 2010 and 2019. Participants were categorized into normal (< 1400cm/s), borderline (1400-1799cm/s), and elevated (≥ 1800cm/s) baPWV groups. Multivariable regression was conducted to analyze the association between baPWV, DD progression, and all-cause mortality during long-term follow-up. At baseline, the prevalence of definite DD was significantly higher in the borderline baPWV group (PR, 1.73; 95%CI, 1.23-2.23) and the elevated baPWV group (PR, 3.25; 95%CI, 2.16-4.33) compared with the normal group. Participants with borderline or elevated baPWV had a faster increase in left ventricular filling pressure (E/e') over a mean follow-up of 4 years. Elevated baPWV was independently associated with an increased risk of incident DD (HR, 2.61; 95%CI, 1.73-3.95) and higher all-cause mortality during follow-up (HR, 3.91; 95%CI, 1.68-9.10), even after adjustment for traditional cardiovascular risk factors. Borderline and elevated baPWV were significantly associated with a higher prevalence and faster DD progression, as well as an increased mortality risk in the general population, suggesting that baPWV is an important factor in DD pathophysiology and a useful noninvasive tool for cardiovascular risk stratification. Clinical neurological examination remains the gold standard to detect, diagnose, and follow-up responses to treatment in acute neurological conditions in the critical care setting. However, in patients with severe neurological deficits at baseline or those requiring sedatives, detecting neurological deterioration can be challenging. In this scenario, noninvasive bedside neuromonitoring as a part of multimodal strategies can be useful in the avoidance of secondary brain injury and in the selection of which patient with acute brain injury would benefit from invasive neuromonitorization. Serum vascular endothelial growth factor (VEGF) levels correlate with structural alterations in Rheumatoid Arthritis (RA). Since P wave dispersion (PWD) is associated with atrial ischemic-related fibrotic changes, it was conceived that there may be a correlation between altered PWD and increased VEGF levels in RA. In this prospective observational study, we evaluated patients with RA, and compared them to control subjects. PWD was considered as the difference between the maximum and minimum duration of the P wave. An altered PWD was considered one that had dispersion≥38ms. Measurements of VEGF serum levels were performed using enzyme-ligand, immunosorbent measurement ELISA kits. A total of 99 patients with RA, and 48 control subjects were evaluated. The PWD was 25.3±4.9ms in the control group vs. 57±14.9ms (p<0.0001) in the RA group. No patient in the control group had altered PWD, while 94 (95%) patients in the RA group presented it (p<0.0001). The value of VEGF in the control group was 15.2±15.1pg/ml vs 51.1±55.5pg/ml (p<0.001) in RA. The value of VEGF in RA without altered PWD was 20±12pg/ml vs 56±57pg/ml in RA with altered PWD (p<0.02). An elevated VEGF value had a specificity of 80%, and a positive predictive accuracy of 95% in predicting altered PWD in RA. This study establishes for the first time that RA patients who possess significantly higher serum levels of VEGF have an altered PWD. The presence of an elevated VEGF serum value has a high specificity, and high positive predictive accuracy of the existence of altered PWD in RA. A renal biopsy represents the gold standard in the diagnosis, prognosis and management of patients with chronic kidney disease and glomerulonephritis. Strain wave elastography (SE) is a developing technique to assess tissue elasticity. The aim of this study was to correlate between the strain index value of renal parenchyma and degree of renal fibrosis detected with renal biopsy. For 68 patients who were referred for a kidney biopsy, SE test was performed. The Banff scoring system was utilized to classify the IFTA grading of kidney fibrosis that assigns a severity level of mild, moderate, or severe. Receiver operating characteristic curve (ROC) was utilized to correlate between the severity of renal fibrosis and the grade of renal elasticity determined by SE. In total, 38 males and 30 females, the echogenicity, qualitative and semiquantitative elastography showed significant positive correlation with serum creatinine, percentage of fibrosis, G score and tubular atrophy and significant negative correlation with eGFR. ROC curve of SE for diagnosis of interstitial fibrosis shown that echogenicity has sensitivity 100.0%, specificity 62.5%, positive predictive value (PPV) 75.0%, negative predictive value (NPV) 100.0% with area under curve (AUC) 0.906, while qualitative elastography has sensitivity 77.8%, specificity 75.0%, PPV 77.8%, NPV 75.0%, AUC 0.833, semi quantitative elastography has sensitivity 83.3%, specificity 93.8%, PPV 93.8%, NPV 83.3% with AUC 0.915. SE approach is simple to use, and can differentiate between varying stages of renal fibrosis. However, further research is required before it can be frequently used in clinical practice. The body contour market has grown rapidly in recent years, due to persistent requests for noninvasive treatments for localized fat adiposities, cellulite, and skin laxity. A variety of different methods are now available to improve body shaping. This review aims to provide an exhaustive compendium of the main recommendations for the optimal use of an innovative device delivering microwaves (MWs) for unwanted fat and cellulite reduction (Onda Coolwaves, DEKA, Florence, Italy), resulting from the experiences of the most expert international users. The availability of this new technology has led to an increasing number of treated patients and clinical studies. However, what is still missing, to the best of our knowledge, is an evaluation of the long-term efficacy and safety of this method. Based on the most recent data available, this compendium focuses on the ideal parameters, patient selection, and treatment methodology for providing safe and effective treatment protocols. Future research findings may suggest changes to the conclusions or recommendations in this report. The progression of chronic kidney disease (CKD) involves the development of alterations in mineral metabolism that are closely related to cardiovascular outcomes and bone disease. Hypomagnesemia is associated with more rapid progression of CKD and other comorbidities. Our objective was to analyze in CKD patients stages 3-4 the impact of the administration of magnesium (Mg) carbonate on bone mineral density (BMD) and hemodynamic changes associated with by vascular calcification (VC). Patients with CKD stages 3-4 were randomized into controls (n=12) or intervention (n=7) group receiving 360mg of Mg carbonate daily during a 15-month period. Parameters related to mineral metabolism, BMD, VC, and pulse wave velocity (PWV) were evaluated. Supplementation with Mg produced an increase in the urinary excretion of Mg while serum Mg levels remained stable and no episodes of hypermagnesemia were reported. In addition, no significant changes were found in the degree of VC assessed by Adragao index, however, both serum and urine Mg were significantly associated with a decrease in PWV, suggesting an increase in vascular compliance. Likewise, BMD did not change fol

Arterial stiffness is associated with left ventricular diastolic dysfunction (DD), which can lead to heart failure with preserved ejection fraction. However, longitudinal data on their relationship in the general population are limited. This study aimed to evaluate the association between arterial stiffness, assessed by brachial-ankle pulse wave velocity (baPWV), and the prevalence and progression of DD, as well as long-term outcomes in a large, community-based cohort. This retrospective cohort study enrolled 16 476 adults (≥ 18 years) who underwent health screening, including echocardiography and baPWV measurements, between 2010 and 2019. Participants were categorized into normal (< 1400cm/s), borderline (1400-1799cm/s), and elevated (≥ 1800cm/s) baPWV groups. Multivariable regression was conducted to analyze the association between baPWV, DD progression, and all-cause mortality during long-term follow-up. At baseline, the prevalence of definite DD was significantly higher in the borderline baPWV group (PR, 1.73; 95%CI, 1.23-2.23) and the elevated baPWV group (PR, 3.25; 95%CI, 2.16-4.33) compared with the normal group. Participants with borderline or elevated baPWV had a faster increase in left ventricular filling pressure (E/e') over a mean follow-up of 4 years. Elevated baPWV was independently associated with an increased risk of incident DD (HR, 2.61; 95%CI, 1.73-3.95) and higher all-cause mortality during follow-up (HR, 3.91; 95%CI, 1.68-9.10), even after adjustment for traditional cardiovascular risk factors. Borderline and elevated baPWV were significantly associated with a higher prevalence and faster DD progression, as well as an increased mortality risk in the general population, suggesting that baPWV is an important factor in DD pathophysiology and a useful noninvasive tool for cardiovascular risk stratification. Clinical neurological examination remains the gold standard to detect, diagnose, and follow-up responses to