Serum prolactin levels in HLA-B27-associated uveitis.

PURPOSE: To evaluate basal serum prolactin levels in patients with HLA-B27-associated uveitis. METHODS: Prospective, nonrandomized comparative trial. Thirty-three patients with HLAB27- associated uveitis and 30 age- and sex-matched healthy control subjects were included. Age, systemic disease, treatment, and uveitis activity were recorded for comparative analysis between groups. Fourteen out of 23 patients with arthritic disease had ankylosing spondylitis. Basal serum prolactin levels were determined by electrochemiluminescence immunoassay on a Modular Analytics E170 analyzer. RESULTS: Prolactinemia was significantly higher (mean=15.84 ng/mL) in patients vs controls (mean=11.50 ng/mL) (p=0.026). Subgroup analysis revealed prolactinemia in arthritic disease patients (mean=17.21 ng/mL) significantly higher than controls (mean=11.50 ng/mL) (p=0.009) and in ankylosing spondylitis (mean=17.65 ng/mL) vs controls (mean=11.50 ng/mL) (p=0.006). No correlation was found between prolactinemia and systemic treatment. Prolactinemia did not correlate with disease activity. Autoimmunity features also correlated with higher prolactinemia (mean=17.26 ng/mL) vs controls (mean=11.50 ng/mL) (p=0.015). CONCLUSIONS: These results suggest the role of serum prolactin levels in HLA-B27-associated uveitis pathogenesis and its subgroups. There was no correlation with disease activity.

Serum prolactin levels and Behçet disease.

PURPOSE: To evaluate serum prolactin levels in Behçet disease (BD) and correlate with phenotypic expression of the disease. METHODS: This was a prospective, nonrandomized comparative trial. Twenty-two patients fulfilling BD Research Committee criteria and 21 healthy control subjects were included. Patients were classified in complete-type or incomplete-type BD subgroups according to clinical characteristics such as recurrent oral ulcers, genital ulcers, skin lesions, and ocular disease. Age, sex, HLA phenotyping, and therapy were recorded for comparative analysis between groups. Serum prolactin levels were determined by electrochemiluminescence immunoassay on a Modular Analytics E170 analyzer. RESULTS: Prolactinemia was significantly higher (mean=19.34 ng/mL) in BD patients vs controls (mean=9.83 ng/mL) (p=0.009). This value was also statistically higher in complete-type BD sub-group vs controls (p=0.02). Younger patients (<30 y) required corticosteroids plus immunosuppressives more often (75%), suggesting an association between age and disease severity, al-though not statistically significant. CONCLUSIONS: Results suggest the role of prolactin in BD pathogenesis and its association with disease expression, especially in complete-type BD.

Macular choroidal thickness after vitreoretinal surgery: Long-term effect of pars plana vitrectomy with and without encircling scleral buckling surgery. / Grosor coroideo macular después de la cirugía vitreorretiniana: efecto a largo plazo de la vitrectomía con y sin cerclaje escleral.

PURPOSE: To evaluate the macular choroidal thickness (CT) of eyes subjected to pars plana vitrectomy (PPV) whether or not combined with encircling scleral buckling (ESB) surgery for primary rhegmatogenous retinal detachment repair at 6 months or more after surgery. METHODS: This observational study included: 15 eyes (15 patients) submitted to combined ESB+PPV; 15 eyes submitted to PPV and their respective 30 normal fellow eyes (FE). Two 6mm lineal perpendicular optical coherence tomography B-scans centred on the fovea with enhanced depth imaging were performed on each eye. CT was measured at several macular locations: subfoveal (SF-CT) and at a radius of 1, 2, and 3mm from the fovea. CTs of the eyes in the CE+PPV group were compared to CT in the PPV group and the CTs of all operated eyes were compared to the CTs of their FE. RESULTS: SF-CT of the eyes in the ESB+PPV group was significantly increased compared to their FE (P=.001). CT at a radius of 1, 2, and 3mm from the fovea of the ESB+PPV group were significantly increased (P=.001, P=.005, and P=.001, respectively). The SF-CT of the PPV group was similar to their FE (P=.691). The SF-CT of the ESB+PPV group was significantly increased compared to SF-CT of the PPV group (P=.019). CONCLUSIONS: The CT of the eyes subjected to combined ESB and PPV was significantly increased at 6 months or more after surgery compared to the CT of their FE and to the CT of the eyes subjected to PPV alone, which could be explained by a venous engorgement caused by the ESB.

