Anti-Müllerian hormone serum levels in systemic lupus erythematosus patients: Influence of the disease severity and therapy on the ovarian reserve

Abstract

Purpose

Systemic lupus erythematosus (SLE) mainly affects childbearing age women and pharmacological treatments may negatively influence the ovarian reserve. Anti-Müllerian hormone (AMH) could be a good biomarker for ovarian reserve.

Methods

AMH serum levels were assessed in 86 consecutive SLE female patients with regular menstrual cycle compared with 44 aged matched healthy controls. Clinical and demographic characteristics, disease duration, pattern of organ involvement, and previous and current therapies were recorded.

Results

AMH levels were comparable between patients and controls (4.2 ± 3.1 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.21). According to disease severity, AMH levels were lower in SLE patients with major organ involvement than in controls (3.8 ± 2.7 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.08); no difference was found between SLE patients with mild organ involvement (4.5 ± 3.4 ng/ml) and controls (p = 0.43). Grouping patients based on the pharmacological treatments, AMH serum levels did not differ among SLE patients treated with antimalarials only (4.7 ± 3.3 ng/ml), conventional disease-modifying antirheumatic drugs (cDMARDs) only (4.8 ± 3.2 ng/ml), cDMARDs and antimalarials (3.9 ± 2.9 ng/ml) or cyclophosphamide (CYC) only (4.9 ± 3.9 ng/ml), compared to controls, but patients sequentially treated with cDMARDs and CYC, had significantly lower AMH serum levels than controls (p = 0.01).

Conclusions

SLE patients showed comparable AMH levels than controls, however, a reduction of the ovarian reserve was associated with sequentially therapy with CYC and cDMARDs and with the disease severity. AMH could be a sensitive and specific biomarker of ovarian reserve in SLE and it could be useful for therapeutic strategy and family planning.

https://ift.tt/2AbfTwV

Anti-Müllerian hormone serum levels in systemic lupus erythematosus patients: Influence of the disease severity and therapy on the ovarian reserve

Abstract

Purpose

Systemic lupus erythematosus (SLE) mainly affects childbearing age women and pharmacological treatments may negatively influence the ovarian reserve. Anti-Müllerian hormone (AMH) could be a good biomarker for ovarian reserve.

Methods

AMH serum levels were assessed in 86 consecutive SLE female patients with regular menstrual cycle compared with 44 aged matched healthy controls. Clinical and demographic characteristics, disease duration, pattern of organ involvement, and previous and current therapies were recorded.

Results

AMH levels were comparable between patients and controls (4.2 ± 3.1 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.21). According to disease severity, AMH levels were lower in SLE patients with major organ involvement than in controls (3.8 ± 2.7 ng/ml vs. 5.0 ± 3.1 ng/ml, p = 0.08); no difference was found between SLE patients with mild organ involvement (4.5 ± 3.4 ng/ml) and controls (p = 0.43). Grouping patients based on the pharmacological treatments, AMH serum levels did not differ among SLE patients treated with antimalarials only (4.7 ± 3.3 ng/ml), conventional disease-modifying antirheumatic drugs (cDMARDs) only (4.8 ± 3.2 ng/ml), cDMARDs and antimalarials (3.9 ± 2.9 ng/ml) or cyclophosphamide (CYC) only (4.9 ± 3.9 ng/ml), compared to controls, but patients sequentially treated with cDMARDs and CYC, had significantly lower AMH serum levels than controls (p = 0.01).

Conclusions

SLE patients showed comparable AMH levels than controls, however, a reduction of the ovarian reserve was associated with sequentially therapy with CYC and cDMARDs and with the disease severity. AMH could be a sensitive and specific biomarker of ovarian reserve in SLE and it could be useful for therapeutic strategy and family planning.

https://ift.tt/2AbfTwV

Maternal estradiol and progesterone concentrations among singleton spontaneous pregnancies during the first trimester

Abstract

Background

Pregnancy hormonal milieu represents a crucial determinant of fetal outcome. We aim to determine 17β-estradiol (E₂) and progesterone (PGT) concentrations in spontaneous pregnancies during the first trimester. In addition, we aim to determine E₂ concentrations as a function of gestational age (GA) and PGT.

Methods

Between November 2015 and March 2017, 104 healthy women of at least 18 years undergoing medical consultation for voluntary interruption of pregnancy were enrolled in an observational study at University Hospital ASST Fatebenefratelli Sacco, Milan, Italy. Only singleton pregnancies between 5⁺⁰ and 13⁺⁶ weeks of gestation were eligible. First trimester ultrasound scans were performed for dating and one fasting venous blood sample was collected for E₂ and PGT determinations.

