Perioperative atrial fibrillation (POAF) in non-cardiac surgery (NCS) is a multifactorial condition with significant prognostic implications. This review summarizes current evidence on the incidence, risk factors, pathophysiology, complications, prevention, and management of POAF in NCS. POAF affects around 3
The 11th Cardiovascular Outcome Trial (CVOT) Summit: Congress on Cardiovascular, Kidney, and Metabolic Outcomes was held virtually on November 20-21, 2025. The Summit provided a multidisciplinary forum to review and discuss recent outcome trials investigating emerging pharmacological therapies targeting diseases of the cardiovascular-kidney-metabolic (CKM) continuum. This report highlights the unique developments of 2025 discussed during the Summit, including the first head-to-head CVOT (SURPASS-CVOT), the growing evidence base for combination therapies across the disease spectrum, new insights into the inflammatory component of the CKM syndrome, and relevant policy developments. The first part of this report summarizes pioneering clinical trials addressing combination therapy with finerenone and empagliflozin (CONFIDENCE), the oral glucagon-like peptide-1 (GLP-1) receptor agonists orforglipron (ATTAIN-1), and the aldosterone synthase inhibitor (ASI) baxdrostat (BaxHTN). The second part presents recent guideline and policy developments discussed by experts in endocrinology, diabetology, cardiology, nephrology, hepatology, and general practice. In addition, advances in medical technology, particularly in continuous glucose and ketone monitoring, are highlighted, as well as emerging therapies for diseases of the CKM continuum. These include pharmacological agents for a broad spectrum of metabolic disorders such as metabolic liver disease and type 1 Diabetes (T1D) alongside emphasis on the importance of early detection and innovative treatment strategies. The 12th Cardiovascular Outcome Trial Summit will be held virtually on 19-20 November 2026 (http://www.cvot.org).
Abstract Background During infection, alterations of the endothelium’s barrier function are multifaceted and virus-specific. Rubella virus (RuV) infection during pregnancy damages the endothelium in the placental and fetal vasculature, thereby contributing to the development of congenital rubella syndrome. However, the extent and mechanisms behind RuV-induced endothelial barrier disruption have not been previously documented. Methods To investigate if RuV directly impairs endothelial barrier integrity, we infected primary human umbilical vein endothelial cells and analyzed the barrier integrity using Electrical Cell-Substrate Impedance Sensing (ECIS). Furthermore, we applied fluorescence microscopy to analyze RuV-induced changes in cell morphology, the actin cytoskeleton, and cell–cell junctions. To dissect the molecular mechanisms behind the observed alterations induced by RuV infection in endothelial cells, we determined levels of RhoA and RhoB GTPases, followed by depletion of both proteins using siRNA transfection and application of pharmacological inhibitors of the Rho/ROCK signaling axis. Results Rubella virus infection in endothelial cells induced a comparatively low level of cytopathogenicity, accompanied by an elongated morphology. Most notably, a reduction in endothelial barrier integrity occurred at later time points of infection, as measured by ECIS. While the overall expression levels of junctional proteins appeared unaffected, membrane localization of zonula occludens-1 (ZO-1) was significantly reduced. This was accompanied by a marked increase in actin stress fibers and enhanced RhoB GTPase levels. The siRNA-mediated downregulation combined with time-dependent inhibitor application confirmed a contributory role for RhoB to RuV infection at early post-entry steps. The elongated morphology of infected endothelial cells was associated with the chemokine CCL5. Notably, cell elongation induced by treatment with supernatant from infected cells was insufficient to impair the barrier integrity in the absence of productive RuV replication. In comparison, depletion of RhoB expression or ROCK inhibitor application revealed the involvement of the RhoB/ROCK signaling axis in the impairment of barrier integrity and induction of stress fibers by RuV infection. Additionally, altered localization of ZO-1 was restored after application of ROCK inhibitor Y-27632 to uninfected control levels. Conclusions Collectively, our data highlight the involvement of Rho GTPase–ROCK signaling in alterations of endothelial cell actin dynamics and barrier integrity in rubella virus pathology.
To identify imaging and clinical factors associated with future liver remnant (FLR) hypertrophy after portal vein embolization (PVE) prior to major hepatectomy. This retrospective single-center study included 98 patients (mean age 61 ± 14 years, 56 female) with benign or malignant liver tumors who underwent PVE between 2019 and 2024 before planned major liver resection. 10 patients also received liver venous deprivation (LVD). FLR volumes were measured on cross-sectional imaging before and after PVE. Embolic agent, cholestasis, arterial perfusion patterns, signal intensities in MRI, spleen volume, and venous diameters were assessed. Mean FLR growth was 35.6 ± 22.2
Abstract Introduction Metastasis-directed radiotherapy is of increasing importance in the multidisciplinary management of oligometastatic non-small cell lung cancer (NSCLC), but outcome patterns for stereotactic body radiotherapy (SBRT) of bone oligometastases (BoM) remain insufficiently defined. We aimed to determine oncological outcomes and prognostic factors of SBRT for BoM of NSCLC. Materials and methods Patients with NSCLC treated with SBRT for < 5 BoM between 2010 and 2024 at 15 European cancer centers were retrospectively analyzed. Outcomes included freedom from local recurrence (FFLR), progression-free survival (PFS), overall survival (OS), and adverse events. Results With a median follow-up of 14 months (IQR: 7–24 months), 85 patients with 111 treated BoM were analyzed. The 2-year FFLR was 87.2% (95%-CI: 73.3%-94.1%). The 1-/2-year PFS for singular BoM was 60.1% (CI: 44.6%-72.5%)/ 39.9% (CI: 24.6%-54.8%), while for 2–3 BoM they amounted to 10.2% (95%-CI: 0.6%-35.8%) and 0%. In multivariable analysis, less favorable outcome for OS and PFS was associated with larger BoM (HR 1.003; p < 0.01 and HR 1.005, p < 0.001) and increased number of treated BoM (HR 1.72; p = 0.03 and HR 1.93; p < 0.01). Treatment was well tolerated, with fracture rates of 5.4% and no grade 4 and 5 adverse events. Conclusion This multicenter cohort analysis revealed that SBRT of BoM from NSCLC appears to be an effective and well-tolerated treatment. Presence of singular BoM was a favorable prognostic factor. Prospective studies are needed to confirm these findings and to determine the role of SBRT in the multidisciplinary management of oligometastases.
