Systemic sclerosis-associated interstitial lung disease (SSc-ILD) is rare, poorly understood, with heterogeneous characteristics resulting in difficult diagnosis. We aimed to systematically review evidence of soluble markers in peripheral blood or bronchoalveolar lavage fluid (BALF) as biomarkers in SSc-ILD.MethodFive databases were screened for observational or interventional, peer-reviewed studies in adults published between January 2000 and September 2021 that assessed levels of biomarkers in peripheral blood or BALF of SSc-ILD patients compared with healthy controls. Qualitative assessment was performed using Critical Appraisal Skills Programme (CASP) checklists. Standardised mean difference (SMD) in biomarkers were combined in random-effects meta-analyses where multiple independent studies reported quantitative data.Results768 published studies were identified; 38 articles were included in the qualitative synthesis. Thirteen studies were included in the meta-analyses representing three biomarkers: KL6, SP-D and IL-8. Greater IL-8 levels were associated with SSc-ILD in both peripheral blood and BALF, overall SMD 0.88 (95% CI 0.61 to 1.15; I2=1%). Greater levels of SP-D and KL-6 were both estimated in SSc-ILD peripheral blood compared with healthy controls, at an SMD of 1.78 (95% CI 1.50 to 2.17; I2=8%) and 1.66 (95% CI 1.17 to 2.14; I2=76%), respectively.ConclusionWe provide robust evidence that KL-6, SP-D and IL-8 have the potential to serve as reliable biomarkers in blood/BALF for supporting the diagnosis of SSc-ILD. However, while several other biomarkers have been proposed, the evidence of their independent value in diagnosis and prognosis is currently lacking and needs further investigation.PROSPERO registration numberCRD42021282452.

In modern cardiology, sodium-glucose cotransporter 2 (SGLT2) inhibitors are critical components of heart failure (HF) treatment algorithms and exert their effects primarily by preventing glucose reabsorption and facilitating its urinary excretion. The objective was to systematically review randomized controlled trials (RCTs) assessing the effects of SGLT2 inhibitors, particularly canagliflozin, empagliflozin, dapagliflozin, ertugliflozin, sotagliflozin (dual SGLT inhibitor), and their use in HF. Systematic searches of PubMed/Medline, The Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials. gov databases were performed. There were no restrictions imposed on the date and status of publication; however, there were restrictions on language for the searched studies. A total of 1139 records were identified in the bibliographic searches from both databases and the register of choice for this systematic review. Following duplicate removal, screening for titles and abstracts, and thorough assessment of full-text articles, 12 RCTs met the inclusion criteria. Altogether, 83 878 patients were included in this review. Among the included studies, two RCTs, with six respective reports, investigated canagliflozin, four RCTs with 13 derived reports investigated dapagliflozin, three RCTs with 12 separate reports studied the effects of empagliflozin, one RCT and its three respective reports assessed ertugliflozin's effects, and two RCTs with one added report investigated the dual inhibitor sotagliflozin. Pooled meta-analytic effects of SGLT2 inhibitors were as follows: on atrial fibrillation odds ratio (OR) = 0.

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Background: To evaluate atherosclerotic changes in carotid arteries (CCA) in uremic patients before and after 18 months of continuous ambulatory peritoneal dialysis (CAPD) treatment, and to evaluate the impact of dyslipidemia and CAPD treatment on vascular remodeling. Materials and Methods: We conducted a longitudinal, prospective study during 2020 and 2021 at the Clinic for Nephrology, Clinical Center University of Sarajevo. Patients with end-stage renal disease were included and were followed during 18 months of CAPD treatment. All patients were treated using commercially prepared biocompatible balanced dialysis solutions. Carotid intima-media thickness (IMT) and atherosclerotic plaques on the common carotid artery (CCA) were measured by echotomography. Results: A total of 50 patients were included and were followed during 18 months of CAPD treatment. Lipid values in the serum of patients with CAPD were significantly lower after 18 months of CAPD treatment compared to the values before treatment, while the value of high-density lipoprotein (HDL) was significantly increased after 18 months of CAPD treatment. The values of IMT and the diameter of the CCA compared to the basal values were significantly lower ( P < 0.001). Conclusion: We demonstrated significantly lower lipid values and higher HDL levels following CAPD treatment. Correct selection of the targeted pharmacological intervention can substantially impact the regression of vascular changes in patients on peritoneal dialysis.