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[PMID]:29187489
[Au] Autor:Zhou W; Saam T; Zhou Y; Trevino J; Liu X; Cao D; Lai J
[Ad] Endereço:Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, P.R. China.
[Ti] Título:Pancreatic Mucinous Cystic Neoplasm Communicating with Main Pancreatic Duct: An Unrecognized Presentation of Pancreatic Mucinous Neoplasm?
[So] Source:Anticancer Res;37(12):7017-7021, 2017 12.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:Mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms (IPMNs) are two well recognized entities of precursor cystic lesions of pancreatic duct adenocarcinoma. The characteristic features of MCNs are the lined mucinous epithelium with underlying ovarian-type stroma, but without communication with the ducts, while that for IPMNs are the communication with the ducts but without the underlying ovarian-type stroma. Here we report a case of MCN communicating with the main pancreatic duct in a 68-year-old woman. The initial radiographic diagnosis was pancreatic IPMN with main pancreatic involvement and this was also confirmed during gross examination. Histologically, the pancreatic cystic neoplasm was lined with mucinous epithelium with underlying ovarian-type of stroma. Immunohistochemical stains confirmed that the stroma cells were positive for ER, PR, alpha-inhibin and focally positive for CD10. The final pathologic diagnosis was pancreatic mucinous cystic neoplasm communicating with the main pancreatic duct. To the best of our knowledge, this is the second pathology confirmed case of MCN communicating with the main pancreatic duct. A careful gross examination and bivalvation of the main duct communicating with the cystic neoplasm helps render the correct diagnosis. If more cases are reported in the future, the MCN communicating with duct could become a new entity of pancreatic mucinous neoplasm.
[Mh] Termos MeSH primário: Adenocarcinoma Mucinoso/diagnóstico
Neoplasias Císticas, Mucinosas e Serosas/diagnóstico
Ductos Pancreáticos/patologia
Neoplasias Pancreáticas/diagnóstico
[Mh] Termos MeSH secundário: Idoso
Carcinoma Papilar/diagnóstico
Diagnóstico Diferencial
Feminino
Seres Humanos
Imuno-Histoquímica
Inibinas/análise
Pâncreas/metabolismo
Pâncreas/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (inhibin-alpha subunit); 57285-09-3 (Inhibins)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171211
[Lr] Data última revisão:
171211
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


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[PMID]:29049585
[Au] Autor:Steiner AZ; Pritchard D; Stanczyk FZ; Kesner JS; Meadows JW; Herring AH; Baird DD
[Ad] Endereço:Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill.
[Ti] Título:Association Between Biomarkers of Ovarian Reserve and Infertility Among Older Women of Reproductive Age.
[So] Source:JAMA;318(14):1367-1376, 2017 10 10.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Despite lack of evidence of their utility, biomarkers of ovarian reserve are being promoted as potential markers of reproductive potential. Objective: To determine the associations between biomarkers of ovarian reserve and reproductive potential among women of late reproductive age. Design, Setting, and Participants: Prospective time-to-pregnancy cohort study (2008 to date of last follow-up in March 2016) of women (N = 981) aged 30 to 44 years without a history of infertility who had been trying to conceive for 3 months or less, recruited from the community in the Raleigh-Durham, North Carolina, area. Exposures: Early-follicular-phase serum level of antimüllerian hormone (AMH), follicle-stimulating hormone (FSH), and inhibin B and urinary level of FSH. Main Outcomes and Measures: The primary outcomes were the cumulative probability of conception by 6 and 12 cycles of attempt and relative fecundability (probability of conception in a given menstrual cycle). Conception was defined as a positive pregnancy test result. Results: A total of 750 women (mean age, 33.3 [SD, 3.2] years; 77% white; 36% overweight or obese) provided a blood and urine sample and were included in the analysis. After adjusting for age, body mass index, race, current smoking status, and recent hormonal contraceptive use, women with low AMH values (<0.7 ng/mL [n = 84]) did not have a significantly different predicted probability of conceiving by 6 cycles of attempt (65%; 95% CI, 50%-75%) compared with women (n = 579) with normal values (62%; 95% CI, 57%-66%) or by 12 