Myelodysplastic Syndromes/Neoplasms (MDS) are a heterogeneous group of blood cancers characterized by a broad spectrum of symptoms and varying impacts on quality of life (QoL). Although the integration of early PC care has long been recognized as an essential part of comprehensive management for patients with solid tumors, experience in the context of MDS is still limited. However, symptom control, QoL, advanced care planning goals, the reduction of aggressive therapies, intensive care use, including intubation before death, and resource use in the end-of-life (EOL) phase are critical issues that are enhanced through early PC in MDS management. Additionally, integrating standard hematological measures with early PC leads to fewer visits and hospital admissions near the EOL, particularly during the last 30 days. Moreover, patients with early PC die at home or in hospice care at a rate nearly in line with their preferences. Therefore, routine early PC is a critical issue for patients with MDS, regardless of disease risk, as it improves patient outcomes, enhances communication, refines resource use, and reduces unnecessary aggressive procedures.
Evaluate the association between preoperative SIRI and early postoperative SSI and to assess its diagnostic performance. Retrospective cohort study was conducted including 500 consecutive adult patients who underwent posterior fusion lumbar spine surgery for degenerative pathology. Preoperative neutrophil, lymphocyte, and monocyte counts were used to calculate SIRI. The primary outcome was early acute deep postoperative SSI. Associations were analyzed using univariate and penalized multivariate logistic regression. Discriminatory performance was assessed using receiver operating characteristic curve analysis. Early postoperative SSI occurred in 27 patients (5.4%). Patients who developed infection had significantly higher preoperative SIRI values than those without infection (median 1.78 [IQR, 1.02-3.41] vs. 1.12 [IQR, 0.62-2.04]; p = 0.031). In the multivariate logistic regression model, log-transformed SIRI remained independently associated with infection (adjusted OR 1.93; 95% CI 1.02-3.67; p = 0.044). Preoperative SIRI demonstrated moderate discriminatory ability for early SSI, with an AUC of 0.66 (95% CI, 0.54-0.77; p = 0.03). The optimal cutoff value of 1.29 yielded a sensitivity of 63.0% and a specificity of 68.3%. Preoperative SIRI is independently associated with early postoperative SSI following instrumented lumbar spine surgery for degenerative pathology. Although its discriminatory performance is moderate, SIRI represents a simple, inexpensive, and readily available adjunctive marker for preoperative risk stratification, particularly useful for identifying patients at low risk of postoperative infection.
Non-small cell lung cancer (NSCLC) is increasingly diagnosed at early stages, yet intraoperative localization of small and subsolid lesions remains challenging. Intraoperative molecular imaging (IMI) using tumor-targeted tracers is effective in many cancers; however, no available optical agents are specific for precursor or early-stage NSCLC. Sodium-glucose cotransporter 2 (SGLT2) is upregulated in in situ and minimally invasive lung cancers. This study aimed to develop and validate GlucoGlo, a novel SGLT2-targeted near-infrared (NIR) contrast agent, for IMI in early-stage NSCLC. GlucoGlo, an SGLT2-targeted fluorescent tracer, was developed and assessed for specificity and efficacy in targeting and detecting NSCLC. Its SGLT2-specific binding was assessed by fluorescence imaging in in vitro and in vivo murine NSCLC models. Mice pretreated with an SGLT2 inhibitor were used to confirm on target binding. GlucoGlo's performance in detecting residual tumor after resection was compared to conventional visualization and palpation. GlucoGlo selectively bound SGLT2-expressing NSCLC cell lines in vitro with minimal fluorescent signal seen in negative controls. In vivo, it accumulated in flank xenografts at clinically relevant doses (peak signal to background ratio (SBR) of 6.85 at 48 h) without toxicity. Fluorescent signal was eliminated with pretreatment with a non-fluorescent SGLT2 inhibitor, confirming target specificity. Histopathologic analysis further confirmed the selective tumor accumulation. In a murine partial-resection model, GlucoGlo exhibited significantly greater sensitivity for detecting residual tumor compared to conventional visualization and palpation in resection models (100% vs. 62.5%; p < 0.01). In ex-vivo human lung tissue, GlucoGlo accurately identified pulmonary malignancy and had significantly greater mean fluorescence in tumor areas compared to normal lung (25,218 vs. 3,371 a.u., respectively, SBR: 7.57; p = 0.009). GlucoGlo demonstrated high sensitivity and specificity for SGLT2 in preclinical models of NSCLC, supporting its potential for clinical translation in intraoperative detection of ground glass opacities and early-stage lung cancer.
