Abstract: El 16 de enero de 2025, la Abogada General (AG) del Tribunal de Justicia de la Unión Europea (TJUE), Sra. Tamara Capeta, emitió sus conclusiones en el asunto C-600/23. Estas conclusiones, aunque no vinculantes, revisten una gran relevancia en el marco del litigio que enfrenta al club de fútbol belga Royal Football Club Seraing (Club Seraing) contra varias instancias federativas del fútbol, incluyendo la FIFA, la UEFA y la Real Asociación Belga de Fútbol (URBSFA). La cuestión prejudicial fue planteada por el Tribunal de Casación belga en un procedimiento que también involucra un laudo del Tribunal de Arbitraje del Deporte (TAS), confirmado previamente por el Tribunal Federal suizo. En este contexto, la sociedad maltesa Doyen Sports Investment Ltd. (Doyen Sports) interviene en apoyo del Club Seraing, dado su papel como fondo de inversión y financiador de clubes deportivos.

Abstract Background Little information exists about vitamin D status in bitches with mammary tumors. Objectives To determine whether low plasma vitamin D concentrations are found in bitches with mammary tumors. Animals Eighty‐five client‐owned bitches with mammary tumors (n = 21 benign, n = 64 malignant) and 39 age‐matched healthy bitches. Methods Case‐control study. Plasma ionized and total calcium, phosphorus, magnesium, urea, creatinine, albumin, total proteins, alanine aminotransferase, alkaline phosphatase, parathyroid hormone (PTH), calcitriol (1,25‐dihydroxyvitamin D), and 25‐hydroxyvitamin D concentrations were measured in all bitches at the time of clinical diagnosis and before any treatments. Statistical analysis was performed to compare variables among groups (control, benign, and malignant). Results No significant differences were found when plasma 25‐hydroxyvitamin D concentrations in bitches with malignant (148.9 [59.9] ng/mL) and benign mammary tumors (150.1 [122.3] ng/mL) were compared with control group (129.9 [54.5] ng/mL). Parathyroid hormone was significantly higher in bitches with malignant (19.9 [20.5] pg/mL), and benign mammary tumors (14.6 [14.9] pg/mL) compared with control group (7.5 [7.5] pg/mL; P < .01). Only the presence of mammary tumors (P < .01) and age (P = .04; adjusted R2 = .22) was significant in predicting PTH. Conclusions Bitches with mammary tumors do not have low 25‐hydroxyvitamin D concentrations thus vitamin D supplementation is unlikely to be useful for prevention of mammary tumors in bitches.

INTRODUCTION:There are conflicting reports about the effect or rapamycin on the kidneys. Rapamycin is known to promote phosphaturia that may be associated to renal injury. METHODS:Detailed histopathological studies were performed on the kidneys of rats with normal (control) and reduced (Nx) renal mass that were treated with rapamycin (1.3 mg/kg for 22 days) or placebo. The effect of rapamycin was also evaluated in control and Nx rats fed different amounts of phosphorus: 0.6% P (NP), 1.2% P (HP), and 0.2% P (LP). Quantitative scores of kidney lesions were obtained for interstitial nephritis (IN), tubular damage (TD), and nephrocalcinosis (NC). RESULTS:When compared with placebo, rapamycin administration to Nx rats resulted in significant increases in IN (4.17 ± 0.74 vs. 1.51 ± 0.53%) and TD (14.45 ± 1.51 vs. 8.61 ± 1.83%). Rapamycin also increased NC both in control (0.86 ± 0.23 vs. 0.14 ± 0.06%) and Nx (0.86 ± 0.32 vs. 0.15 ± 0.14%) rats. In control rats receiving rapamycin, feeding HP aggravated IN (3.25 ± 0.48%), TD (22.47 ± 4.56%), and NC (3.66 ± 0.75%), while feeding LP prevented development of any renal lesions. In Nx rats treated with rapamycin, HP intake also increased IN (8.95 ± 1.94%), TD (26.86 ± 3.95%), and NC (2.77 ± 0.60%), whereas feeding LP reduced all lesions to lower levels than in rats fed NP. Rapamycin treatment increased fractional excretion of P (FEP), and an excellent correlation between scores for renal lesions and FEP was found. CONCLUSION:Rapamycin has deleterious effects on kidney pathology causing lesions that are located mainly at tubular and tubulointerstitial level. Rapamycin-induced kidney damage is more evident in rats that already have decreased renal function and seems to be related to the phosphaturic effect of the drug. Dietary P restriction prevents kidney damage in rats treated with rapamycin.