cycles of attempt (84% [95% CI, 70%-91%] vs 75% [95% CI, 70%-79%], respectively). Women with high serum FSH values (>10 mIU/mL [n = 83]) did not have a significantly different predicted probability of conceiving after 6 cycles of attempt (63%; 95% CI, 50%-73%) compared with women (n = 654) with normal values (62%; 95% CI, 57%-66%) or after 12 cycles of attempt (82% [95% CI, 70%-89%] vs 75% [95% CI, 70%-78%], respectively). Women with high urinary FSH values (>11.5 mIU/mg creatinine [n = 69]) did not have a significantly different predicted probability of conceiving after 6 cycles of attempt (61%; 95% CI, 46%-74%) compared with women (n = 660) with normal values (62%; 95% CI, 58%-66%) or after 12 cycles of attempt (70% [95% CI, 54%-80%] vs 76% [95% CI, 72%-80%], respectively). Inhibin B levels (n = 737) were not associated with the probability of conceiving in a given cycle (hazard ratio per 1-pg/mL increase, 0.999; 95% CI, 0.997-1.001). Conclusions and Relevance: Among women aged 30 to 44 years without a history of infertility who had been trying to conceive for 3 months or less, biomarkers indicating diminished ovarian reserve compared with normal ovarian reserve were not associated with reduced fertility. These findings do not support the use of urinary or blood follicle-stimulating hormone tests or antimüllerian hormone levels to assess natural fertility for women with these characteristics.
[Mh] Termos MeSH primário: Hormônio Antimülleriano/sangue
Hormônio Foliculoestimulante/sangue
Inibinas/sangue
Reserva Ovariana/fisiologia
Tempo para Engravidar
[Mh] Termos MeSH secundário: Adulto
Biomarcadores/sangue
Biomarcadores/urina
Feminino
Hormônio Foliculoestimulante/urina
Seres Humanos
Infertilidade Feminina/diagnóstico
Gravidez
Modelos de Riscos Proporcionais
Estudos Prospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, N.I.H., EXTRAMURAL; RESEARCH SUPPORT, N.I.H., INTRAMURAL
[Nm] Nome de substância:
0 (Biomarkers); 0 (inhibin B); 57285-09-3 (Inhibins); 80497-65-0 (Anti-Mullerian Hormone); 9002-68-0 (Follicle Stimulating Hormone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171121
[Lr] Data última revisão:
171121
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.14588


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[PMID]:28952695
[Au] Autor:Osadchuk LV; Popova AV; Erkovich AA; Voroshilova NA; Osadchuk AV
[Ad] Endereço:Federal Research Center Institute of Cytology and Genetics of the Siberian Branch of the RAS.
[Ti] Título:[Effects of smoking and alcohol consumptionon reproductive and metabolic indicators in young men in western siberia].
[So] Source:Urologiia;(4):62-67, 2017 Sep.
[Is] ISSN:1728-2985
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:INTRODUCTION: Smoking and alcohol consumption remain widespread throughout the world, including Russia. Recently, due to the increase in male infertility and subfertility, special attention has been paid to the effects of smoking and alcohol on the reproductive health of young men. The aim of this study was to assess the effects of smoking and moderate alcohol consumption on spermatogenesis, reproductive hormone levels and metabolic status in young men living in Western Siberia (Novosibirsk). MATERIALS AND METHODS: One hundred thirty-three volunteers (mean age 21.1+/-0.3 years) were tested for the sperm concentration, the proportion of mobile and morphologically normal spermatozoa in the ejaculate, blood serum levels of follicle-stimulating and luteinizing hormones, prolactin, testosterone, estradiol, inhibin B, triglycerides, total cholesterol, high and low density lipoprotein cholesterol, glucose and uric acid. RESULTS: and conclusions The studied lifestyle factors were found to have no effects on spermatogenesis. Smoking more than 10 cigarettes per day and a moderate frequency of alcohol consumption (up to 1 time per week) was associated with higher blood serum testosterone levels and engaging in more frequent sexual contacts compared to non-smoking and non-drinking men. Drinking alcohol more than once a week and smoking more than 8 cigarettes per day was associated, along with the increase in testosterone levels and the frequency of sexual contacts, with lower levels of follicle-stimulating hormone and higher serum triglyceride levels. Thus, in young men, frequent drinking and smoking can alter the hormonal and metabolic balance, which, as the duration of the exposure and the strength of the factors increase, will increase the risk of reproductive disorders.