treatment in acute neurological conditions in the critical care setting. However, in patients with severe neurological deficits at baseline or those requiring sedatives, detecting neurological deterioration can be challenging. In this scenario, noninvasive bedside neuromonitoring as a part of multimodal strategies can be useful in the avoidance of secondary brain injury and in the selection of which patient with acute brain injury would benefit from invasive neuromonitorization. Serum vascular endothelial growth factor (VEGF) levels correlate with structural alterations in Rheumatoid Arthritis (RA). Since P wave dispersion (PWD) is associated with atrial ischemic-related fibrotic changes, it was conceived that there may be a correlation between altered PWD and increased VEGF levels in RA. In this prospective observational study, we evaluated patients with RA, and compared them to control subjects. PWD was considered as the difference between the maximum and minimum duration of the P wave. An altered PWD was considered one that had dispersion≥38ms. Measurements of VEGF serum levels were performed using enzyme-ligand, immunosorbent measurement ELISA kits. A total of 99 patients with RA, and 48 control subjects were evaluated. The PWD was 25.3±4.9ms in the control group vs. 57±14.9ms (p<0.0001) in the RA group. No patient in the control group had altered PWD, while 94 (95%) patients in the RA group presented it (p<0.0001). The value of VEGF in the control group was 15.2±15.1pg/ml vs 51.1±55.5pg/ml (p<0.001) in RA. The value of VEGF in RA without altered PWD was 20±12pg/ml vs 56±57pg/ml in RA with altered PWD (p<0.02). An elevated VEGF value had a specificity of 80%, and a positive predictive accuracy of 95% in predicting altered PWD in RA. This study establishes for the first time that RA patients who possess significantly higher serum levels of VEGF have an altered PWD. The presence of an elevated VEGF serum value has a high specificity, and high positive predictive accuracy of the existence of altered PWD in RA. A renal biopsy represents the gold standard in the diagnosis, prognosis and management of patients with chronic kidney disease and glomerulonephritis. Strain wave elastography (SE) is a developing technique to assess tissue elasticity. The aim of this study was to correlate between the strain index value of renal parenchyma and degree of renal fibrosis detected with renal biopsy. For 68 patients who were referred for a kidney biopsy, SE test was performed. The Banff scoring system was utilized to classify the IFTA grading of kidney fibrosis that assigns a severity level of mild, moderate, or severe. Receiver operating characteristic curve (ROC) was utilized to correlate between the severity of renal fibrosis and the grade of renal elasticity determined by SE. In total, 38 males and 30 females, the echogenicity, qualitative and semiquantitative elastography showed significant positive correlation with serum creatinine, percentage of fibrosis, G score and tubular atrophy and significant negative correlation with eGFR. ROC curve of SE for diagnosis of interstitial fibrosis shown that echogenicity has sensitivity 100.0%, specificity 62.5%, positive predictive value (PPV) 75.0%, negative predictive value (NPV) 100.0% with area under curve (AUC) 0.906, while qualitative elastography has sensitivity 77.8%, specificity 75.0%, PPV 77.8%, NPV 75.0%, AUC 0.833, semi quantitative elastography has sensitivity 83.3%, specificity 93.8%, PPV 93.8%, NPV 83.3% with AUC 0.915. SE approach is simple to use, and can differentiate between varying stages of renal fibrosis. However, further research is required before it can be frequently used in clinical practice. The body contour market has grown rapidly in recent years, due to persistent requests for noninvasive treatments for localized fat adiposities, cellulite, and skin laxity. A variety of different methods are now available to improve body shaping. This review aims to provide an exhaustive compendium of the main recommendations for the optimal use of an innovative device delivering microwaves (MWs) for unwanted fat and cellulite reduction (Onda Coolwaves, DEKA, Florence, Italy), resulting from the experiences of the most expert international users. The availability of this new technology has led to an increasing number of treated patients and clinical studies. However, what is still missing, to the best of our knowledge, is an evaluation of the long-term efficacy and safety of this method. Based on the most recent data available, this compendium focuses on the ideal parameters, patient selection, and treatment