To determine whether prompt genetic diagnosis in children with KCNQ2 neonatal epilepsy enabling targeted therapy is associated with improved outcomes, and identify early predictors of developmental outcomes. Thirty-seven children with KCNQ2 neonatal epilepsy were recruited from five pediatric centers. We reviewed demographic, clinical, EEG, and genetic data. We determined differences in outcomes between individuals with prompt (greater than 30 days from seizure onset) and later genetic diagnosis, and we identified neonatal factors associated with developmental outcome. Baseline characteristics were similar between children with prompt (n = 6, median age at genetic diagnosis 15 days) and later (n = 31, median age 309 days, p < .05) diagnosis. All with prompt diagnosis received sodium channel blocking (SCB) anti-seizure medication (ASM) in the neonatal period compared with 15/31 (48%) in the later diagnosis group. Children with prompt diagnosis had higher rates of seizure freedom at age 12 months than those with later diagnosis (6/6 [100%] vs. 17/31 [54%]; p .049], and lower number of emergency department representations (median 0 vs. 2), and hospital readmissions (median 0 vs. 1). Factors in the neonatal period associated with abnormal developmental outcome included neurological abnormalities (e.g., abnormal tone) and markedly abnormal neonatal EEG background (11/11 [100%] with markedly abnormal EEG vs. 11/24 [46%] with normal to moderately abnormal EEG). Prompt genetic diagnosis was associated with targeted therapy, resulting in improved seizure control and reduced hospital representation. Clinical features present in the neonate assist in predicting outcome severity, which is critically important in counselling families receiving a KCNQ2 diagnosis soon after seizure onset. In KCNQ2 neonatal epilepsy, sodium channel blocking antiseizure medicines are recommended, but the benefits of starting treatment early have been uncertain. Our findings show that prompt genetic diagnosis enabled early targeted treatment, with potential to improve outcomes. Specifically, prompt genetic diagnosis was associated with improved seizure control and reduced hospital visits compared with delayed diagnosis. However, a prospective, long-term study is needed to determine whether early treatment also improves developmental outcomes. Predicting outcome severity in newborns remains challenging, although abnormal neurological examination and markedly abnormal EEG in the newborn period were linked to abnormal developmental outcomes.
Early neurological deterioration due to ischemic progression (ENDi) remains a poorly understood complication in acute ischemic stroke (AIS). We aim to uncover exosomal protein signatures for ENDi risk prediction and potential targets for intervention. From 110 prospectively enrolled AIS patients undergoing thrombolysis, we selected 3 ENDi and 5 age- and sex-matched early neurological improvement (ENI) patients. Plasma exosomes isolated before and 24 h post-thrombolysis were subjected to 4D-DIA proteomics, followed by Gene Set Enrichment Analysis (GSEA) and cellular origin analyses. Baseline differentially expressed proteins (DEPs) were further analyzed via functional enrichment and protein-protein interaction networks to identify candidate biomarkers and validated by ELISA in an independent cohort. We identified 1,238 exosomal proteins, among which 69 DEPs at baseline distinguished the ENDi from ENI patients. Cellular origin analysis revealed a post-thrombolytic reduction in monocyte-derived exosomal proteins in the ENDi group, while the ENI group showed upregulation of naive B cell-derived exosomal proteins. Regarding biological processes, ENDi after thrombolysis was characterized by activation of the coagulation and neuroinflammation pathways, along with suppression of the complement pathway and humoral immunity. From thrombo-inflammatory-related DEPs, we identified C-C motif chemokine 5 (CCL5) as a promising biomarker, and independent validation confirmed that elevated baseline plasma exosomal CCL5 was correlated with ENDi. In conclusion, our study highlights the role of exosomal proteins in immunothrombosis and establishes CCL5 as a potential predictor for ENDi. Importantly, we propose a novel mechanism involving immunoglobulin- and complement-related humoral immune suppression in the pathogenesis of ENDi, offering new directions for therapeutic intervention.
