Computational model for survey and trend analysis of patients with endometriosis : a decision aid tool for EBM

Endometriosis is increasingly collecting worldwide attention due to its medical complexity and social impact. The European community has identified this as a “social disease”. A large amount of information comes from scientists, yet several aspects of this pathology and staging criteria need to be clearly defined on a suitable number of individuals. In fact, available studies on endometriosis are not easily comparable due to a lack of standardized criteria to collect patients’ informations and scarce definitions of symptoms. Currently, only retrospective surgical stadiation is used to measure pathology intensity, while the Evidence Based Medicine (EBM) requires shareable methods and correct statistical models for disease classification and prognosis. We addressed this issue by setting up a unified evaluation model designated “Endometriosis Index” (EI), obtained from a real-time software using 32 clinical indicators after homotetic transformation. The indicators, collected by the gynecologists are expressed as normalised scores. Normalised variables are cumulated in order to obtain the EI value. The entire panel of variables is then expressed by a unique number to possibly suggest a) grade of the disease, b) indication to surgery, c) trend of disease recurrence and d) prognostic indications . The model of the EI construction has been conceived to be easily applicable and interpretable by all doctors under different clinical protocols. Moreover, all variables were considered as discrete scores, computed to reliably and simultaneously express three concurrent elements: a) patient pain self-assessment, b) physician examination and 3) laboratory diagnostics. This work briefly explains the mathematical model, describes its software functional features and reports its practical application in a group of patients with endometriosis. A summary of the statistics of an observational study is also cited in order to explain the multi-centre consensus validation of the model

Reduction of serum IGF-I levels in patients affected with Monoclonal Gammopathies of undetermined significance or Multiple Myeloma. Comparison with bFGF, VEGF and K-ras gene mutation

<p>Abstract</p> <p>Background</p> <p>Serum levels of IGF-I in patients affected with multiple myeloma (MM) have been scarcely studied. The present study is aimed to explore this point comparing 55 healthy subjects, 71 monoclonal gammopaties of uncertain significance (MGUS) and 77 overt MM patients. In the same subjects, basic FGF and VEGF, have been detected. All three mediators were analyzed in function of K-<it>ras </it>mutation and melphalan response. Concerning IGF-I, two representative monitoring examples have also been added.</p> <p>Methods</p> <p>Cytokine determinations were performed by commercially available ELISA kits, while K12-<it>ras </it>mutation was investigated on genomic DNA isolated from bone marrow cell specimens by RFLP-PCR assay.</p> <p>Results</p> <p>Significant reductions of IGF-I levels were observed in MGUS and MM as compared with healthy controls. In addition, MM subjects showed significantly decreased serum IGF-I levels than MGUS. Conversely, increasing levels were observed for bFGF and VEGF, molecules significantly correlated. A multivariate analysis corrected for age and gender confirmed the significant difference only for IGF-I values (P = 0.01). K12-<it>ras </it>mutation was significantly associated with malignancy, response to therapy and with significantly increased serum bFGF levels.</p> <p>Conclusion</p> <p>IGF-I reduction in the transition: Controls→MGUS→MM and changes observed over time suggest that IGF-I should be furtherly studied in future clinical trials as a possible monitoring marker for MM.</p

Human Herpesvirus 8 Infection in Patients With Cutaneous Lymphoproliferative Diseases

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Insulin-like growth factor-I and complications of prematurity: a focus on bronchopulmonary dysplasia.

At least four premature newborn complications have been reported to be associated with low serum insulin-like growth factor-I (IGF-I) levels: bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis and brain damage. Local IGF-I concentrations have only been reported for bronchopulmonary dysplasia and these findings show that lung IGF-I levels are clearly increased (epithelial lining fluid levels), emphasizing the fact that IGF-I is differently regulated in the general circulation or at local level. The present review discusses the meaning of the association between serum IGF-I amounts and development of complications in premature newborns. Finally, some methodological indications are reported regarding the IGF-I assay procedures. It is important to establish what are the possible relationships between blood levels and those of different compartments involved in the diseases