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041; 95% CI, 0.026-0.055; P less then 0.001; P value for heterogeneity=0.70), equivalent to a 1.14-m/s increase in standard carotid-femoral pulse wave velocity per decade per 20-mm Hg systolic BP, independent of age. Unstandardized, adjusted associations were similar (1762 patients; β=0.0047; 95% CI, 0.004-0.006; P less then 0.001; P value for heterogeneity=0.64), equivalent to a 0.94-m/s increase per decade per 20-mm Hg systolic BP. In limited studies, standardized associations between mean BP and arterial stiffness progression were not significant and heterogeneous (913 patients; β=0.039; 95% CI, -0.008 to 0.086; P=0.11; P value for heterogeneity=0.03). Conclusions Baseline systolic BP was associated with a clinically important progression of arterial stiffness, independent of age, providing a reference for the potential effect of arterial stiffness in mediating changes in clinical outcomes associated with hypertension and providing a reference value to aid clinical trial design.

Globally millions of people with diabetes still prick their fingers to measure blood glucose. The aim of this study was to comprehensively evaluate and to compare three lancing devices set at the minimum ("1") and at the maximum ("5") lancing depth with respect to blood volume (BV) and pain related to lancing.

Lancing devices tested were A-

, B-

(both HTL-Strefa S.A., Poland), and C-

(Ascensia Diabetes Care, Switzerland), all used with personal lancets of three sizes 28G, 30G, and 33G. learn more BVs were measured with calibrated capillaries. Pain related to lancing was expressed as a derivative of pain rating with visual analog scale.

In 90 participants with diabetes, 360 lancing procedures were performed. Overall, BV and pain were higher for "maximum" compared to "minimum" lancing depth (for both

< .001). Pain differed between devices (

≤ .001), overall was higher for device A compared to B or C; in paired comparisons differences were significant for the following settings A > B for 28G/1 and 33G/1, B > C for 30G/1, and A > C for 28G/1, 30G/1, and 33G/1. In aggregated comparison we did not prove a significant effect of lancet size on either BV nor pain (

= .1109,

= .4966, respectively).

BV depended mainly on lancing depth. Pain depended on lancing depth and to some degree on device type. The results may serve as a source of comparative data of lancing devices performance for studies in which other lancing devices and/or lancets would be tested.The study was registered at ClinicalTrials.gov NCT03479619.

BV depended mainly on lancing depth. Pain depended on lancing depth and to some degree on device type. The results may serve as a source of comparative data of lancing devices performance for studies in which other lancing devices and/or lancets would be tested.The study was registered at ClinicalTrials.gov NCT03479619.

To validate and assess the reliability of the Italian version of self-administered ALSFRS-R, considering patients' clinical and cognitive features and caregiver's help.

During the COVID-19 pandemic, by analyzing the results of 70 paired self-administered vs standard telephone-administered ALSFRS-R, we calculated overall score, single item scores, ALSFRS-R domain scores, King's and MiToS stage inter-rater agreement and reliability using different validated methods. We created the Italian version of self-administered ALSFRS-R following ENCALS recommendation.

Correlation between the two scales was 0.94 and no systematic directional bias was found. The intraclass correlation coefficient (ICC) was very high (>0.90) for the vast majority of the considered classification criteria, especially King's total score (0.96) and MiToS score (0.94). A higher ICC was found when the patients answered the questionnaire with the caregiver's help (0.95).

Online self-administered ALSFRS-R scale is a valid tool to stratify ALS patients into clinical stages and to implement telemedicine monitoring.

0.90) for the vast majority of the considered classification criteria, especially King's total score (0.96) and MiToS score (0.94). A higher ICC was found when the patients answered the questionnaire with the caregiver's help (0.95). Conclusions Online self-administered ALSFRS-R scale is a valid tool to stratify ALS patients into clinical stages and to implement telemedicine monitoring.

Breast cancer is the most common cancer in women worldwide. Despite the development of targeted therapies that have significantly improved survival, effective breast cancer evaluation is still challenging due to the complexity of this disease. Liquid biopsy might allow the noninvasive real-time monitoring of the tumor course and response to therapy.

This review summarizes the latest advances on the various circulating analytes used as liquid biopsy (circulating tumor cells and tumor DNA, and more recently extracellular vesicles) for breast cancer work-up. Several studies have shown that in breast cancer, liquid biopsy can be used to predict disease progression or relapse and to monitor the treatment response. Moreover, circulating analytes are more easily accessible than tissue biopsies and might represent a powerful source of specific knowledge.

The new evidence coming from the increasing number of clinical trials, and the continuous improvements in the technologies to isolate these tumor-derived analytes should strengthen the role of liquid biopsy in the clinic for personalized medicine of breast cancer.

The new evidence coming from the increasing number of clinical trials, and the continuous improvements in the technologies to isolate these tumor-derived analytes should strengthen the role of liquid biopsy in the clinic for personalized medicine of breast cancer.The development of painful diabetic neuropathy (PDN) is a common complication of chronic diabetes that can be associated with significant disability and healthcare costs. Prompt symptom identification and aggressive glycemic control is essential in controlling the development of neuropathic complications; however, adequate pain relief remains challenging and there are considerable unmet needs in this patient population. Although guidelines have been established regarding the pharmacological management of PDN, pain control is inadequate or refractory in a high proportion of patients. Pharmacotherapy with anticonvulsants (pregabalin, gabapentin) and antidepressants (duloxetine) are common first-line agents. The use of oral opioids is associated with considerable morbidity and mortality and can also lead to opioid-induced hyperalgesia. Their use is therefore discouraged. There is an emerging role for neuromodulation treatment modalities including intrathecal drug delivery, spinal cord stimulation, and dorsal root ganglion stimulation.

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