Covert hepatic encephalopathy (CHE) is a frequent and clinically relevant complication of liver cirrhosis, affecting approximately 30-70% of patients. Despite the absence of overt neurological symptoms, CHE is associated with impaired quality of life and increased risks of falls, traffic accidents, hospitalization, progression to overt HE (OHE), and mortality. The pathophysiology of HE, including CHE and OHE, is multifactorial and involves complex interactions among hyperammonemia, systemic inflammation, oxidative stress, gut dysbiosis, bile acid dysregulation, and sarcopenia along the gut-liver-brain axis. Several diagnostic tools are available, including psychometric batteries, computerized neuropsychological assessments, the Stroop test, critical flicker frequency, and the inhibitory control test. However, time and resource constraints hinder their routine implementation in real-world clinical settings, leading to substantial underdiagnosis of CHE. Although treatment strategies for CHE have not yet been fully established, non-absorbable disaccharides and rifaximin have emerged as promising ammonia-lowering therapies and microbiota-targeted interventions for improving cognitive function and reducing the risk of progression to overt HE. Early recognition and multidisciplinary intervention for CHE are essential to prevent disease progression and improve clinical outcomes. This review summarizes the current evidence on the epidemiology, pathophysiology, diagnosis, clinical significance, and therapeutic approaches for CHE in cirrhosis, with the aim of enhancing its recognition and optimizing patient management.
This study aimed to assess EI referral and enrollment rates among substance-exposed newborns (SENs) with and without a diagnosis of NAS in MA and to compare rates to infants and toddlers without known substance exposure. We analyzed the 2013-2020 Pregnancy to Early Life Longitudinal dataset, which includes maternal-infant birth hospitalization records linked with EI data. SEN and NAS were identified using ICD-9/10 codes. We conducted descriptive statistics and bivariate analysis to compare EI referral and enrollment between (1) SENs with and without NAS diagnoses and (2) SENs and the unexposed population. Among 6565 SENs, 85.3% (n = 5602) were referred to EI, and of those referred, 49.5% (n = 2775) enrolled. Compared with SENs without an NAS diagnosis, SENs with an NAS diagnosis were more likely to be referred to (87.6%, n = 4242 vs 79.0%, n = 1360) and enroll in (53.2%, n = 2255 vs 38.2%, n = 520) EI. Among infants and toddlers without identified substance exposure, referral rates were lower (34.6%), but enrollment rates were higher among those referred (56.7%). Substance-exposed newborns in MA had relatively high rates of EI referral but lower rates of enrollment compared with the general population, particularly among SENs without a diagnosis of NAS, suggesting a referral-to-enrollment gap.