methodology for providing safe and effective treatment protocols. Future research findings may suggest changes to the conclusions or recommendations in this report. The progression of chronic kidney disease (CKD) involves the development of alterations in mineral metabolism that are closely related to cardiovascular outcomes and bone disease. Hypomagnesemia is associated with more rapid progression of CKD and other comorbidities. Our objective was to analyze in CKD patients stages 3-4 the impact of the administration of magnesium (Mg) carbonate on bone mineral density (BMD) and hemodynamic changes associated with by vascular calcification (VC). Patients with CKD stages 3-4 were randomized into controls (n=12) or intervention (n=7) group receiving 360mg of Mg carbonate daily during a 15-month period. Parameters related to mineral metabolism, BMD, VC, and pulse wave velocity (PWV) were evaluated. Supplementation with Mg produced an increase in the urinary excretion of Mg while serum Mg levels remained stable and no episodes of hypermagnesemia were reported. In addition, no significant changes were found in the degree of VC assessed by Adragao index, however, both serum and urine Mg were significantly associated with a decrease in PWV, suggesting an increase in vascular compliance. Likewise, BMD did not change fol

Arterial stiffness is associated with left ventricular diastolic dysfunction (DD), which can lead to heart failure with preserved ejection fraction. However, longitudinal data on their relationship in the general population are limited. This study aimed to evaluate the association between arterial stiffness, assessed by brachial-ankle pulse wave velocity (baPWV), and the prevalence and progression of DD, as well as long-term outcomes in a large, community-based cohort. This retrospective cohort study enrolled 16 476 adults (≥ 18 years) who underwent health screening, including echocardiography and baPWV measurements, between 2010 and 2019. Participants were categorized into normal (< 1400cm/s), borderline (1400-1799cm/s), and elevated (≥ 1800cm/s) baPWV groups. Multivariable regression was conducted to analyze the association between baPWV, DD progression, and all-cause mortality during long-term follow-up. At baseline, the prevalence of definite DD was significantly higher in the borderline baPWV group (PR, 1.73; 95%CI, 1.23-2.23) and the elevated baPWV group (PR, 3.25; 95%CI, 2.16-4.33) compared with the normal group. Participants with borderline or elevated baPWV had a faster increase in left ventricular filling pressure (E/e') over a mean follow-up of 4 years. Elevated baPWV was independently associated with an increased risk of incident DD (HR, 2.61; 95%CI, 1.73-3.95) and higher all-cause mortality during follow-up (HR, 3.91; 95%CI, 1.68-9.10), even after adjustment for traditional cardiovascular risk factors. Borderline and elevated baPWV were significantly associated with a higher prevalence and faster DD progression, as well as an increased mortality risk in the general population, suggesting that baPWV is an important factor in DD pathophysiology and a useful noninvasive tool for cardiovascular risk stratification. Clinical neurological examination remains the gold standard to detect, diagnose, and follow-up responses to treatment in acute neurological conditions in the critical care setting. However, in patients with severe neurological deficits at baseline or those requiring sedatives, detecting neurological deterioration can be challenging. In this scenario, noninvasive bedside neuromonitoring as a part of multimodal strategies can be useful in the avoidance of secondary brain injury and in the selection of which patient with acute brain injury would benefit from invasive neuromonitorization. Serum vascular endothelial growth factor (VEGF) levels correlate with structural alterations in Rheumatoid Arthritis (RA). Since P wave dispersion (PWD) is associated with atrial ischemic-related fibrotic changes, it was conceived that there may be a correlation between altered PWD and increased VEGF levels in RA. In this prospective observational study, we evaluated patients with RA, and compared them to control subjects. PWD was considered as the difference between the maximum and minimum duration of the P wave. An altered PWD was considered one that had dispersion≥38ms. Measurements of VEGF serum levels were performed using enzyme-ligand, immunosorbent measurement ELISA kits. A total of 99 patients with RA, and 48 control subjects were evaluated. The PWD was 25.3±4.9ms in the control group vs. 57±14.9ms (p<0.0001) in the RA group. No