Atrial fibrillation (AF), a prevalent cardiac arrhythmia and a major contributor to stroke risk, is anticipated to increase in incidence with the aging global population. For effective AF management, particularly for paroxysmal AF (PAF), long-term and accurate monitoring is essential. However, traditional monitoring methods, including Holter ECGs and implantable cardiac monitors (ICMs), present limitations in comfort, compliance and extended monitoring capabilities. Recent advancements in wearable technology have introduced smart textile-based ECG devices, which incorporate electrochemical sensors into fabrics, enabling non-invasive, continuous monitoring while enhancing user comfort. This review evaluates textile-based ECG devices by comparing their performance—assessed through AF detection rates, signal-to-noise ratio (SNR) and total analysis time—against conventional Holter monitoring and the 12-lead ECG. Furthermore, this review examines user acceptability factors, including patient-reported comfort, usability during resting and physical activities and skin-related adverse effects. The findings aim to provide insights for future device development and facilitate their integration into clinical practice.

Gastric cancer (GC) remains a significant global health challenge, with late-stage diagnosis impacting treatment options and decreased survival rates. To address this, there has been a growing interest in the development of innovative screening and diagnostic methods. Over the past 20 years, nanobiosensors have undergone multiple iterations and unveiled remarkable features that pledge to reshape patient care. Despite the excitement over the plethora of ground-breaking advancements for cancer detection, use-ready samples and streamlined healthcare information monitoring and usage, this technology is still awaiting entry into clinical trials, urging a closer gaze within the medical community. Oligonucleotide-based biosensors, leveraging DNA or RNA’s long-term storage of information, offer great specificity and sensitivity, as described throughout this paper. Consequently, this renders them as an ideal choice for revolutionizing GC diagnosis and facilitating early intervention. The aim of this review is to provide an overview of this cutting-edge, invaluable technology and its limitations across various aspects.

Despite being a transformative intervention in treating obesity, bariatric surgery, encompassing procedures like Roux-en-Y gastric bypass and vertical sleeve gastrectomy, presents unique challenges in postoperative pain management due to altered pharmacokinetics in both adult and pediatric populations. Opioid medication, while being effective, poses risks of addiction and life-threatening side effects, thus, inviting alternative therapeutic approaches. Nanotechnology holds promise as it provides targeted solutions via nano-drug delivery systems, thereby reducing adverse effects and enhancing efficacy in an altered gastrointestinal system. Different methods, including subcutaneous and nasal delivery systems, prolong drug release, offer potential alternatives for patients with modified drug absorption and metabolism, as demonstrated by in vivo and in vitro studies investigating tramadol, ketamine, fentanyl, buprenorphine and others. Currently, safety issues associated with nanocarriers hinder their clinical deployment. This review prompts a new perspective on nano-controlled release methods and their applications in opioid analgesia, indicating that nanotechnology could address the pharmacokinetic challenges in pain management post-bariatric surgery. Alternative strategies, including the use of endogenous neuropeptides, are discussed for mitigating opioid-related complications and improving pain management outcomes.

Background/Objectives: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has caused post-acute sequelae, especially for people with pre-existing conditions, including chronic kidney disease (CKD), which may impact the cardiovascular system. Yet, despite the preliminary description of the general population’s long-COVID-19 consequences, data on CKD patients is scarce. The aim of this study was to investigate the longitudinal effects of COVID-19 on echocardiographic parameters of cardiac function and on cardiac biomarkers in patients with CKD. Methods: A total of 163 patients were included in this observational prospective trial (listed under NCT05125913 code): 88 in the COVID-19 group and 75 in the control group. The serial echocardiographic characteristics in patients who survived beyond one year, focused on left and right ventricular systolic function, together with cardiac biomarkers evolution, were compared between the two groups. Results: At baseline, there were no significant differences in left ventricular (LV) function parameters, except for a higher Tei Index in the COVID-19 group (p < 0.01). Right ventricular (RV) systolic dysfunction was more frequent in the COVID-19 group, with worse fractional area change (FAC) (p = 0.01), RV free wall longitudinal strain (RVFWLS) (p = 0.01), and RV Tei Index (p = 0.01). Over time, the control group showed a decline in LV ejection fraction (EF), while the COVID-19 group slightly improved. RV global systolic function was better preserved in the COVID-19 group. To the best of our knowledge, this is the first study that demonstrates a statistically significant increase in LAVi in patients with COVID-19. Conclusions: Prior COVID-19 infection influenced the trajectory of LV and RV function in CKD patients over 12 months, suggesting potential transient myocardial adaptations. While overall cardiac function did not differ significantly between groups, COVID-19 survivors exhibited better preservation of some ventricular function parameters.