[The effect of the woman's age, the rate of cleavage and embryo quality on obtaining a pregnancy by in-vitro fertilization]. / Repercussão da idade da mulher, da taxa de clivagem e da qualidade embrionária, na obtenção de gravidez por fertilização in vitro.

Multiple factors influence the probability of obtaining a pregnancy through in vitro fertilization (IVF) and embryo transfer (ET). This retrospective study was designed to assess their importance in order to improve prognostic ability and treatment success. 341 consecutive embryo transfer cycles using the same ovarian stimulation protocol were considered and divided in two main groups: 92 cycles in which a clinical pregnancy was achieved and 249 cycles without success. All the embryo transfers were performed in patients from the in vitro fertilization program of the Human Reproductive Unit, Santa Maria Hospital, Lisbon, between January 1991 and December 1993. No significant differences were found between the two groups studied concerning the IVF indications, ovarian response to the stimulation, sperm quality, oocyte maturation and mean number of oocytes retrieved per patient. The women's age was higher in the group which did not achieve a pregnancy, when compared with the pregnant group (p < 0.001), showing a decline of success after the age of 35. Overall oocyte fertilization rate was 88.2% in cycles with pregnancy and 83.5% in cycles without pregnancy (p < 0.02). In the pregnant patients, there was a significantly higher rate of embryo transfers in which all the embryos received had reached at least the four-cell stage at 42-43 hr postinsemination, compared with the non pregnant patients (82% versus 63%, p < 0.001). All the 92 pregnancies originated from transfers of at least one embryo that had undergone two or more mitotic divisions.(ABSTRACT TRUNCATED AT 250 WORDS)

[Urinary calcium, magnesium and uric acid in normal children]. / Calciúria, magnesiúria e uricosúria em crianças normais.

In a group of 327 normal children, aged 4 to 11, we measured Calcium (Ca) and Creatinine (Cr) in the second morning urine. In 226 of them, Magnesium (Mg) and Uric Acid (UA) were also calculated. Means and SD were respectively Ca/Cr: 0.11 +/- 0.09, Mg/Cr: 0.10 +/- 0.03, Mg/Ca: 1.56 +/- 1.48 and UA/Cr: 0.093 +/- 0.29. Distribution was not normal, so we used the 97.5 centile for the upper acceptable limit. This value was higher for Ca/Cr (0.37) and different for Mg/Cr (0.17), compared to the previous reports. Our values of Mg/Ca were related to age (p less than 0.01). These results suggest the need for local establishment of normal ranges and a better definition of hypercalciuria and hypermagnesiuria.

Pituitary down-regulation in IVF cycles: is it necessary to use strict criteria?

PURPOSE: In a retrospective study we have reviewed the data of 570 consecutive IVF cycles in which a GnRH agonist (GnRHa) was started in the early follicular phase (long protocol). Cycles were divided in groups according to estradiol levels before HMG administration: A, < 20 pg/ml; B, 20 to 50 pg/ml; C, 51 to 100 pg/ml. Our objective was to determine if the degree of pituitary suppression had any effect on the ovarian response to stimulation by exogenous gonadotropins, and/or on the IVF outcome. RESULTS: There were no significant differences in cycle cancellation rates, no. of days of stimulation and ampoules of HMG, serum estradiol after HMG, no. of oocytes retrieved and fertilization rates between groups. Pregnancy rates (19.4%, 21% and 31.8%/cycle, and 24.1%, 27.5% and 37.8% / embryo transfer, respectively) and live-birth rates (16.2%, 16.1% and 25.0%/cycle, 20.1%, 21.2% and 29.7%/embryo transfer, respectively) were also not significantly different. CONCLUSIONS: The degree of pituitary suppression had no effects on either the ovarian response to gonadotropins (including HMG requirements) or the overall IVF results.