Radiofrequency ablation (RFA) under endoscopic ultrasound (EUS) guidance has been developed and utilized over the last decade to provide the loco-regional treatment of solid and cystic pancreatic neoplastic lesions. The advantage of this approach relies on the close proximity of the EUS transducer to the target pancreatic lesion, which, coupled with the development of specifically designed RFA ablation devices, has made the procedure minimally invasive, with a clear reduction in adverse events as compared to the high morbidity of the surgical approach. EUS-RFA has been applied so far to pancreatic functional and non-functional neuroendocrine neoplasms, pancreatic ductal adenocarcinoma or metastases to the pancreas, and pancreatic neoplastic cysts. Excluding neuroendocrine tumors, for other indications, most of these procedures have been performed in patients who refused surgery or were at high surgical risk. More studies evaluating EUS-RFA in selected patients, not at surgical risk, are gradually becoming available and will pave the road to extend the indications for this therapeutic approach, also in association with other oncological therapies. The present manuscript will critically review the available evidence in the field of the EUS-guided RFA of solid and cystic pancreatic neoplasms.

Introduction: There appears to be an increased prevalence of obstructive sleep apnea (OSA) in patients with rheumatoid arthritis (RA). OSA is associated with elevated serum levels of tumor necrosis factor-α and interleukin-6, two potent pro-inflammatory cytokines that constitute targets for disease‑modifying therapies in RA. Objective: To summarize the evidence of OSA interaction with RA and identify gaps in knowledge. Methods: We searched PubMed, Embase, Web of Science and Scopus databases for articles including patients with both RA and OSA. Results: Sixty-one eligible studies were identified. Most studies focused on the prevalence of OSA in RA patients, but applied different assessment methods. Some used polysomnography, the diagnostic gold standard, while others relied on the Berlin Questionnaire which estimates the risk of OSA. Studies concentrating on patients with long-standing disease complicated by temporomandibular joint involvement or occipito-cervical disease, reported a higher OSA prevalence. The association between OSA and a higher RA disease activity was variable across studies. A limited number of population‑based studies have examined the risk of incident RA among OSA patients, yielding inconsistent results. Only one study assessed cardiovascular risk in individuals with concurrent OSA and RA and found no RA‑related increase in cardiovascular risk. Conclusion: RA patients seem to have a higher prevalence of OSA, potentially related to low physical activity and increased weight, repetitive administration of low-dose corticosteroids or acquired changes in joint architecture (micrognathia, retrognathia). The association with a higher disease burden remains unclear.