Whether early-onset (EO-NEC) and late-onset necrotizing enterocolitis (LO-NEC) represent distinct entities remains debated. We compared clinical presentation, radiologic features, and surgical outcomes. In this retrospective study (2013-2023), neonates with Bell stage II-III NEC were stratified into EO-NEC (< 14 days) and LO-NEC (≥ 14 days). Fifty-seven infants were included: 37 (64.9%) EO-NEC and 20 (35.1%) LO-NEC. EO-NEC was associated with higher birth weight (1611 ± 767 vs. 1111 ± 377 g; p = 0.0017) and gestational age (31.4 ± 4.5 vs. 29.3 ± 2.7 weeks; p = 0.033). LO-NEC occurred more frequently in very-low-birth-weight infants (55% vs. 8%; p < 0.001) and showed higher rates of portal venous gas (70% vs. 30%; p = 0.005) and indomethacin-treated PDA (25% vs. 2.7%; p = 0.031). Intestinal perforation occurred exclusively in EO-NEC (27%; p = 0.01). Surgical intervention rates, intestinal resection lengths, and mortality were comparable. EO-NEC and LO-NEC differ in infant maturity and perinatal exposures but not in overall severity or mortality.
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BackgroundPrevious work has shown that proper name recall from the Logical Memory (LM) task is sensitive to PET and cerebrospinal fluid biomarkers of Alzheimer's disease (AD) in older adult populations. These findings indicate potential utility in identifying preclinical AD.ObjectiveThe purpose of this study is to validate previous findings of the association of proper name recall and blood-based plasma pTau217.MethodsParticipants came from the Wisconsin Registry for Alzheimer's Prevention study. We fit linear mixed effects models of longitudinal LM and proper name recall as a function of most recent pTau217 values. Follow-up analyses added interaction terms to models for group differences in sex and APOE ε4 allele carriage. As an exploratory aim, logistic regression models were used to examine if proper name recall aided in predicting clinical diagnosis.ResultsParticipants with higher concentrations of pTau217 showed a steeper decline on both conventional LM and proper name recall. APOE ε4 allele carriers with higher concentrations of pTau217 showed a greater decline in longitudinal task performance, while there was no significant interaction for sex, indicating that men and women with high pTau217 show similar rates of decline.ConclusionsOur findings validate that proper name recall is sensitive to blood-based pTau217. Measuring proper name recall may be an efficient marker assessing early cognitive change that could be leveraged when designing future cognitive tests.
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This cohort study examines the rates, causes, and implications of the death of fathers of children 5 years or younger in the state of Georgia from 2017 to 2022.
This case series describes the presymptomatic treatment of infants with mucopolysaccharidoses detected by newborn screening using enzyme replacement therapy and reduced-intensity conditioning cord blood transplant, combined with intracerebroventricular enzyme replacement therapy.
Understanding early predictors of independent performance of daily living skills (DLS) in adolescents with autism can guide targeted interventions to promote independence and improve outcomes. To compare DLS performance among adolescents with autism, other developmental disabilities (DD), and the general population (POP), and identify early childhood predictors of independently performed DLS acquired by adolescence. This longitudinal study collected data from caregivers of adolescents 12 to 16 years old (2018-2021) with a mean follow-up of 9.7 (range, 7-12) years. The study took place at 4 US sites that surveyed caregivers of adolescents from the Study to Explore Early Development (SEED). Participants included caregivers of adolescents who participated in SEED at ages 2 to 5 years. Analyses were conducted June to August 2025. Adolescents who met diagnostic criteria for autism at ages 2 to 5 years. The primary outcome was independent DLS in adolescence measured with the Waisman Activities of Daily Living scale. Other measures included early learning abilities, social symptoms, emotional functioning, and intellectual disability (ID) in adolescence. Model-based recursive partitioning identified early childhood predictors of independent DLS acquired by adolescence. The analytic sample included 852 caregivers of adolescents (median age, 14.7 years; 533 male [63%] and 319 female [37%]): 204 with autism, 341 with other DD, and 307 in the POP group. Adolescents with autism had lower Waisman Activities of Daily Living Scale scores (median [IQR], 24.5 [17-29]) compared with the DD (30 [IQR, 26-33]) and POP groups (32 [IQR, 30-33]) (P < .001). Compared with the DD and POP groups, adolescents with autism performed fewer DLS independently with frequency decreasing as skill complexity increased. Among adolescents with autism or other DD, those with lower expressive language and fine motor skills in early childhood acquired the fewest number of independent DLS, while those with stronger expressive language, without ID, and with fewer attention problems in early childhood acquired the greatest number of independent DLS. In this study, DLS were lower in adolescents with autism compared with adolescents without autism. Early expressive language, fine motor skills, and attention problems predicted wide variation in the independent DLS acquired by adolescents with autism and other DD. These findings highlight potential early prognostic indicators that may help prioritize early support to improve DLS acquisition and promote greater independence.