Both mTOR and α-klotho play a role in the pathophysiology of renal disease, influence mineral metabolism and participate in the aging process. The influence of mTOR inhibition by rapamycin on renal α-klotho expression is unknown. Rats with normal (controls) and reduced (Nx) renal function were treated with rapamycin, 1.3 mg/kg/day, for 22 days. The experiments were conducted with rats fed 0.6% P diet (NP) and 0.2% P diet (LP). Treatment with rapamycin promoted phosphaturia in control and Nx rats fed NP and LP. A decrease in FGF23 was identified in controls after treatment with rapamycin. In rats fed NP, rapamycin decreased mRNA α-klotho/GADPH ratio both in controls, 0.6±0.1 vs 1.1±0.1, p = 0.001, and Nx, 0.3±0.1 vs 0.7±0.1, p = 0.01. At the protein level, a significant reduction in α-klotho was evidenced after treatment with rapamycin both by Western Blot: 0.6±0.1 vs 1.0±0.1, p = 0.01, in controls, 0.7±0.1 vs 1.1±0.1, p = 0.02, in Nx; and by immunohistochemistry staining. Renal α-klotho was inversely correlated with urinary P excretion (r = -0.525, p = 0.0002). The decrease in α-klotho after treatment with rapamycin was also observed in rats fed LP. In conclusion, rapamycin increases phosphaturia and down-regulates α-klotho expression in rats with normal and decreased renal function. These effects can be observed in animals ingesting normal and low P diet.

To describe mechanical ventilation (MV) practices in Argentina, and to explore factors associated with ICU mortality in this population.A prospective, multicenter, observational study was carried out.Intensive Care.We enrolled patients above 18 years old admitted to any of the participating ICUs requiring invasive MV for at least 12 h since the admission to the healthcare institution, including MV initiation in emergency department, operating room or other hospitals.None.All variables were classified into three categories: variables related to demographic and clinical factors before the MV, factors related to the first day on MV, and factors related to events happening during the MV (complications and weaning from MV). Mechanical ventilation weaning and mortality were classified according to WIND.The primary analysis included 950 patients. The main indication for MV was acute respiratory failure (58% of patients). Initial ventilation mode was volume control-continuous mandatory ventilation in 75% of cases. ICU and hospital mortality were 44.6% and 47.9% respectively. The variables identified as independent predictors of mortality in ICU were age (OR 3.48 IC 95% 1.22–11.66; p = 0.028), failure to implement NIV before MV (OR 2.76 IC 95% 1.02–7.10; p = 0.038), diagnosis of sepsis (OR 2.46 IC 95% 1.09–5.47; p = 0.027) and extubation failure (OR 4.50 IC 95% 2.05–9.90; p < 0.001).The present study allowed us to describe the characteristics and clinical course of the patients who received mechanical ventilation in Argentina, finding as the main result that mortality was higher than that reported in international studies.Describir las prácticas relacionadas a ventilación mecánica (VM) en Argentina y explorar los factores asociados a la mortalidad en UCI en esta población.Se realizó un estudio observacional, prospectivo, multicéntrico.Unidad de Cuidados Intensivos.Incluimos pacientes mayores de 18 años ingresados ​​en las UCI participantes que requirieron VM invasiva durante al menos 12 horas desde el ingreso a la institución de salud.Ninguna.Todas las variables se clasificaron en tres categorías: variables relacionadas con factores demográficos y clínicos antes de la VM, factores relacionados con el primer día de VM y factores relacionados con los eventos ocurridos durante la VM (complicaciones y destete de la VM). El destete de la ventilación mecánica y la mortalidad se clasificaron según WIND (Weaningaccording to a New Definition).El análisis primario incluyó a 950 pacientes. La principal indicación de VM fue insuficiencia respiratoria aguda (58% de los pacientes). El modo de ventilación inicial fue ventilación mandatoria continua con control de volumen en el 75% de los casos. La mortalidad en UCI y hospitalaria fue del 44,6% y 47,9% respectivamente. Las variables identificadas como predictoras independientes de mortalidad en UCI fueron edad (OR 3,48 IC 95% 1,22–11,66; p = 0,028), fracaso en la implementación de VNI antes de VM (OR 2,76 IC 95% 1,02–7,10; p = 0,038), diagnóstico de sepsis (OR 2,46 IC 95% 1,09–5,47; p = 0,027) y fracaso de la extubación (OR 4,50 IC 95% 2,05–9,90; p < 0,001).El presente estudio permitió describir las características y evolución clínica de los pacientes que recibieron ventilación mecánica en Argentina, encontrando como principal resultado que la mortalidad fue mayor a la reportada en estudios internacionales.

