Functional motor disorders (FMDs) represent a frequent and disabling neurological condition. The lack of reliable diagnostic biomarkers and their heterogeneity might affect diagnosis. We identified multimodal biomarkers distinguishing FMDs from healthy controls (HCs) using machine-learning approaches. In this multicenter cross-sectional study, consecutive adults with a clinically established FMDs diagnosis (n = 75, 74.7
Cystoscopy is a cornerstone diagnostic procedure in urology, especially for diagnosing and monitoring various bladder pathologies, including urothelial tumours and haematuria of unknown origin. Recently, advancements in endoscopic technology have introduced single-use flexible cystoscopies (SU-FC) as an alternative to traditional reusable flexible cystoscopies (R-FC), potentially simplifying workflow and reducing infection risk compared with reusable scopes. This prospective study aims to compare patient- and operator-reported outcomes, including comfort, pain levels, image quality and overall satisfaction when employing single-use versus reusable flexible cystoscopes. From October to December 2023, a single-centre study was conducted, enrolling 200 patients undergoing diagnostic flexible cystoscopy, 10 urologists and 10 urologic scrub nurses. Standardized questionnaires, adapted from validated instruments, were used to collect data on perceived pain (Visual Analogue Scale), device performance, image quality and operator satisfaction. Statistical analyses (Wilcoxon rank-sum, Fisher's exact) tested for significant differences between SU-FC and R-FC. Of the 200 patients, 100 underwent cystoscopy using SU-FC and 100 with R-FC. Patients in the single-use group reported significantly lower or milder pain (p = 0.0112) and higher satisfaction distributions (p < 0.0001). Operator assessments (physicians and nurses) indicated higher satisfaction with single-use devices in terms of image clarity, navigation and instrument performance (p < 0.0001). SU-FC confer notable benefits for both patients and healthcare professionals, including reduced pain, superior image quality and enhanced workflow. These findings support the broader investigation of disposable cystoscopy in routine practice while urging cost-effectiveness and sustainability evaluations.
AIMS:Radiofrequency (RF) renal denervation (RDN) safely lowers office and 24-h blood pressure (BP). This meta-analysis examined the long-term durability of RF RDN based on randomized trials and observational studies. METHODS AND RESULTS:Patients with uncontrolled hypertension undergoing RF RDN using the Symplicity Flex™ or Spyral™ device and a minimum follow-up of 3 years were included. Key outcomes included office and 24-h BP change from baseline as well as changes in anti-hypertensive drugs. A random effects meta-analysis was conducted over 3 years, or the last reported follow-up beyond 3 years. A total of 2212 patients identified among 18 reports were evaluated for BP. The mean duration of follow-up was 4.4 years (range 3-9.4). The long-term reduction in office systolic BP from baseline in 15 reports (n = 2040) was -23.0 mmHg (95% confidence interval: -26.8 to -19.1, P < 0.05) for the random effects model and -20.5 (-21.6 to -19.4) for the fixed effect model. Twenty-four-hour ambulatory systolic BP was available in 11 reports (n = 1018) and decreased significantly by -13.6 mmHg (-16.5 to -10.8, P < 0.05). Fixed effect model results were similar. Diastolic office and 24-h BP paralleled these findings in both models. Nighttime systolic BP also decreased significantly by -14.2 mmHg (-27.6 to -0.8, P < 0.05). The number of prescribed anti-hypertensive drugs and eGFR also decreased. Heart rate remained unchanged through the final follow-up in both models. Safety events were rare, with a mean rate of renal artery complications of 0.14% (0.08-0.20%). CONCLUSION:This meta-analysis comprising 18 studies demonstrated sustained and significant office and ambulatory BP reductions following Symplicity RDN through at least 3 years without an increase in anti-hypertensive medication.
Prone positioning is recommended for patients with acute respiratory distress syndrome not only to improve oxygenation, but also to reduce lung stress, and lower mortality. The association between improved oxygenation during prone position and reduced mortality is still controversial. In previous studies, oxygenation improvement during the first prone positioning cycle was linked to lower intensive care unit (ICU) mortality, especially with prolonged duration. However, physiological data during subsequent cycles were lacking. This study aims to explore the association between ICU mortality and physiological responses to prone positioning—such as arterial oxygenation, dead space, and respiratory mechanics—and to assess how the cumulative time spent in prone or supine positions across all studied cycles influences outcomes. International registry including adult patients who underwent prone positioning for acute hypoxemic respiratory failure due to COVID-19. We measured the difference for arterial partial pressure of oxygen to inspired fraction of oxygen ratio (PaO2/FiO2) and ventilatory ratio between baseline supine position and at either the end of cycle of prone position (Delta-PP) or re-supination (Delta-PostPP), focusing on the cycles following the first one. We included 1523 patients from 53 centers. Both Delta-PP and Delta-PostPP for PaO2/FiO2 were significantly higher in ICU survivors than in ICU non-survivors for all the analyzed prone positioning cycles (p ≤ 0.001 for all comparisons). Delta-PP and Delta-PostPP for ventilatory ratio were significantly lower in ICU survivors than in ICU non-survivors for all the analyzed prone positioning cycles (p < 0.05 for all comparisons). No difference in the overall time spent in prone position was found between ICU survivors and non-survivors [61 (38, 84) h vs 58 (32, 85) h, respectively, p = 0.175]. The cumulative length of prone position was associated with ICU mortality only for the second prone positioning cycle [OR (95
Post-traumatic stress disorder (PTSD) is frequently accompanied by additional sleep disturbances, such as nightmares and insomnia. Recent findings suggest a potential association between PTSD and REM sleep behavior disorder (RBD). This systematic review evaluates the current evidence on the PTSD-RBD relationship, with attention to prevalence, diagnostic approaches, shared pathophysiological mechanisms, and clinical implications. A comprehensive search of PubMed, Web of Science, EMBASE, and PsycINFO was conducted up to July 2025. Eligible studies included observational, cohort, and experimental designs assessing RBD in individuals with PTSD. Methodological quality was appraised using the Newcastle-Ottawa Scale. Seven studies, encompassing 4152 participants, met the inclusion criteria. Overall, PTSD was linked to a higher prevalence of probable or confirmed RBD, particularly among veterans. Adding to this, patients with isolated RBD appeared more likely to report comorbid PTSD than those diagnosed with other parasomnias. Evidence also indicated that PTSD-related RBD may be associated with more severe psychopathology, including heightened depressive symptoms, recurrent nightmares, and emotional dysregulation. From a clinical standpoint, it is advisable to evaluate PTSD patients presenting with parasomnia symptoms for possible RBD, and to investigate PTSD history in those exhibiting dream enactment behaviors.