Transitional Kindergarten (TK) is a relatively new and under-researched model of early childhood education. Using data from Michigan TK, this study examines impacts for children (50% female, 78% White, 9% Black, 7% Hispanic) who enrolled at age 4 in 2014-2015 and 2018-2019 using a regression discontinuity design. Michigan TK improved kindergarten readiness (0.9 SD, N = 1,943) and third-grade math scores (0.2-0.3 SD, N = 15,680). It had no impact on ever being placed in special education from kindergarten through second grade, but it did cause earlier entry into special education in kindergarten (N = 15,704). Our findings add to the larger evidence base on early education programs and contribute substantially to the evidence base on TK specifically. Transitional Kindergarten (TK) is a relatively new and under-researched model of early childhood education. This study examines how enrolling in TK at age 4 affects children's early educational outcomes. We use statewide education data from Michigan public schools and focus on children who were 4 years old in the 2014–15 and 2018–19 school years. We find that TK enrollment boosted children's performance on kindergarten readiness assessments and, years later, on third-grade math exams. It had no impact on ever being placed in special education between kindergarten and second grade, though it did cause earlier entry into special education in kindergarten. These findings add to the larger evidence base on early education programs and contribute substantially to the evidence base on TK specifically.
Cancer therapy-related cardiac dysfunction (CTRCD) represents a major cause of morbidity among cancer survivors, even in the absence of overt left ventricular (LV) systolic impairment. Current cardio-oncology surveillance strategies predominantly focus on LV ejection fraction and global longitudinal strain, potentially overlooking early alterations in diastolic function and atrial remodeling. The atria, particularly the left atrium, play a pivotal role in modulating ventricular filling pressures and serve as sensitive integrators of cumulative hemodynamic stress. Increasing evidence supports the prognostic value of left atrial volume index and left atrial strain for the early detection of subclinical cardiotoxicity, refinement of diastolic function assessment, and prediction of heart failure and atrial arrhythmias. Moreover, emerging data suggest that right atrial size and mechanics may provide additional insights into right heart involvement during immunotherapy and thoracic radiotherapy, although evidence remains limited. This narrative review summarizes current evidence on atrial volumetric and functional assessment in cardio-oncology, with a particular focus on strain imaging, diastolic function, and novel indices such as left atrial stiffness and mechanical dispersion. We highlight methodological challenges, gaps in standardization, and future directions, including artificial intelligence-assisted imaging and multimodal risk stratification. Integrating atrial imaging into routine cardio-oncology practice may improve early detection of CTRCD, enhance prognostic stratification, and support personalized surveillance strategies in cancer patients exposed to cardiotoxic therapies.