patient in the control group had altered PWD, while 94 (95%) patients in the RA group presented it (p<0.0001). The value of VEGF in the control group was 15.2±15.1pg/ml vs 51.1±55.5pg/ml (p<0.001) in RA. The value of VEGF in RA without altered PWD was 20±12pg/ml vs 56±57pg/ml in RA with altered PWD (p<0.02). An elevated VEGF value had a specificity of 80%, and a positive predictive accuracy of 95% in predicting altered PWD in RA. This study establishes for the first time that RA patients who possess significantly higher serum levels of VEGF have an altered PWD. The presence of an elevated VEGF serum value has a high specificity, and high positive predictive accuracy of the existence of altered PWD in RA. A renal biopsy represents the gold standard in the diagnosis, prognosis and management of patients with chronic kidney disease and glomerulonephritis. Strain wave elastography (SE) is a developing technique to assess tissue elasticity. The aim of this study was to correlate between the strain index value of renal parenchyma and degree of renal fibrosis detected with renal biopsy. For 68 patients who were referred for a kidney biopsy, SE test was performed. The Banff scoring system was utilized to classify the IFTA grading of kidney fibrosis that assigns a severity level of mild, moderate, or severe. Receiver operating characteristic curve (ROC) was utilized to correlate between the severity of renal fibrosis and the grade of renal elasticity determined by SE. In total, 38 males and 30 females, the echogenicity, qualitative and semiquantitative elastography showed significant positive correlation with serum creatinine, percentage of fibrosis, G score and tubular atrophy and significant negative correlation with eGFR. ROC curve of SE for diagnosis of interstitial fibrosis shown that echogenicity has sensitivity 100.0%, specificity 62.5%, positive predictive value (PPV) 75.0%, negative predictive value (NPV) 100.0% with area under curve (AUC) 0.906, while qualitative elastography has sensitivity 77.8%, specificity 75.0%, PPV 77.8%, NPV 75.0%, AUC 0.833, semi quantitative elastography has sensitivity 83.3%, specificity 93.8%, PPV 93.8%, NPV 83.3% with AUC 0.915. SE approach is simple to use, and can differentiate between varying stages of renal fibrosis. However, further research is required before it can be frequently used in clinical practice. The body contour market has grown rapidly in recent years, due to persistent requests for noninvasive treatments for localized fat adiposities, cellulite, and skin laxity. A variety of different methods are now available to improve body shaping. This review aims to provide an exhaustive compendium of the main recommendations for the optimal use of an innovative device delivering microwaves (MWs) for unwanted fat and cellulite reduction (Onda Coolwaves, DEKA, Florence, Italy), resulting from the experiences of the most expert international users. The availability of this new technology has led to an increasing number of treated patients and clinical studies. However, what is still missing, to the best of our knowledge, is an evaluation of the long-term efficacy and safety of this method. Based on the most recent data available, this compendium focuses on the ideal parameters, patient selection, and treatment methodology for providing safe and effective treatment protocols. Future research findings may suggest changes to the conclusions or recommendations in this report. The progression of chronic kidney disease (CKD) involves the development of alterations in mineral metabolism that are closely related to cardiovascular outcomes and bone disease. Hypomagnesemia is associated with more rapid progression of CKD and other comorbidities. Our objective was to analyze in CKD patients stages 3-4 the impact of the administration of magnesium (Mg) carbonate on bone mineral density (BMD) and hemodynamic changes associated with by vascular calcification (VC). Patients with CKD stages 3-4 were randomized into controls (n=12) or intervention (n=7) group receiving 360mg of Mg carbonate daily during a 15-month period. Parameters related to mineral metabolism, BMD, VC, and pulse wave velocity (PWV) were evaluated. Supplementation with Mg produced an increase in the urinary excretion of Mg while serum Mg levels remained stable and no episodes of hypermagnesemia were reported. In addition, no significant changes were found in the degree of VC assessed by Adragao index, however, both serum and urine Mg were significantly associated with a decrease in PWV, suggesting an increase in vascular compliance. Likewise, BMD did not change fol