[Mh] Termos MeSH primário: Consumo de Bebidas Alcoólicas/efeitos adversos
Reprodução
Fumar/efeitos adversos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Consumo de Bebidas Alcoólicas/sangue
Glicemia/análise
Colesterol/sangue
Estradiol/sangue
Hormônio Foliculoestimulante/sangue
Seres Humanos
Inibinas/sangue
Hormônio Luteinizante/sangue
Masculino
Prolactina/sangue
Análise do Sêmen
Sibéria
Fumar/sangue
Espermatogênese
Testosterona/sangue
Triglicerídeos/sangue
Ácido Úrico/sangue
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Blood Glucose); 0 (Triglycerides); 0 (inhibin B); 268B43MJ25 (Uric Acid); 3XMK78S47O (Testosterone); 4TI98Z838E (Estradiol); 57285-09-3 (Inhibins); 9002-62-4 (Prolactin); 9002-67-9 (Luteinizing Hormone); 9002-68-0 (Follicle Stimulating Hormone); 97C5T2UQ7J (Cholesterol)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170928
[St] Status:MEDLINE


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[PMID]:28874128
[Au] Autor:Chu QJ; Hua R; Luo C; Chen QJ; Wu B; Quan S; Zhu YT
[Ad] Endereço:Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Nanfang Hospital/ The First School of Clinical Medicine, Southern Medical University, Guangzhou, 510515, China.
[Ti] Título:Relationship of genetic causes and inhibin B in non obstructive azoospermia spermatogenic failure.
[So] Source:BMC Med Genet;18(1):98, 2017 Sep 06.
[Is] ISSN:1471-2350
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Chromosomal disorders in non obstructive azoospermia (NOA) may have an important influence on spermatogenesis, which may be reflected by the serum inhibin B levels. Till now, few studies have concerned the relationship of genetic causes and inhibin B in NOA. METHODS: In this retrospective study, 322 men with NOA in Center for Reproductive Medicine, Nanfang Hospital, Southern Medical University were collected. The level of follicle stimulating hormone (FSH), inhibin B, Y chromosome microdeletion test (YCMD) and karyotype were measured. RESULTS: Abnormal karyotypes were present in 38.5% of NOA, and YCMD were present in 18.0%, there was a high correlation between karyotypes and YCMD (χ = 11.892, P < 0.001). The level of inhibin B in chromosomal abnormality from lowest to highest was 46,XX (or 45,X), 47, XXY, mosaics, polymorphisms, inversion and translocation. And the level of inhibin B within Non-AZF a&b region deletion was higher than AZF a&b microdeletion. CONCLUSION: According to the level of inhibin B, spermatogenesis in chromosomal abnormality from lowest to highest was 46,XX (or 45,X), 47, XXY, mosaics, polymorphisms, inversion and translocation. And spermatogenesis within Non-AZF a&b region deletion was better than AZF a&b microdeletion.
