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Given the complex relationship between cardiovascular disease (CVD) and chronic kidney disease (CKD), CVD-related markers may serve as CKD biomarkers. We examined associations of three major CVD-markers [mid-regional pro-adrenomedullin (MR-proADM), MR-pro-atrial natriuretic peptide (MR-proANP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP)] with CKD. Cross-sectional analyses included up to 61,830 participants, and longitudinal analyses (NT-proBNP only) 4205 individuals. Kidney function was assessed by estimated glomerular filtration rate (eGFR) using creatinine, cystatin C, or both (eGFRcr-cys). Markers were categorized into four groups. Cross-sectional analyses found that higher levels of all three markers were consistently associated with lower eGFR and higher CKD prevalence. For example, per 1 standard deviation (SD) increase in log-transformed NT-proBNP, corresponding to a 2.71-fold increase in the original concentration, was associated with -2.35 (-2.49, -2.21) ml/min/1.73m 2 lower eGFRcr-cys, and the highest NT-proBNP group had a 5.72-fold higher odds of CKDcr-cys (eGFRcr-cys < 60 ml/min/1.73m 2 ) compared with the lowest. Associations with eGFR were stronger among participants with CVD and diabetes. In longitudinal analyses, participants with higher baseline NT-proBNP had faster declines in eGFR, with a 10-year decline of -1.37 (-1.77, -0.98) ml/min/1.73m 2 eGFRcr-cys per 1 SD increase, and higher CKD incidence. These findings suggest MR-proADM, MR-proANP, and NT-proBNP as CKD biomarkers.

Purpose The precise effects of non-steroidal anti-inflammatory drugs on the neuroendocrine hydro-electrolytic regulation are not precisely understood. The aim of this pilot study was to evaluate, in healthy subjects, the neuroendocrine response of the antidiuretic system to intravenous diclofenac infusion. Methods For this single-blinded, cross-over study, we recruited 12 healthy subjects (50% women). Test sessions were divided into three observation times (pre-test; test; 48 h post-test), which were repeated equally on two different occasions, with the administration of diclofenac (75 mg in saline solution 0.9% 100 cc) on 1 day, or placebo (saline solution 0.9% 100 cc) on another day. The night before the test the subjects were asked to collect a salivary cortisol and cortisone sample, which was repeated on the night of the procedure session. Serial urine and blood samples were collected on the test day (for osmolality, electrolytes, ACTH, cortisol, copeptin, MR-proADM, MR-proANP; the last three represent more stable and analytically reliable molecules than their respective active peptides). Moreover, the subjects were evaluated with the bioimpedance vector analysis (BIVA) before and after the test. Forty-eight hours after the end of the procedure urine sodium, urine potassium, urine osmolality, serum sodium and copeptin were revaluated together with BIVA. Results No significant changes in circulating hormone levels were observed; anyway, 48 h after diclofenac, BIVA showed a significant water retention ( p  < 0.00001), especially in extracellular fluid (ECF) (16.47 ± 1.65 vs 15.67 ± 1.84, p  < 0.001). Salivary cortisol and cortisone tended to increase only the night after placebo administration ( p  = 0.054 cortisol; p  = 0.021 cortisone). Conclusion Diclofenac resulted in an increased ECF at 48 h, but this phenomenon seems to be associated with a greater renal sensibility to the action of vasopressin rather than with an increase in its secretion. Moreover, a partial inhibitory effect on cortisol secretion can be hypothesized.

Diabetic retinopathy (DR) is a complication of diabetes mellitus that damages the blood vessels in the retina. DR is considered a serious vision-threatening impediment that most diabetic subjects are at risk of developing. Effective automatic detection of DR is challenging. Feature extraction plays an important role in the effective classification of disease. Here we focus on a feature extraction technique that combines two feature extractors, speeded up robust features and binary robust invariant scalable keypoints, to extract the relevant features from retinal fundus images. The selection of top-ranked features using the MR-MR (maximum relevance-minimum redundancy) feature selection and ranking method enhances the efficiency of classification. The system is evaluated across various classifiers, such as support vector machine, Adaboost, Naive Bayes, Random Forest, and multi-layer perception (MLP) when giving input image features extracted from standard datasets (IDRiD, MESSIDOR, and DIARETDB0). The performances of the classifiers were analyzed by comparing their specificity, precision, recall, false positive rate, and accuracy values. We found that when the proposed feature extraction and selection technique is used together with MLP outperforms all the other classifiers for all datasets in binary and multiclass classification.

: Peripheral artery disease (PAD) is a manifestation of atherosclerosis that affects the extremities, leading to reduced perfusion and functional impairment. Non-contrast magnetic resonance angiography (NC-MRA) provides a safe and quantitative approach for early detection of PAD without the risks associated with contrast agents. The purpose of this study was to demonstrate the application of standard and centric - FBI techniques for rapid three-station NC-MRA of the entire lower extremity. : This prospective cross-sectional study compared standard three-station fresh blood imaging (sFBI) with centric - ordered fresh blood imaging (cFBI) sequences in 10 healthy subjects and 3 patients with PAD (age range: 23-79 years; 7 females) using a 3-Tesla magnetic resonance imaging (MRI) system. Both sequences were acquired at the iliac, femoral, and tibial stations. Image quality (0-4 scale), signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were evaluated. Statistical analysis was performed using repeated-measures analysis of variance (ANOVA) with significance set at α = 0.05. : Image quality did not differ significantly between sFBI and cFBI ( = 1.0). The iliac station exhibited lower image quality than the femoral station ( < 0.01). In a PAD patient with an iliac stent, cFBI preserved good image quality in the femoral and tibial stations, whereas sFBI was affected by N/2 aliasing artifacts. Both methods failed to visualize the stented iliac segment. Compared to sFBI, cFBI yielded significantly lower SNR ( < 0.01) and CNR ( < 0.001) but reduced total scan time by approximately 40% (468 s vs. 291 s). : Three-station non-contrast FBI MRA of the peripheral arteries is feasible. The cFBI sequence substantially shortens scan time without compromising diagnostic image quality, offering practical advantages for clinical implementation, improved patient comfort, and reduced motion artifacts.