Pelvic fractures are classified as stable or unstable. They correlate with a severity of trauma and the initial medical treatment is decisive. This study evaluated the transferrals of such fractures and described the initial treatment as well as the clinical course. We analysed retrospective data from a large cohort of the TraumaRegister DGU® (TR-DGU), covering the period from 2014 to 2023, comprising a total of n = 397,910 patients. All patients aged ≥ 16 years were included. Injury patterns were described according to the Abbreviated Injury Scale (AIS), the mechanically unstable fractures were classified with an AIS ≥ 3. We considered all participating hospitals within Germany. The patients were subdivided in three groups: Group 1 = primary admitted patients with outcome, group 2 = pre-treated patients transferred in from other hospitals, and group 3 = primary admitted and early (< 48 h) transferred out. The majority of the patients was male and about 53 years old. Blunt trauma was the leading trauma mechanism. Concomitant injuries (AIS 2+) affected thorax (56%), spinal cord (41%), lower extremities (38%), head (31%) and abdomen (24%). Among primary admitted cases with pelvic fractures (n = 36,398), 21,091 cases (57.9%) had an unstable pelvic fracture (AIS pelvis 3-5). Level 1 trauma centers not only treated 12,836 primary admitted cases with unstable pelvic fractures (83.5%) but also received 2,365 patients (15.4%) from other hospitals via transfer; while only 1% of cases were transferred out early (n = 170). Transfusion was administered in 5,984 patients (16.5%) (AIS 2-5). A pelvic binder was applied in 7,096 (36.3%) patients and surgical stabilisation was performed in 4,075 (14.9%) patients. The length of stay on intensive care unit was highest in AIS 5 with 6 days. The mortality rate was 38.5% in AIS 5, and 9.9% in AIS 2. Over the course of the last 10 years, the prevalence of unstable pelvic ring fractures (AIS 3-5) constantly remained around 9%. Unstable pelvic fractures were increasingly transferred to a Level I trauma center. Unstable pelvic fractures correlated with a high Injury Severity Score (ISS). The early treatment involved the transfusion of packed red blood cells, the application of a pelvic binder and the surgical stabilisation. Though, these tools were increasingly utilized with the severity of trauma.
Premenopausal patients with node-positive, hormone receptor-positive, early breast cancer derive benefit from extended endocrine therapy (EET) following 5 years of luteinizing hormone-releasing hormone (LHRH) agonist-based treatment. The benefit of EET may differ according to surrogate breast cancer subtypes in postmenopausal patients. To evaluate the risk of invasive and distant recurrence across all surrogate breast cancer subtypes among patients with node-positive, hormone receptor-positive early breast cancer who remained premenopausal after completing 5 years of adjuvant therapy with an LHRH agonist who received and did not receive EET. This multicenter cohort study conducted in the United States and Italy used data from 2 prospectively maintained datasets: the Young Women's Breast Cancer Study and the European Institute of Oncology Breast Cancer cohort. Eligible patients were diagnosed with early breast cancer at 40 years of age or younger between January 2005 and December 2016, had node-positive hormone receptor-positive disease, and remained premenopausal after 5 years of adjuvant LHRH agonist therapy with no evidence of recurrence. Median (IQR) follow-up was 7.3 (4.9-10.3) years. Data were analyzed June 2025. EET (with tamoxifen monotherapy, LHRH agonist plus tamoxifen, or LHRH agonist plus aromatase inhibitor), irrespective of the duration of EET, measured at study baseline (defined as the first day of the sixth year after the initiation of adjuvant ET). Invasive breast cancer-free survival and distant recurrence-free survival (DRFS) distributions were estimated using the adjusted Kaplan-Meier method among patients with or without the exposure, weighted through propensity score (PS) weighting analysis, with the scientific approach. In total, 487 patients were included (median [IQR] age at diagnosis, 37 [35-39] years in the EET group and 37 [33-39] years in the no EET group), and 276 received EET for a median (IQR) duration of 3.7 (2.2-5.0) years. Overall, 89 patients (18%) had luminal A-like disease, 298 (61%) had luminal B-like disease, and 100 (21%) had ERBB2 (formerly HER2)-positive disease. The PS-weighted hazard ratio (HR) for invasive breast cancer-free survival comparing the EET with the no EET group was 0.68 (95% CI, 0.32-1.45) in luminal A-like, 0.63 (95% CI, 0.40-1.00) in luminal B-like/ERBB2-negative, and 0.62 (95% CI, 0.21-1.87) in ERBB2-positive subgroups. The cause-specific PS-weighted HR for DRFS was 0.25 (95% CI, 0.08-0.75) in luminal A-like, 0.54 (95% CI, 0.32-0.94) in luminal B-like/ERBB2-negative, and 0.54 (95% CI, 0.12-2.53) in ERBB2-positive subgroups. In this cohort study, a lower estimated risk with EET use was observed across all surrogate breast cancer subtypes. However, the lower estimated risk was greatest among patients with luminal A-like disease, a finding that warrants confirmation in larger, prospective cohorts.