[Mh] Termos MeSH primário: Azoospermia/genética
Inibinas/sangue
[Mh] Termos MeSH secundário: Adulto
Azoospermia/sangue
Deleção Cromossômica
Cromossomos Humanos Y
Hormônio Foliculoestimulante
Seres Humanos
Cariotipagem
Masculino
Estudos Retrospectivos
Aberrações dos Cromossomos Sexuais
Espermatogênese/genética
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (inhibin B); 57285-09-3 (Inhibins); 9002-68-0 (Follicle Stimulating Hormone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170912
[Lr] Data última revisão:
170912
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170907
[St] Status:MEDLINE
[do] DOI:10.1186/s12881-017-0456-x


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[PMID]:28762499
[Au] Autor:Kaewsuksai P; Jitsurong S
[Ad] Endereço:Department of Obstetrics and Gynecology, Songkhla Hospital, Songkhla, Thailand.
[Ti] Título:Prospective study of the feasibility and effectiveness of a second-trimester quadruple test for Down syndrome in Thailand.
[So] Source:Int J Gynaecol Obstet;139(2):217-221, 2017 Nov.
[Is] ISSN:1879-3479
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate the feasibility and effectiveness of a quadruple test for Down syndrome in the second trimester of pregnancy in clinical settings in Thailand. METHODS: From October 2015 to September 2016, a prospective study was undertaken in 19 hospitals in Songkhla province, Thailand. Women with a singleton pregnancy of 14-18 weeks were enrolled and underwent the quadruple test. The risk cutoff value was set at 1:250. All women with a positive test (risk ≥1:250) were offered amniocentesis. Women were followed up until delivery. RESULTS: Among 2375 women, 206 (8.7%) had a positive quadruple test; 98 (47.6%) of these women voluntarily underwent amniocentesis. Overall, seven pregnancies were complicated with chromosomal abnormalities (2.9 cases in 1000), including four cases of Down syndrome (1.7 in 1000) and three of other abnormalities. The detection, false-positive, and accuracy rates of the quadruple test for Down syndrome were 75.0%, 8.6%, and 91.4%, respectively. CONCLUSION: The quadruple test was found to be a feasible and efficient method for screening for Down syndrome in the second trimester of pregnancy in a Thai clinical setting. The test should be performed for pregnant women before an invasive test for Down syndrome.
[Mh] Termos MeSH primário: Biomarcadores/sangue
Síndrome de Down/diagnóstico
Diagnóstico Pré-Natal
[Mh] Termos MeSH secundário: Adulto
Gonadotropina Coriônica/sangue
Síndrome de Down/sangue
Estriol/sangue
Feminino
Seres Humanos
Inibinas/sangue
Valor Preditivo dos Testes
Gravidez
Segundo Trimestre da Gravidez
Estudos Prospectivos
Tailândia
alfa-Fetoproteínas
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Nome de substância:
0 (Biomarkers); 0 (Chorionic Gonadotropin); 0 (alpha-Fetoproteins); 0 (inhibin A); 57285-09-3 (Inhibins); FB33469R8E (Estriol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12290


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[PMID]:28502826
[Au] Autor:Luke AM; Moroney JW; Snitchler A; Whiteway SL
[Ad] Endereço:San Antonio Uniformed Services Health Education Consortium, JBSA, Fort Sam Houston, San Antonio, Texas.
[Ti] Título:Ovarian Sertoli-Leydig Cell Tumor with Elevated Inhibin B as a Cause of Secondary Amenorrhea in an Adolescent with Germ Line DICER1 Mutation.
[So] Source:J Pediatr Adolesc Gynecol;30(5):598-600, 2017 Oct.
[Is] ISSN:1873-4332
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Ovarian tumors, although uncommon in children, can retain endocrine function that disrupts normal feedback mechanisms leading to amenorrhea. Inheritance of germline DICER1 mutations can lead to increased risk for development of ovarian Sertoli-Leydig cell tumors (SLCTs). CASE: We report, to our knowledge, the first case of secondary amenorrhea due to elevated inhibin B levels in a female adolescent with an ovarian SLCT. SUMMARY AND CONCLUSION: Ovarian tumors should be included in the differential diagnosis for pediatric patients who present with menstrual irregularities. Early evaluation of the hypothalamic-pituitary-ovarian axis and inhibin levels is appropriate. Our case also emphasizes the need for testing for DICER1 mutations in pediatric patients with ovarian SLCTs.