Increased dietary acid load has a negative impact on health, particularly when renal function is compromised. Fibroblast growth factor 23 (FGF23) is a bone-derived hormone that is elevated during renal failure. The relationship between metabolic acidosis and FGF23 remains unclear. To investigate the effect of dietary acid load on circulating levels of FGF23, rats with normal renal function and with a graded reduction in renal mass (1/2 Nx and 5/6 Nx) received oral NH4Cl for 1 month. Acid intake resulted in a consistent decrease of plasma FGF23 concentrations in all study groups when compared with their non-acidotic control: 239.3 ± 13.5 vs. 295.0 ± 15.8 pg/mL (intact), 346.4 ± 19.7 vs. 522.6 ± 29.3 pg/mL (1/2 Nx) and 988.0 ± 125.5 vs. 2549.4 ± 469.7 pg/mL (5/6 Nx). Acidosis also decreased plasma PTH in all groups, 96.5 ± 22.3 vs. 107.3 ± 19.1 pg/mL, 113.1 ± 17.3 vs. 185.8 ± 22.2 pg/mL and 504.9 ± 75.7 vs. 1255.4 ± 181.1 pg/mL. FGF23 showed a strong positive correlation with PTH (r = 0.877, p < 0.0001) and further studies demonstrated that acidosis did not influence plasma FGF23 concentrations in parathyroidectomized rats, 190.0 ± 31.6 vs. 215 ± 25.6 pg/mL. In conclusion, plasma concentrations of FGF23 are consistently decreased in rats with metabolic acidosis secondary to increased acid intake, both in animals with intact renal function and with decreased renal function. The in vivo effect of metabolic acidosis on FGF23 appears to be related to the simultaneous decrease in PTH.

Background The molecular-based classification of canine mammary carcinomas (CMCs) has been the focus of much current research. Both in canines and humans, the triple-negative (TN) molecular subtype of mammary cancer is defined by a lack of expression of progesterone receptor (PR), oestrogen receptor (ER) and HER2. It has a poor prognosis; no effective targeted therapy is available. Vitamin D displays anticarcinogenic properties, and the expression of its receptor (VDR) has been found in different molecular subtypes, being about 30–40 % of TN breast cancer (TNBC) positive to it. We assessed the VDR expression in the different molecular subtypes of 58 CMCs from 45 female dogs using an immunohistochemical panel for the molecular classification of included: PR, ER, HER2, cytokeratin (CK) 5, CK14, and Ki67. In addition, we studied the relationship among the molecular subtypes of CMCs and clinicopathologic parameters. Results Investigation showed VDR positivity in 45.0 % of the triple-negative CMCs (TNCMCs), 27.3 % of luminal B and 19.0 % of luminal A. Luminal A was the most molecular subtype represented of the total tumours (36.2 %), followed of TNCMCs (34.5 %), luminal B (20.7 %) and HER2-overexpression (10.3 %). Both HER2-overexpression and TNCMC subtypes were positively related to lymphatic invasion ( P = 0.028), simple histologic subtype ( P = 0.007), a higher histological grade ( P = 0.045) and a trend to higher proliferation index ( P = 0.09). Conclusions The highest VDR expression was observed in TNCMC, being almost half of them (45 %) positive to this receptor. VDR expression was absent in HER2-overexpression tumours and low in luminal A and B molecular subtypes.