Background: Chronic kidney disease (CKD) is associated with a high burden of cardiovascular remodeling and increased risk of heart failure with preserved ejection fraction (HFpEF). However, the interpretation of natriuretic peptide-based HFpEF diagnostic remains challenging in CKD populations, where structural cardiac abnormalities and elevated NT-proBNP levels frequently coexist. Methods: We conducted a cross-sectional study including ambulatory patients with CKD stages G3–G4 and NYHA II dyspnea. Clinical, metabolic, vascular, and echocardiographic assessments were performed. HFpEF was assessed using a modified HFA-PEFF-based approach derived from the ESC-recommended diagnostic algorithm. We evaluated the impact of NT-proBNP thresholds on HFpEF classification and explored the relationship between NT-proBNP, echocardiographic diastolic dysfunction, and structural cardiac abnormalities. Results: The cohort displayed a high cardiometabolic burden (74.9%), and structural cardiac abnormalities were highly prevalent. Using a modified HFA-PEFF diagnostic algorithm, HFpEF was identified in 52.9% of patients. However, when the biomarker domain was excluded, 86.7% of patients remained within the intermediate-probability range. In an exploratory analysis, a cutoff of 700 pg/mL was identified as the cohort-adapted threshold with the best diagnostic balance and identified 19.8% patients as having HFpEF. Conclusions: Patients with CKD G3–G4 exhibited substantial structural and functional cardiovascular abnormalities despite no prior diagnosis of heart failure. HFpEF classification varied according to the NT-proBNP threshold applied, while NT-proBNP demonstrated limited discriminatory performance for echocardiographic diastolic dysfunction. These findings support the need for more refined and CKD-sensitive approaches for HFpEF characterization in this population.

Background: A growing body of research has implicated systemic inflammation in the pathogenesis of diabetic nephropathy (DN), with the neutrophil-to-lymphocyte ratio (NLR) emerging as a potential biomarker. However, individual studies and previous evidence syntheses have reported substantial heterogeneity in patient populations, DN definitions, renal function measures, and NLR thresholds, limiting the comparability and interpretation of findings. The extent to which these clinical and methodological differences contribute to variability in the association between NLR and DN remains insufficiently characterized. Objective: This systematic review aims to quantify the association between NLR and DN across measures of disease presence, severity, and prognosis and to investigate potential sources of between-study heterogeneity through prespecified subgroup, sensitivity, and meta-regression analyses. Methods: The protocol was designed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A comprehensive literature search of the MEDLINE (Ovid), Embase, the CENTRAL, and Scopus databases was conducted from inception to February 28, 2025. Eligible studies included adults (aged >18 years) with type 2 diabetes mellitus (T2DM) and evaluated the predictive or prognostic value of NLR in relation to DN, using validated measures of DN including albuminuria, estimated glomerular filtration rate (eGFR), glomerular filtration rate (GFR), or serum creatinine. Randomized and nonrandomized interventional studies and observational studies were eligible, with no language restrictions. Two reviewers independently screened studies and extracted data on NLR levels and relevant effect estimates. The methodological quality of observational studies was assessed using the Newcastle-Ottawa Scale. Meta-analyses were performed in RStudio (version 4.5.1) using standardized mean differences or odds ratios, as appropriate, with 95% CIs. Random-effects models were used, and subgroup, sensitivity, and meta-regression analyses were performed to explore potential sources of heterogeneity. Results: The study was initiated on August 31, 2024, and the protocol was first submitted to PROSPERO (CRD42025641025) on February 6, 2025. The literature search identified 1927 records, of which 805 (41.8%) duplicate records were removed. Following title and abstract screening, 123/1,222 (11%) full-text reports were assessed for eligibility, with 45/123 (36.6%) studies included in the qualitative synthesis and 40/45 in the quantitative synthesis. Screening of search results against the inclusion criteria was completed in March 2025. Data extraction was conducted from March 2025 to May 2025, followed by risk-of-bias and quality assessment from May 2025 to July 2025 and data analysis from July 2025 to October 2025. The completed systematic review and meta-analysis was submitted for publication on May 30, 2026. Conclusions: This systematic review sought to synthesize the available evidence on the association between NLR and DN occurrence, severity, and prognosis in T2DM, examining its potential as a biomarker and the sources of variability across studies. If the anticipated associations are supported, NLR may warrant evaluation within risk-stratification models for T2DM.