Results

E₂ and PGT concentrations steadily increased according to GA. The correlation between E₂ on a logarithmic scale and PGT concentrations was expressed by the following equation, explaining 12.6% of E₂ variance: logE₂ = 2.57 + 0.1 × PGT, (r = 0.34, p < 0.001). By performing a multivariable linear regression analysis adjusted for variables significantly correlated with E₂ concentrations, we obtained a model explaining the 53.5% of E₂ variance. The final equation to determine E₂ concentrations among Caucasian women was: logE₂ = 1.96 + 0.01 × GA + 0.004 × PGT.

Conclusions

Gestational week-specific reference intervals are reported for maternal E₂ and PGT concentrations during early pregnancy, further providing a model for E₂ assessment in this period. This will represent a starting point for further evaluations between twin and ART pregnancies, as well as to potentially improve pregnancy outcome and future health of the offspring.

https://ift.tt/2yityAK

Comparison of diagnostic effects of infrared imaging and bitewing radiography in proximal caries of permanent teeth

Abstract

This study aimed to compare the diagnostic efficacy of VistaCam iX intraoral camera system using infrared light and bitewing radiography for detection of proximal caries in permanent teeth. This in vitro study was performed on 108 teeth. The proximal surfaces of the teeth were examined for caries using ICDAS II criteria, bitewing radiography, and the Proxi head of VistaCam iX. The teeth were then sectioned and histologically analyzed (gold standard). Data were analyzed using SPSS version 25 via the correlation test at P < 0.05 level of significance. The overall and segmental sensitivity and specificity values were calculated for (1) the contact area and higher regions, (2) below the contact area to the cementoenamel junction (CEJ), and (3) below the CEJ. Radiography had the highest specificity. VistaCam had the highest overall and segmental sensitivity for enamel caries. Radiography had the highest segmental sensitivity for dentin. In region 1, VistaCam had the highest sensitivity and lowest specificity, and radiography and ICDAS II had the highest specificity and lowest sensitivity. In region 2, radiography showed the highest sensitivity and specificity. VistaCam had the lowest sensitivity and ICDAS II had the lowest specificity in this region. In region 3, VistaCam did not detect any caries and radiography had a better performance than ICDAS II. The specificity value was equal for both methods. VistaCam had the highest diagnostic efficacy among the three methods for caries in region 1; however, bitewing radiography had a superior efficacy in regions 2 and 3.

https://ift.tt/2AatPXT

Systematic analysis of parameters predicting pathological axillary status (ypN0 vs. ypN+) in patients with breast cancer converting from cN+ to ycN0 through primary systemic therapy (PST)

Abstract

Optimization of axillary staging among patients converting from clinically node-positive disease to clinically node-negative disease through primary systemic therapy is needed. We aimed at developing a nomogram predicting the probability of positive axillary status after chemotherapy based on clinical/pathological parameters. Patients from study arm C of the SENTINA trial were included. Univariable/multivariable analyses were performed for 13 clinical/pathological parameters to predict a positive pathological axillary status after chemotherapy using logistic regression models. Odds ratios and 95%-confidence-intervals were reported. Model performance was assessed by leave-one-out cross-validation. Calculations were performed using the SAS Software (Version 9.4, SAS Institute Inc., Cary, NC, USA). 369 of 553 patients in Arm C were included in multivariable analysis. Stepwise backward variable selection based on a multivariable analysis resulted in a model including estrogen receptor (ER) status (odds ratio (OR) 3.916, 95% confidence interval (CI) 2.318–6.615, p < 0.001), multifocality (OR 2.106, 95% CI 1.203–3.689, p = 0.0092), lymphovascular invasion (OR 9.196, 95% CI 4.734–17.864, p < 0.001), and sonographic tumor diameter after PST (OR 1.034, 95% CI 1.010–1.059, p = 0.0051). When validated, our model demonstrated an accuracy of 70.2% using 0.5 as cut-point. An area under the curve of 0.81 was calculated. The use of individual parameters as predictors of lymph node status after chemotherapy resulted in an inferior accuracy. Our model was able to predict the probability of a positive axillary nodal status with a high accuracy. The use of individual parameters showed reduced predictive performance. Overall, tumor biology was the strongest parameter in our models.

https://ift.tt/2pRggGO

Monitoring treatment response in patients affected by actinic keratosis: dermoscopic assessment and metalloproteinases evaluation after piroxicam 0.8% and sunfilter cream

Dermatologic Therapy, Volume 0, Issue ja, -Not available-.