The influence of energy restriction (ER) on muscle is controversial, and the mechanisms are not well understood. To study the effect of ER on skeletal muscle phenotype and the influence of vitamin D, rats (n = 34) were fed a control diet or an ER diet. Muscle mass, muscle somatic index (MSI), fiber-type composition, fiber size, and metabolic activity were studied in tibialis cranialis (TC) and soleus (SOL) muscles. Plasma vitamin D metabolites and renal expression of enzymes involved in vitamin D metabolism were measured. In the ER group, muscle weight was unchanged in TC and decreased by 12% in SOL, but MSI increased in both muscles (p < 0.0001) by 55% and 36%, respectively. Histomorphometric studies showed 14% increase in the percentage of type IIA fibers and 13% reduction in type IIX fibers in TC of ER rats. Decreased size of type I fibers and reduced oxidative activity was identified in SOL of ER rats. An increase in plasma 1,25(OH)2-vitamin D (169.7 ± 6.8 vs. 85.4 ± 11.5 pg/mL, p < 0.0001) with kidney up-regulation of CYP27b1 and down-regulation of CYP24a1 was observed in ER rats. Plasma vitamin D correlated with MSI in both muscles (p < 0.001), with the percentages of type IIA and type IIX fibers in TC and with the oxidative profile in SOL. In conclusion, ER preserves skeletal muscle mass, improves contractile phenotype in phasic muscles (TC), and reduces energy expenditure in antigravity muscles (SOL). These beneficial effects are closely related to the increases in vitamin D secondary to ER.

The aim of this paper is to review current knowledge about how calorie intake influences mineral metabolism focussing on four aspects of major interest for the renal patient: (a) phosphate (P) handling, (b) fibroblast growth factor 23 (FGF23) and calcitriol synthesis and secretion, (c) metabolic bone disease, and (d) vascular calcification (VC). Caloric intake has been shown to modulate P balance in experimental models: high caloric intake promotes P retention, while caloric restriction decreases plasma P concentrations. Synthesis and secretion of the phosphaturic hormone FGF23 is directly influenced by energy intake; a direct correlation between caloric intake and FGF23 plasma concentrations has been shown in animals and humans. Moreover, in vitro, energy availability has been demonstrated to regulate FGF23 synthesis through mechanisms in which the molecular target of rapamycin (mTOR) signalling pathway is involved. Plasma calcitriol concentrations are inversely proportional to caloric intake due to modulation by FGF23 of the enzymes implicated in vitamin D metabolism. The effect of caloric intake on bone is controversial. High caloric intake has been reported to increase bone mass, but the associated changes in adipokines and cytokines may as well be deleterious for bone. Low caloric intake tends to reduce bone mass but also may provide indirect (through modulation of inflammation and insulin regulation) beneficial effects on bone. Finally, while VC has been shown to be exacerbated by diets with high caloric content, the opposite has not been demonstrated with low calorie intake. In conclusion, although prospective studies in humans are needed, when planning caloric intake for a renal patient, it is important to take into consideration the associated changes in mineral metabolism.

Abstract Background and Aims Vascular calcification (VC) is an important contributor to the high rate of cardiovascular mortality associated to chronic kidney disease. The inability to eliminate phosphorus (P) and the subsequent P retention promotes CV. P metabolism and uremic VC are influenced by obesity and by the caloric content of the diet. Caloric restriction (CR) has been shown to have multiple beneficial effects on health, for example, CR has been reported to improve vascular health and retard vascular ageing. However, to our knowledge the effect of CR on the development of uremic VC has not been explored. We hypothesize that CR may be beneficial to prevent the development of uremic VCs. Thus, the objective of the present study was to determine if rats subjected to CR were protected against VC. Method 48 Wistar rats were divided in four groups. The control diet provided Metabolizable Energy = 3.528 kcal/g and contained 0.6% Calcium (Ca) and 0.6% P. Additional diets of identical composition to the control diet but containing varying levels of Ca and P: 0.9% Ca, 0.9% P; 0.6% Ca, 1.2% P; and 0.9% Ca, 1.8% P, were also used in the experiments. Rats in Group 1 and 3 were fed 15 g/day of the control diet. Rats in Group 2 and 4 were calorie restricted and fed 10 g/day of diet with Ca/P = 0.9%/0.9%. Thus the daily P intake should be identical in the four groups. Uremia was induced by 5/6 nephrectomy (Nx). After Nx rats in Group 1 and 2 were fed ad libitum a diet with 0.6% Ca and 1.2% P. While rats in Group 3 and 4 were fed ad libitum a diet with 0.9% Ca and 1.8% P. Rats were supplemented with calcitriol. At the end of the experiment, rats were sacrificed to obtain blood samples and tissue samples (thoracic and abdominal aortas). After blood collection, plasma was separated by centrifugation and stored at –20° C until assayed. Plasma creatinine, Ca and P were measured by spectrophotometry. Energy intake was calculated based on food intake. VC was studied by histology and by measuring the tissue Ca content. Values are expressed as mean ± standard error (SE), the difference between groups was assessed by ANOVA. Fisher LSD test was used as a post-hoc procedure. p<0.05 was considered significant. Results Before Nx, caloric intake was significantly lower in calorie restricted rats (35.4 ± 0.1 and 35.8 ± 0.1 kcal/day) than in rats eating normal calories (52.7 ± 0.1 and 52.8 ± 0.2 kcal/day); however, P intake was almost identical in the four groups and ranged between 89.8 and 91.6 mg/day. After Nx, rats in all groups reduced food intake and, consequently, caloric intake. Thus, although the P content of the diet was increased after Nx, daily P intake was not increased in Groups 1 and 2; however, P intake was significantly increased in Groups 3 and 4 (120.9 ± 4.6 and 122.2 ± 6.2 mg/day, respectively). In all groups, rats had high plasma concentrations of creatinine and P, and low plasma concentrations of Ca. Also, all rats had elevated Ca content in the aorta. No significant differences between the study groups were found in any of these parameters (Table 1). Von Kossa staining of the aortas showed abundant mineral deposition in the four groups. Conclusion This study shows that, contrary to what was expected, CR did not prevent or ameliorate uremic calcifications.