[Mh] Termos MeSH primário: Amenorreia/etiologia
RNA Helicases DEAD-box/genética
Inibinas/sangue
Neoplasias Ovarianas/patologia
Ribonuclease III/genética
Tumor de Células de Sertoli-Leydig/complicações
[Mh] Termos MeSH secundário: Adolescente
Diagnóstico Diferencial
Feminino
Seres Humanos
Mutação
Neoplasias Ovarianas/complicações
Neoplasias Ovarianas/genética
Tumor de Células de Sertoli-Leydig/genética
Tumor de Células de Sertoli-Leydig/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (inhibin B); 57285-09-3 (Inhibins); EC 3.1.26.3 (DICER1 protein, human); EC 3.1.26.3 (Ribonuclease III); EC 3.6.4.13 (DEAD-box RNA Helicases)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170516
[St] Status:MEDLINE


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[PMID]:28299766
[Au] Autor:Jin G; Liu J; Qin Q; Gao S; Zhang F; Ma Y; Ding C; Dong L; Yin H; Wang Y
[Ad] Endereço:Central Laboratory, Shanxi Provincial People's Hospital, Affiliate of Shanxi Medical University, Taiyuan, China.
[Ti] Título:Increased Level of c-kit in Semen of Infertile Patients with Varicocele.
[So] Source:Urol J;14(2):3023-3027, 2017 Mar 16.
[Is] ISSN:1735-546X
[Cp] País de publicação:Iran
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Varicocele is the most common risk factor for male infertility, however, not all males with varicocele experience infertility. In fact, most patients with varicocele have normal spermatogenesis. The molecular mechanism of varicocele-associated infertility is yet to be completely understood. The aim of this study is to assess the association of a number of fertility regulatory factors on varicocele associated infertility and to throw light on the mechanism of varicocele-associated infertility. MATERIALS AND METHODS: Semen from 30 infertile patients with varicocele and 30 fertile men with varicocele were collected. The concentrations of the following factors in seminal plasma were determined by ELISA: follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T), androgen binding protein (ABP), transferrin (Trf), inhibin B (INHB) and stem cell factor (SCF). The expression level of c-kit in seminal precipitate of patients with varicocele was detected by real-time PCR. RESULTS: The concentrations of sexual hormones, FSH, LH and T, had no differences between infertile patients with varicocele and fertile men with varicocele (P > 0.05). Factors secreted by Sertoli cells, ABP, Trf, INHB andSCF, showed no significant differences between the two groups (P > 0.05). Interestingly, the expression of c-kit was significant higher in infertile patients with varicocele than that in fertile men with varicocele (P < 0.01). CONCLUSION: Neither the sexual hormones nor the Sertoli cells was responsible for the infertility induced by varicocele.The aberrant expression of c-kit in infertile patients with varicocele may provide new insight into the mechanism of varicocele-associated infertility.
[Mh] Termos MeSH primário: Infertilidade Masculina/genética
Infertilidade Masculina/metabolismo
Proteínas Proto-Oncogênicas c-kit/genética
Sêmen/metabolismo
Varicocele/genética
Varicocele/metabolismo
[Mh] Termos MeSH secundário: Adulto
Proteína de Ligação a Androgênios/metabolismo
Estudos de Casos e Controles
Hormônio Foliculoestimulante/metabolismo
Expressão Gênica
Seres Humanos
Infertilidade Masculina/etiologia
Inibinas/metabolismo
Hormônio Luteinizante/metabolismo
Masculino
Análise do Sêmen
Fator de Células-Tronco/metabolismo
Testosterona/metabolismo
Transferrina/metabolismo
Varicocele/complicações
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Androgen-Binding Protein); 0 (Stem Cell Factor); 0 (Transferrin); 0 (inhibin B); 3XMK78S47O (Testosterone); 57285-09-3 (Inhibins); 9002-67-9 (Luteinizing Hormone); 9002-68-0 (Follicle Stimulating Hormone); EC 2.7.10.1 (Proto-Oncogene Proteins c-kit)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171019
[Lr] Data última revisão:
171019
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170317
[St] Status:MEDLINE


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[PMID]:28295159
[Au] Autor:Alldred SK; Takwoingi Y; Guo B; Pennant M; Deeks JJ; Neilson JP; Alfirevic Z
[Ad] Endereço:Department of Women's and Children's Health, The University of Liverpool, First Floor, Liverpool Women's NHS Foundation Trust, Crown Street, Liverpool, UK, L8 7SS.