https://ift.tt/2OqCVJ2

Pretarsal roll augmentation with dermal hyaluronic acid filler injection

Abstract

Pretarsal roll augmentation with dermal hyaluronic acid filler injection focuses on restoring pretarsal fullness. This study aimed to introduce a method of pretarsal roll augmentation with dermal hyaluronic acid filler injection and establish the level of difficulty, safety, and effectiveness of this method. Eighty female patients were enrolled in this study. Hyaluronic acid filler was used to perform pretarsal roll augmentation. Physician and patient satisfaction at 1 month and 4 months after surgery was investigated. The level of satisfaction was graded from points 1 to 5. The patient satisfaction and physician scores were 4.7 ± 1.1 (mean ± standard deviation) points at 1 month and 4.8 ± 0.9 points at 4 months and 4.6 ± 0.9 points at 1 month and 4.8 ± 1.0 points at 4 months, respectively. No major complications were observed. Our technique provided a natural and younger appearance with pretarsal fullness. This technique was easy to perform for the restoration of pretarsal fullness, and it improved periorbital contouring, rejuvenated the pretarsal roll, and provided excellent esthetic results.

Level of Evidence: Level V, therapeutic study.

https://ift.tt/2RVeUIa

Response to Critical appraisal of LIBERTY AD CHRONOS: reply from authors

British Journal of Dermatology, EarlyView.


https://ift.tt/2IXQCcn

Response to critical appraisal of LIBERTY AD CHRONOS

British Journal of Dermatology, EarlyView.


https://ift.tt/2OnCzCS

Shared Decision Making in Psoriasis: A Systematic Review of Quantitative and Qualitative Studies

Abstract

Background

Patients with psoriasis face numerous treatment and self-management decisions. Shared decision making is a novel approach where patients' preferences and values are considered in cooperation with healthcare professionals before making treatment decisions.

Objective

The objective of this systematic review was to explore what is illuminated in psoriasis research regarding shared decision making, and to estimate the effects of shared decision-making interventions in this context.

Methods

Qualitative, quantitative, and mixed-methods studies were eligible for inclusion. We searched six electronic databases up to January 2018. Two reviewers independently applied inclusion and quality criteria. The SPIDER framework was used to identify eligibility criteria for study inclusion. Narrative and thematic syntheses were utilized to identify prominent themes emerging from the data.

Results

A total of 23 studies were included in the review. Of these, we included 18 studies (19 papers) to describe what was illuminated with regard to shared decision making in psoriasis research. Four major themes emerged: interpersonal communication; exchange of competence and knowledge; different world view; and involvement and preference, organized under two analytical themes; "Co-creation of decisions" and "Organization of treatment and treatment needs". For shared decision-making effects, we included four controlled studies. These varied in scope and interventional length and showed limited use of shared decision making-specific outcome measures, reflecting the early stage of the literature. Because of study heterogeneity, a meta-synthesis was not justified.

Conclusions

There appears to be a need to strengthen the relationship between medical doctors and patients with psoriasis. The evident lack of knowledge about each other's competence and the lack of self-efficacy for both patients and providers challenges the basic principles of shared decision making. The effects of shared decision making in psoriasis are inconclusive, and more research appears necessary to determine the possible benefits of shared decision-making interventions.

https://ift.tt/2IWfP74

Jellyfish‐like sonographic pattern can help recognition of dermatofibrosarcoma protuberans. Report of 3 new cases and review of the literature

Australasian Journal of Dermatology, EarlyView.


https://ift.tt/2yhGRlh

A non-interventional multicenter study to document the implants success and survival rates in daily dental practices of the CONELOG screw-line implant

Abstract

Objective

This multicenter prospective non-interventional study evaluated the success and survival of the CONELOG implants inserted according to the standard protocol with one- or two-step surgery in daily practice three years after loading. Changes of soft tissue and bone level over time, esthetical outcome, and patient satisfaction were assessed.

Materials and methods

The study included patients in six centers. The implants were used in accordance with standard practice of each particular center, and the use was documented systematically. Failure rate, implant success, bone level changes, different clinical parameters, and patients' satisfaction were assessed.

Results

In total, 130 dental implants were placed in 94 patients (64 female, 30 male). Mean age of patients was 50.4 ± 13.7. At 3-year post-loading, 108 implants in 78 patients were available for evaluation. Success and survival rate were 98.4% after placement and 100% 36 months post-loading. Bone loss from surgery to loading was 0.52 ± 0.55 mm. From loading to 36 months post-loading, the bone level change remained stable. Patient assessments were performed for function, ability to chew, speech, esthetics, and general satisfaction. Patients were very satisfied (82.3%) or satisfied (16.1%). None of the patients was dissatisfied.