Caloric restriction (CR) is known to have multiple beneficial effects on health and longevity. To study the effect of CR on phosphorus metabolism and vascular calcification (VC), rats were fed normal or restricted calories (67% of normal). The phosphorus content of the diets was adjusted to provide equal phosphorus intake independent of the calories ingested. After 50 days of CR, rats had negative phosphorus balance, lower plasma phosphorus, glucose, triglycerides, and leptin, and higher adiponectin than rats fed normal calories. Uremia was induced by 5/6 nephrectomy (Nx). After Nx, rats were treated with calcitriol (80 ng/kg ip every other day) and high-phosphorus diets (1.2% and 1.8%). No differences in aortic calcium content were observed between rats that ate normal or restricted calories before Nx in either rats that received 1.2% phosphorus (11.5 ± 1.7 vs. 10.9 ± 2.1 mg/g tissue) or in rats that received 1.8% phosphorus (12.5 ± 2.3 vs. 12.0 ± 2.9 mg/g of tissue). However, mortality was significantly increased in rats subjected to CR before Nx in both the 1.2% phosphorus groups (75% vs. 25%, P = 0.019) and 1.8% phosphorus groups (100% vs. 45%, P < 0.001). After calcitriol administration was stopped and phosphorus intake was normalized, VC regressed rapidly, but no significant differences in aortic calcium were detected between rats that ate normal or restricted calories during the regression phase (5.7 ± 2.7 and 5.2 ± 1.5 mg/g tissue). In conclusion, CR did not prevent or ameliorate VC and increased mortality in uremic rats.

Abstract Background Foods prone to deteriorate renal function are rich in fat and in phosphorus (P), but the interaction between these two factors is not well studied. Method Detailed structural and ultrastructural histopathological studies were performed on the kidneys of rats fed different amounts of fat and P: low (4%) fat (LF) and normal (0.6%) P (NP), LF and high (1.2%) P (HP), high (35%) fat (HF) and NP, HF and HP, and HF with low (0.2%) P (LP) for 28 weeks. Results Glomeruli of the HF groups showed segmental areas of retraction, sclerosis and thickening of the Bowman’s capsule and basal membranes, which were more accentuated in the HF–HP group. Ultrastructural lesions in the glomeruli also were prominent in rats fed HF, particularly in the HF–HP group, and included thickening of the capillary membrane, endothelial damage, mesangial matrix hypercellularity and podocyte effacement. P restriction reduced the severity of endothelial damage, mesangial matrix hypercellularity, thickening of capillary basement membrane and podocyte effacement. The kidneys of rats fed HP showed significant tubular atrophy and dilatation, focal tubular hyperplasia, thickening of the tubular basal membrane, interstitial edema, inflammation and calcification. All groups fed HF also showed tubular lesions that were more prominent in the HF–HP group. P restriction had a beneficial effect on inflammation and calcification. Conclusions Intake of both HF and HP damages the kidneys and their noxious effects are additive. HF intake was preferentially associated with glomerular lesions, while lesions related to HP intake were located mainly in the tubuli and in the interstitium.