[Ti] Título:First and second trimester serum tests with and without first trimester ultrasound tests for Down's syndrome screening.
[So] Source:Cochrane Database Syst Rev;3:CD012599, 2017 Mar 15.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Down's syndrome occurs when a person has three copies of chromosome 21 (or the specific area of chromosome 21 implicated in causing Down's syndrome) rather than two. It is the commonest congenital cause of mental disability. Non-invasive screening based on biochemical analysis of maternal serum or urine, or fetal ultrasound measurements, allows estimates of the risk of a pregnancy being affected and provides information to guide decisions about definitive testing.  Before agreeing to screening tests, parents need to be fully informed about the risks, benefits and possible consequences of such a test. This includes subsequent choices for further tests they may face, and the implications of both false positive (i.e. invasive diagnostic testing, and the possibility that a miscarried fetus may be chromosomally normal) and false negative screening tests (i.e. a fetus with Down's syndrome will be missed). The decisions that may be faced by expectant parents inevitably engender a high level of anxiety at all stages of the screening process, and the outcomes of screening can be associated with considerable physical and psychological morbidity. No screening test can predict the severity of problems a person with Down's syndrome will have. OBJECTIVES: To estimate and compare the accuracy of first and second trimester serum markers with and without first trimester ultrasound markers for the detection of Down's syndrome in the antenatal period, as combinations of markers. SEARCH METHODS: We conducted a sensitive and comprehensive literature search of MEDLINE (1980 to 25 August 2011), Embase (1980 to 25 August 2011), BIOSIS via EDINA (1985 to 25 August 2011), CINAHL via OVID (1982 to 25 August 2011), the Database of Abstracts of Reviews of Effectiveness (the Cochrane Library 25 August 2011), MEDION (25 August 2011), the Database of Systematic Reviews and Meta-Analyses in Laboratory Medicine (25 August 2011), the National Research Register (Archived 2007), and Health Services Research Projects in Progress database (25 August 2011). We did not apply a diagnostic test search filter. We did forward citation searching in ISI citation indices, Google Scholar and PubMed 'related articles'. We also searched reference lists of retrieved articles SELECTION CRITERIA: Studies evaluating tests of combining first and second trimester maternal serum markers in women up to 24 weeks of gestation for Down's syndrome, with or without first trimester ultrasound markers, compared with a reference standard, either chromosomal verification or macroscopic postnatal inspection. DATA COLLECTION AND ANALYSIS: Data were extracted as test positive/test negative results for Down's and non-Down's pregnancies allowing estimation of detection rates (sensitivity) and false positive rates (1-specificity). We performed quality assessment according to QUADAS criteria. We used hierarchical summary ROC meta-analytical methods to analyse test performance and compare test accuracy. Analysis of studies allowing direct comparison between tests was undertaken. We investigated the impact of maternal age on test performance in subgroup analyses. MAIN RESULTS: Twenty-two studies (reported in 25 publications) involving 228,615 pregnancies (including 1067 with Down's syndrome) were included. Studies were generally high quality, although differential verification was common with invasive testing of only high risk pregnancies. Ten studies made direct comparisons between tests. Thirty-two different test combinations were evaluated formed from combinations of eight different tests and maternal age; first trimester nuchal translucency (NT) and the serum markers AFP, uE3, total hCG, free ßhCG, Inhibin A, PAPP-A and ADAM 12. We looked at tests combining first and second trimester markers with or without ultrasound as complete tests, and we also examined stepwise and contingent strategies.Meta-analysis of the six most frequently evaluated test combinations showed that a test strategy involving maternal age and a combination of first trimester NT and PAPP-A, and second trimester total hCG, uE3, AFP and Inhibin A significantly outperformed other test combinations that involved only one serum marker or NT in the first trimester, detecting about nine out of every 10 Down's syndrome pregnancies at a 5% false positive rate. However, the evidence was limited in terms of the number of studies evaluating this strategy, and we therefore cannot recommend one single screening strategy. AUTHORS' CONCLUSIONS: Tests involving first trimester ultrasound with first and second trimester serum markers in combination with maternal age are significantly better than those without ultrasound, or those evaluating first trimester ultrasound in combination with second trimester serum markers, without first trimester serum markers. We cannot make recommendations about a specific strategy on the basis of the small number of studies available.