Conclusion

The 3-year results of this non-interventional multicenter study indicate that the CONELOG implants are reliable and effective over the course of the observation while used in standard conditions of daily environment and confirm the results obtained in controlled clinical trials.

Clinical relevance

Performance of CONELOG implants under daily routine is similar to controlled clinical trials.

https://ift.tt/2J0j7q0

The case for a national survey of eating disorders in Australia

Abstract

In this Commentary we outline the case for a national survey of eating disorders in Australia. Given the recent focus of the federal government to provide further funding for mental health research, we call for a national survey to be made a key priority. Such high-quality, nationally representative data are critically important to informing all other domains of eating disorders research in the Australian context, and to informing the research agenda internationally.

https://ift.tt/2AaI9Qc

Editorial Board

Publication date: November 2018

Source: Journal of Autoimmunity, Volume 94

Author(s):

https://ift.tt/2AbhbIp

White blood cell mitochondrial DNA copy number is decreased in rheumatoid arthritis and linked with risk factors. A twin study

Publication date: Available online 14 October 2018

Source: Journal of Autoimmunity

Author(s): Anders J. Svendsen, Qihua Tan, Marianne A. Jakobsen, Bharat Thyagarajan, Marianne Nygaard, Lene Christiansen, Jonas Mengel-From

Abstract

Low mitochondrial DNA copy number (mtDNA CN) has been associated with e.g. cancer, cardiovascular and autoimmune diseases. We aimed to study a potential association between mtDNA CN and rheumatoid arthritis (RA).

The relative quantity of mitochondrial DNA compared to nuclear DNA was measured in peripheral white blood cells from 149 RA affected twin pairs and 1321 non-affected twin pairs. Multiple regression analysis including RA discordant twin pairs was performed in order to separate specific effects of RA and familial RA predisposition using non-RA affected twin pairs as reference group. In addition, we performed a twin pair level analysis including only RA discordant twin pairs evaluating the effect of cell type, auto antibodies and RA genetic risk factors.

Both the RA twins and their non-affected co-twins had significantly lower mtDNA CN than non-affected twins (−28.7 and −23.1 mtDNA CN, respectively). Adjusting for cell count attenuated these differences (−23.1 mtDNA CN and −20.1 mtDNA CN respectively). Within RA discordant twin pairs PTPN22(T) positive RA twins had a significantly lower amount than their co-twins (−16.3 mtDNA CN). PTPN22(T) had no effect among twins from non-affected twin pairs.

MtDNA CN is significantly lower in persons with established RA and in predisposed non-affected RA co-twins suggesting that mitochondrial variation may be involved in the RA disease pathways. Our results also suggest that the RA associated genetic risk factor, PTPN22(T), further decreases the mtDNA CN, but only in carriers with established RA.

https://ift.tt/2QQ8msS

Cognitive Symptoms in US Government Personnel in Cuba: The mending is worse than the hole

Publication date: Available online 13 October 2018

Source: Cortex

Author(s): Sergio Della Sala, Robert D. McIntosh, Roberto Cubelli, Jason A. Kacmarski, Holly M. Miskey, Robert D. Shura

https://ift.tt/2QNJulG

Firing Up Glycolysis: BCG Vaccination Effects on Type 1 Diabetes Mellitus

Publication date: Available online 13 October 2018

Source: Trends in Endocrinology & Metabolism

Author(s): Rinke Stienstra, Mihai G. Netea

In addition to the impact of Bacillus Calmette–Guerin (BCG) vaccination on antimicrobial host defence, a novel study reveals beneficial effects on glycaemic control in patients with long-standing type 1 diabetes mellitus (T1DM). These effects are ascribed to an accelerated glucose consumption in immune cells due to increased glycolysis and reduced oxidative phosphorylation.

https://ift.tt/2Pzu2t2

Normal human skin is superior to monkey esophagus substrate for detection of circulating BP180‐NC16A‐specific immunoglobulin G antibodies in bullous pemphigoid

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2QSpdeL

Prediction of Disease Relapse in a Cohort of Juvenile Localized Scleroderma Patients

British Journal of Dermatology, Volume 0, Issue ja, -Not available-.


https://ift.tt/2CJR6Cz

Coverage from the American Thyroid Association® (ATA) 88th Annual Meeting

Coverage from the 88^th Annual Meeting of the American Thyroid Association^®
From Medscape Diabetes & Endocrinology

The post Coverage from the American Thyroid Association^® (ATA) 88^th Annual Meeting appeared first on American Thyroid Association.

https://ift.tt/2Ekk1ig