To test the hypothesis that fibroblast growth factor 23 (FGF23) is directly regulated by energy intake, in vivo and in vitro experiments were conducted. Three groups of rats were fed diets with high (HC), normal (NC) and low (LC) caloric content that resulted in different energy intake. In vitro , UMR106 cells were incubated in high (HG, 4.5 g/l) or low glucose (LG, 1 g/l) medium. Additional treatments included phosphorus (P), mannitol, rapamycin and everolimus. Intestinal absorption of P and plasma P concentrations were similar in the three groups of rats. As compared with NC, plasma FGF23 concentrations were increased in HC and decreased in the LC group. A significant correlation between energy intake and plasma FGF23 concentrations was observed. In vitro , mRNA FGF23 was significantly higher in UMR106 cells cultured in HG than in LG. When exposed to high P, mRNA FGF23 increased but only when cells were cultured in HG. Cells incubated with HG and mechanistic target of rapamycin (mTOR) inhibitors expressed low mRNA FGF23, similar to the values obtained in LG. In conclusion, this study shows a direct regulation of FGF23 production by energy availability and demonstrates that the mTOR signaling pathway plays a central role in this regulatory system.

This paper studies the content and scope of the important STS 463/2019, of September 11, relating to the early maturity clauses in the mortgage guarantee loan agreements. To do this, the main jurisprudence of the CJEU and the TS itself, which has served as a precedent of said resolution, is previously covered. Next, the jurisprudential guidelines or guidelines offered in this judgment are analyzed, with a critical sense and trying to show their successes and weaknesses. And it ends with some valuations and proposals.

Calcimimetics decrease parathyroid hormone (PTH) secretion in patients with secondary hyperparathyroidism. The decrease in PTH should cause a reduction in bone turnover; however, the direct effect of calcimimetics on bone cells, which express the calcium-sensing receptor (CaSR), has not been defined. In this study, we evaluated the direct bone effects of CaSR activation by a calcimimetic (AMG 641) in vitro and in vivo. To create a PTH "clamp," total parathyroidectomy was performed in rats with and without uremia induced by 5/6 nephrectomy, followed by a continuous subcutaneous infusion of PTH. Animals were then treated with either the calcimimetic or vehicle. Calcimimetic administration increased osteoblast number and osteoid volume in normal rats under a PTH clamp. In uremic rats, the elevated PTH concentration led to reduced bone volume and increased bone turnover, and calcimimetic administration decreased plasma PTH. In uremic rats exposed to PTH at 6-fold the usual replacement dose, calcimimetic administration increased osteoblast number, osteoid surface, and bone formation. A 9-fold higher dose of PTH caused an increase in bone turnover that was not altered by the administration of calcimimetic. In an osteosarcoma cell line, the calcimimetic induced Erk1/2 phosphorylation and the expression of osteoblast genes. The addition of a calcilytic resulted in the opposite effect. Moreover, the calcimimetic promoted the osteogenic differentiation and mineralization of human bone marrow mesenchymal stem cells in vitro. Thus, calcimimetic administration has a direct anabolic effect on bone that counteracts the decrease in PTH levels.

OBJECTIVES:To review the diagnostic accuracy of ultrasound-guided core-needle biopsy (CNB) in the diagnosis of salivary gland tumours (SGT).METHODS:Retrospective, institutional review board approved, analysis of the CNB of SGT performed at our centre in 8 years. We used an automatic 18-G spring-loaded device. The final diagnosis was based on surgery in the cases that were operated on, and on clinical evolution and biopsy findings in the rest.RESULTS:Four hundred and nine biopsies were performed in 381 patients (ages, 2-97 years; mean, 55.9). There were two minor complications. Biopsy was diagnostic in 98.3%. There were eight false negatives. The diagnostic values for malignancy were: sensitivity 89.6%, specificity 100%, positive predictive value (PPV) 100% and negative predictive value (NPV) 98%. For the detection of neoplasms were: sensitivity 98.7%, specificity 99%, PPV 99.7% and VPN 96.1%.CONCLUSIONS:Accuracy of CNB in SGT is very high, with a very high sensitivity and an absolutely reliable diagnosis of malignancy. Complication rate is very low. It should be considered the technique of choice when a STG is detected. Normal tissue results warrant repeating biopsy.KEY POINTS:• Ultrasound-guided core-biopsy is the technique of choice in salivary glands nodules • Sensitivity, specificity for detecting neoplasms (which should be resected) are around 99% • Diagnosis of malignancy in core-biopsy is absolutely reliable • A CNB result of "normal tissue", however, warrants repeating the biopsy • Complication rate is very low.