Acute kidney injury (AKI) is a life-threatening condition whose early diagnosis is crucial. The most used method to evaluate renal function is the glomerular filtration rate (eGFR). The detection of new circulating molecules has gained traction for the early identification of kidney damage. In this prospective observational study, 57 patients with acute kidney disease and 23 patients without acute renal damage were consecutively enrolled; urinary concentrations of NGAL, LFABP, CYR61, TIMP-2, IGFBP-7, and [TIMP-2 X IGFBP-7], and serum concentrations of PENK and KIM-1 were obtained in all patients. The primary endpoint was to assess the role of serum and urinary markers in distinguishing prerenal from renal pathogenesis of AKI. The secondary endpoint was to evaluate the possible association between urinary and serum concentrations of these markers and the severity of acute kidney injury. Urinary TIMP-2, NGAL, and IGFBP-7 concentrations were higher in patients with AKI compared with the control group, with statistical significance. Among patients with AKI, we found higher concentrations of LFABP, Cyr61, TIMP-2, NGAL, IGFBP-7, and [TIMP-2]x[IGFBP-7] according to AKI aetiology, with statistical significance maintained in multivariable logistic regression for IGFBP-7. The ROC curve confirmed that IGFBP-7 has a predictive role in the aetiological diagnosis of AKI. A significant association between urinary LFABP and TIMP-2 and serum KIM-1 concentrations (p = 0.0001) and the variation in creatinine values from baseline to enrollment was found. Furthermore, we found a statistically significant correlation between KIM-1 and the variation in creatinine levels from admission to discharge. This study highlights an association between the concentrations of the novel biomarkers and the aetiology of AKI, with a possible role for these molecules in stratifying patients with acute renal disease.
This scoping review aims to map prospective evidence on the vascular effects of major smoking cessation therapies, including pharmacotherapy, nicotine replacement therapy and exclusive switching to electronic cigarettes, in adult smokers. A comprehensive search of PubMed, Scopus and Web of Science was conducted on December 2, 2025. Eligible studies included randomized controlled trials, quasi-experimental designs and prospective cohort studies reporting quantitative or narrative findings on vascular function following smoking cessation or exclusive electronic cigarette use. Only studies with at least 1 week of follow-up and resting vascular measurements were included. Data were charted using a standardized extraction template and synthesized narratively, consistent with scoping review methodology. Twenty-two prospective studies met the inclusion criteria. Pharmacotherapy-assisted cessation, nicotine replacement therapy and exclusive switching to electronic cigarettes were all associated with improvements in vascular outcomes among participants who fully abstained from combustible cigarettes. Increases in flow-mediated dilation were observed across treatment categories, with several studies reporting measurable gains within the first 3 to 12 months. Reductions in pulse-wave velocity and augmentation index also emerged in most cohorts, although effect sizes varied according to study design, follow-up duration and population characteristics. Evidence from studies on exclusive electronic cigarette use, although limited in number, showed improvements in endothelial function and arterial stiffness comparable to those observed with conventional cessation therapies. Prospective evidence indicates that multiple smoking cessation therapies, including exclusive switching to electronic cigarettes, may be associated with early improvements in vascular function when combustible cigarette exposure is fully eliminated. The evidence base remains constrained by heterogeneity, small sample sizes and short follow-up, particularly within studies on electronic cigarette switching. Larger and long-term prospective studies are needed to clarify the durability and clinical implications of these early vascular changes.