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Objective: Postacute COVID-19 syndrome (PACS) is an emerging entity characterised by a large array of manifestations, including musculoskeletal complaints, fatigue and cognitive or sleep disturbances. Since similar symptoms are present also in patients with fibromyalgia (FM), we decided to perform a web-based cross-sectional survey aimed at investigating the prevalence and predictors of FM in patients who recovered from COVID-19., Methods: Data were anonymously collected between 5 and 18 April 2021. The collection form consisted of 28 questions gathering demographic information, features and duration of acute COVID-19, comorbid diseases, and other individual's attributes such as height and weight. The American College of Rheumatology (ACR) Survey Criteria and the Italian version of the Fibromyalgia Impact Questionnaire completed the survey., Results: A final sample of 616 individuals (77.4% women) filled the form 6±3 months after the COVID-19 diagnosis. Of these, 189 (30.7%) satisfied the ACR survey criteria for FM (56.6% women). A multivariate logistic regression model including demographic and clinical factors showed that male gender (OR: 9.95, 95% CI 6.02 to 16.43, p<0.0001) and obesity (OR: 41.20, 95% CI 18.00 to 98.88, p<0.0001) were the strongest predictors of being classified as having post-COVID-19 FM. Hospital admission rate was significantly higher in men (15.8% vs 9.2%, p=0.001) and obese (19.2 vs 10.8%, p=0.016) respondents., Conclusion: Our data suggest that clinical features of FM are common in patients who recovered from COVID-19 and that obesity and male gender affect the risk of developing post-COVID-19 FM., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Urate is a cause of gout, kidney stones, and acute kidney injury from tumor lysis syndrome, but its relationship to kidney disease, cardiovascular disease, and diabetes remains controversial. A scientific workshop organized by the National Kidney Foundation was held in September 2016 to review current evidence. Cell culture studies and animal models suggest that elevated serum urate concentrations can contribute to kidney disease, hypertension, and metabolic syndrome. Epidemiologic evidence also supports elevated serum urate concentrations as a risk factor for the development of kidney disease, hypertension, and diabetes, but differences in methodologies and inpacts on serum urate concentrations by even subtle changes in kidney function render conclusions uncertain. Mendelian randomization studies generally do not support a causal role of serum urate in kidney disease, hypertension, or diabetes, although interpretation is complicated by nonhomogeneous populations, a failure to consider environmental interactions, and a lack of understanding of how the genetic polymorphisms affect biological mechanisms related to urate. Although several small clinical trials suggest benefits of urate-lowering therapies on kidney function, blood pressure, and insulin resistance, others have been negative, with many trials having design limitations and insufficient power. Thus, whether uric acid has a causal role in kidney and cardiovascular diseases requires further study., (Copyright © 2018 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Lower extremity peripheral arterial disease (PAD) is a marker of widespread atherosclerosis. Individuals with PAD, most of whom do not show typical PAD symptoms ('asymptomatic' patients), are at increased risk of cardiovascular ischaemic events. American College of Cardiology/American Heart Association guidelines recommend that individuals with asymptomatic lower extremity PAD should be identified by measurement of ankle-brachial index (ABI). However, despite its associated risk, PAD remains under-recognised by clinicians and the general population and office-based ABI detection is still poorly-known and under-used in clinical practice. The Prevalence of peripheral Arterial disease in patients with a non-high cardiovascular disease risk, with No overt vascular Diseases nOR diAbetes mellitus (PANDORA) study has a primary aim of assessing the prevalence of lower extremity PAD through ABI measurement, in patients at non-high cardiovascular risk, with no overt cardiovascular diseases (including symptomatic PAD), or diabetes mellitus. Secondary objectives include documenting the prevalence and treatment of cardiovascular risk factors and the characteristics of both patients and physicians as possible determinants for PAD under-diagnosis., Methods/design: PANDORA is a non-interventional, cross-sectional, pan-European study. It includes approximately 1,000 primary care participating sites, across six European countries (Belgium, France, Greece, Italy, The Netherlands, Switzerland). Investigator and patient questionnaires will be used to collect both right and left ABI values at rest, presence of cardiovascular disease risk factors, current pharmacological treatment, and determinants for PAD under-diagnosis., Discussion: The PANDORA study will provide important data to estimate the prevalence of asymptomatic PAD in a population otherwise classified at low or intermediate risk on the basis of current risk scores in a primary care setting., Trial Registration Number: Clinical Trials.gov Identifier: NCT00689377.

Objective: The objective of this study was to determine the contribution of elevated blood pressure parameters to the long-term incidence of cardiovascular events., Design: A prospective, population-based longitudinal epidemiological cohort., Settings: The population of the town of Brisighella., Patients: The Brisighella Heart Study involved 2939 randomly selected residents of Brisighella, Italy aged 14 to 84 years, free of cardiovascular (CV) disease at enrollment and followed since 1972. Subjects were clinically evaluated at baseline and every 4 years following enrollment when extensive clinical and laboratory data were obtained in addition to the assessment of morbidity and mortality., Main Outcome Measurements: The Cox regression analysis, adjusted for the main risk factors for CV disease was used to determine the independent prognostic significance of systolic, (SBP), diastolic (DBP), and pulse pressure (PP). The events of interest were coronary heart disease (CHD) and cerebrovascular disease (CVD)., Results: Adjusted hazard ratios (HRs) for combined CHD + CVD at SBP categories of 120-139, 140-159, and 159 mmHg were 1.45 [95% confidence interval, (CI), P= 0.035], 1.88 (95% CI, P= 0.0008), and 2.31 (95% CI, P<0.0001), respectively. For DBP ranges of 70-79, 80-89, and 89 mmHg, HRs were 0.91 (95% CI, P= 0.677), 1.33 (95% CI, P= 0.169), and 1.65 (95% CI, P= 0.029), respectively. PP ranges from 54-67 and 67 mmHg were associated with HRs of 1.23 (95% CI, P= 0.149), and 1.38 (95% CI, P= 0.030), respectively. Similar results were seen for CVD and CHD as separate endpoints., Conclusions: The present study demonstrates that SBP is a stronger predictor of cardiovascular events than DBP in the Brisighella population. The added prognostic significance of PP is also demonstrated, particularly if PP exceeds 67 mmHg.