The effect of dietary phosphorus (P) on fibroblast growth factor 21 (FGF21)/β-klotho axis was investigated in rats that were fed diets with: Normal (NP) or high P (HP) and either normal (NC), high (HC) or low calories (LC). Sampling was performed at 1, 4 and 7 months. Plasma FGF21 concentrations were higher (p < 0.05) in NC and HC than in LC groups. Increasing P intake had differing effects on plasma FGF21 in rats fed NC and HC vs. rats fed LC at the three sampling times. When compared with the NP groups, FGF21 concentrations decreased at the three sampling points in rats fed NC-HP (80 vs. 194, 185 vs. 382, 145 vs. 403 pg/mL) and HC-HP (90 vs. 190, 173 vs. 353, 94 vs. 434 pg/mL). However, FGF21 did not decrease in rats fed LC-HP (34 vs. 20, 332 vs. 164 and 155 vs. 81 pg/mL). In addition, LC groups had a much lower liver FGF21 messenger ribonucleic acid/glyceraldehyde 3-phosphate dehydrogenase (mRNA/GAPDH) ratio (0.51 ± 0.08 and 0.56 ± 0.07) than the NC-NP (0.97 ± 0.14) and HC-NP (0.97 ± 0.22) groups. Increasing P intake reduced liver FGF21 mRNA/GAPDH in rats fed NC and HC to 0.42 ± 0.05 and 0.37 ± 0.04. Liver β-klotho mRNA/GAPDH ratio was lower (p < 0.05) in LC groups (0.66 ± 0.06 and 0.59 ± 0.10) than in NC (1.09 ± 0.17 and 1.03 ± 0.14) and HC (1.19 ± 0.12 and 1.34 ± 0.19) groups. A reduction (p < 0.05) in β-klotho protein/α-tubulin ratio was also observed in LC groups (0.65 ± 0.05 and 0.49 ± 0.08) when compared with NC (1.12 ± 0.11 and 0.91 ± 0.11) and HC (0.93 ± 0.17 and 0.87 ± 0.09) groups. In conclusion β-klotho is potently regulated by caloric restriction but not by increasing P intake while FGF21 is regulated by both caloric restriction and increased P intake. Moreover, increased P intake has a differential effect on FGF21 in calorie repleted and calorie depleted rats.

Objectives: Blood pressure (BP) and albuminuria has been associated with increased cardiovascular mortality. The aim of this study was to evaluate differences in Blood pressure across albuminuria levels in patients without chronic kidney disease. Methods: The analysis was carried out on a sample of AWHS, whose initial design and methodology have been previously published. 2682 General Motors’ workers (Figuerelas-Spain) without chronic kidney disease were analyzed. Patients were classified according to urine albumin-to-creatinine ratio (ACR), as normoalbuminuria (< 30 mg/g) and microalbuminuria (30–300 mg/g). We excluded examinees who had ACR > 300 mg/g. Blood pressure were determined with standardized methods and conditions. Results: Systolic Blood Pressure (SBP) was 8 mmHg higher in patients with microalbuminuria than in those with normoalbuminuria (P < 0.001), and Diastolic Blood Pressure (DBP) had 5 mmHg grater than in those with normoalbuminuria (P < 0.001). Chi-square analysis revealed that microalbuminuria was correlated with the systolic blood pressure in among patients diabetes (4 mmHg, P < 0.001). In a logistic regression model adjusted for sex, age, body mass index (BMI), hypertension and diabetes revealed systolic blood pressure was statistically significantly associated with microalbuminuria (p < 0.04) (OR:1.03; 95% CI:1.01–1.05). Conclusion: Albuminuria is accompanied by higher SBP in patients with and without diabetes.