[Mh] Termos MeSH primário: Síndrome de Down/sangue
Síndrome de Down/diagnóstico
Medição da Translucência Nucal
Primeiro Trimestre da Gravidez/sangue
Segundo Trimestre da Gravidez/sangue
[Mh] Termos MeSH secundário: Biomarcadores/sangue
Gonadotropina Coriônica/sangue
Síndrome de Down/diagnóstico por imagem
Estriol/sangue
Reações Falso-Positivas
Feminino
Seres Humanos
Inibinas/sangue
Idade Materna
Gravidez
Proteína Plasmática A Associada à Gravidez/análise
Sensibilidade e Especificidade
alfa-Fetoproteínas/análise
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Biomarkers); 0 (Chorionic Gonadotropin); 0 (alpha-Fetoproteins); 0 (inhibin A); 57285-09-3 (Inhibins); EC 3.4.24.- (Pregnancy-Associated Plasma Protein-A); FB33469R8E (Estriol)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170316
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD012599


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[PMID]:28281288
[Au] Autor:Xu YT; Shen MH; Jin AY; Li H; Zhu R
[Ad] Endereço:Department of Obstetrics and Gynecology, First Affiliated Hospital of Soochow University, Suzhou, China.
[Ti] Título:Maternal circulating levels of transforming growth factor-ß superfamily and its soluble receptors in hypertensive disorders of pregnancy.
[So] Source:Int J Gynaecol Obstet;137(3):246-252, 2017 Jun.
[Is] ISSN:1879-3479
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess circulating levels of transforming growth factor (TGF)-ß superfamily members and their soluble receptors in hypertensive disorders of pregnancy, and to investigate associations with clinical manifestations. METHODS: A retrospective study was conducted using data for women admitted to a center in China for delivery between May 2011 and April 2013. Women with severe pre-eclampsia, mild pre-eclampsia, and gestational hypertension were included, along with a control group. Serum levels of activin A, inhibin A, TGF-ß1, soluble endoglin (sEng), and soluble betaglycan (sBG) were measured. RESULTS: Women with severe pre-eclampsia (n = 17) had higher mean levels of activin A (23.5±2.1 µg/L), inhibin A (1.7±0.2 µg/L), sEng (32.1±3.2 µg/L), and sBG (84.1±9.4 µg/L) than did normotensive controls (n = 18), women with gestational hypertension (n = 15), and those with mild pre-eclampsia (n = 14; all P<0.05). Women with early-onset pre-eclampsia (n = 13) had higher levels of these serum markers than did preterm normotensive controls (n = 8; all P<0.001). Women with severe or early-onset pre-eclampsia had the lowest TGF-ß1 levels. Activin A, inhibin A, sEng, and sBG levels were positively correlated with mean arterial pressure and proteinuria (all P<0.01). CONCLUSION: Pre-eclampsia is associated with an imbalance of members of the TGF-ß superfamily and their soluble receptors, which might contribute to the development of pre-eclampsia and help to predict onset and severity.
[Mh] Termos MeSH primário: Hipertensão Induzida pela Gravidez/sangue
Receptores de Fatores de Crescimento Transformadores beta/sangue
Fator de Crescimento Transformador beta/sangue
[Mh] Termos MeSH secundário: Ativinas/sangue
Adulto
Endoglina/sangue
Feminino
Seres Humanos
Inibinas/sangue
Pré-Eclâmpsia/sangue
Gravidez
Proteoglicanas/sangue
Estudos Retrospectivos
Fator de Crescimento Transformador beta1/sangue
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Endoglin); 0 (Proteoglycans); 0 (Receptors, Transforming Growth Factor beta); 0 (Transforming Growth Factor beta); 0 (Transforming Growth Factor beta1); 0 (activin A); 0 (inhibin A); 104625-48-1 (Activins); 145170-29-2 (betaglycan); 57285-09-3 (Inhibins)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171020
[Lr] Data última revisão:
171020
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170311
[St] Status:MEDLINE
[do] DOI:10.1002/ijgo.12142


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[PMID]:28261833
[Au] Autor:Sukumar SP; Bhansali A; Sachdeva N; Ahuja CK; Gorsi U; Jarial KD; Walia R
[Ad] Endereço:Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
[Ti] Título:Diagnostic utility of testosterone priming prior to dynamic tests to differentiate constitutional delay in puberty from isolated hypogonadotropic hypogonadism.
[So] Source:Clin Endocrinol (Oxf);86(5):717-724, 2017 May.
[Is] ISSN:1365-2265
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:CONTEXT: Differentiation between constitutional delay in puberty (CDP) and isolated hypogonadotropic hypogonadism (IHH) during adolescence is a great clinical challenge, and the available diagnostic tests are of limited value. OBJECTIVE: To study the effect of withdrawal of short-term, low-dose testosterone therapy (testosterone priming) on the discriminatory power of dynamic tests for hypothalamo-pituitary-testicular axis to differentiate CDP from IHH. DESIGN: A prospective study (n = 30) consisting of 20 boys with delayed puberty (group A) and 10 patients with IHH (group B). INTERVENTION: Patients in groups A and B underwent Triptorelin and hCG stimulation tests, prior to and 2 months after withdrawal of 'testosterone priming' (100 mg intramuscularly 4 weekly for 3 months) and were followed up until the onset of puberty or 18 years of age, whichever was earlier. RESULTS: At baseline, Triptorelin-stimulated 4 h LH, with a cut-off of 2·8 IU/l, and hCG-stimulated day 7 testosterone with a cut-off of 3·8 nmol/l had sensitivities of 80% each, and specificities of 93% and 87%, respectively, to diagnose CDP. After withdrawal of testosterone, a 4 h LH cut-off of 14·7 IU/l and day 7 testosterone cut-off of 10·3 nmol/l had sensitivities of 93% and 88% respectively, and specificity and positive predictive value of 100% each. A basal inhibin B > 94·7 ng/l was discriminatory for diagnosing CDP after withdrawal of testosterone priming. CONCLUSIONS: Inhibin B levels or 4 h LH after Triptorelin stimulation are the best discriminatory tests to differentiate CDP from IHH, when performed after withdrawal of 'testosterone priming'.
[Mh] Termos MeSH primário: Hipogonadismo/sangue
Hipogonadismo/diagnóstico
Valor Preditivo dos Testes
Puberdade Tardia/sangue
Puberdade Tardia/diagnóstico
Testosterona/administração & dosagem
[Mh] Termos MeSH secundário: Adolescente
Diagnóstico Diferencial
Seguimentos
Seres Humanos
Inibinas
Hormônio Luteinizante/sangue
Luteolíticos/administração & dosagem
Masculino
Pamoato de Triptorrelina/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Luteolytic Agents); 0 (inhibin B); 3XMK78S47O (Testosterone); 57285-09-3 (Inhibins); 57773-63-4 (Triptorelin Pamoate); 9002-67-9 (Luteinizing Hormone)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170307
[St] Status:MEDLINE
[do] DOI:10.1111/cen.13321



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