HBV reactivation in patients with rheumatoid arthritis treated with anti-interleukin-6:a systematic review and meta-analysis

OBJECTIVE: The objective of this study was to assess the possibility of HBV reactivation (HBVr) in patients with RA under anti-IL-6 treatment.METHODS: Using PubMed, Scopus and EMBASE, we performed a systematic literature search for articles related to HBVr in RA patients under anti-IL-6 treatment. The search was performed with no date limits and was last updated 28 January 2023. The results from all the databases were combined and duplicates were excluded, as were non-English articles, case reports, position articles, comments, and paediatric studies.RESULTS: Our initial search led to 427 articles; 28 were duplicates, 46 non-English, 169 reviews, 31 books/letters, 25 case reports, and 88 irrelevant to the meta-analysis aim; 21 were excluded due to inadequate information, leaving 19 articles, with a sum of 372 RA patients with chronic HBV (CHB) or resolved HBV infection, for further analysis. The overall risk for HBVr in RA patients with CHB was 6.7%, increasing to 37% when only RA patients with CHB and no antiviral prophylaxis were included. On the contrary, HBVr was close to 0% in RA patients with resolved HBV infection, irrespective of antiviral prophylaxis. All RA patients experiencing HBVr in these studies were successfully managed with antiviral treatment and/or drug withdrawal.CONCLUSION: Overall, anti-IL-6 treatment comes with a significant risk of HBVr in RA patients with CHB; risk is diminished when antiviral prophylaxis is used. In contrast, in RA patients with resolved HBV infection, the risk of HBVr seems to be extremely low. Large, well-designed studies (either controlled trials or multicentre/international observational studies) are warranted to further validate these results.</p

Radial Basis Function Artificial Neural Network for the Investigation of Thyroid Cytological Lesions

Objective. This study investigates the potential of an artificial intelligence (AI) methodology, the radial basis function (RBF) artificial neural network (ANN), in the evaluation of thyroid lesions. Study Design. The study was performed on 447 patients who had both cytological and histological evaluation in agreement. Cytological specimens were prepared using liquid-based cytology, and the histological result was based on subsequent surgical samples. Each specimen was digitized; on these images, nuclear morphology features were measured by the use of an image analysis system. The extracted measurements (41,324 nuclei) were separated into two sets: the training set that was used to create the RBF ANN and the test set that was used to evaluate the RBF performance. The system aimed to predict the histological status as benign or malignant. Results. The RBF ANN obtained in the training set has sensitivity 82.5%, specificity 94.6%, and overall accuracy 90.3%, while in the test set, these indices were 81.4%, 90.0%, and 86.9%, respectively. Algorithm was used to classify patients on the basis of the RBF ANN, the overall sensitivity was 95.0%, the specificity was 95.5%, and no statistically significant difference was observed. Conclusion. AI techniques and especially ANNs, only in the recent years, have been studied extensively. The proposed approach is promising to avoid misdiagnoses and assists the everyday practice of the cytopathology. The major drawback in this approach is the automation of a procedure to accurately detect and measure cell nuclei from the digitized images

The role of the architectural structure of expert systems when applied to diagnostic cytology

AIM: TO INVESTIGATE THE POTENTIAL OF EXPERT SYSTEMS IN THE DISCRIMINATION OF CYTOLOGICAL LESSIONS. MATTERIAL & METHODS: A CUSTOMIZED IMAGE ANALYSIS SYSTEM HAS BEEN DEVELOPED AND USED TO MEASURE 25 PARAMETERS CHARACTERIZING THE SHAPE, THE SIZE AND THE CHROMATINE TEXTURE OF NUCLEI FROM BENIGN OR MALIGNANT CELLS. IN THIS STUDY THERE HAVE BEEN STUDIED BENIGN AND MALIGNANT PATIENT CASES BASED ON THREE DIFFERENT HUMAN ORGANS. SPECIFICALLY THERE HAVE BEEN STUDIED BENIGN AND MALIGNANT CASES OF THE STOMACH, THE BREAST AND THE LOWER URINARY SYSTEM. THE CYTOLOGICAL EXAMINATION OF ALL THE CASES HAS BEEN CONFIRMED BY THE HISTOLOGICAL EXAMINATION AND BY THE CLINICAL CONFIRMATION. FOR EACH ORGAN THERE WAS ATTEMPTED TO DISCRIMINATE INTO TWO LEVELS, THE CELLULAR LEVEL WHERE A DISCRIMINATION BETWEEN BENIGN AND MALIGNANT NUCLEI HAS BEEN PERFORMED, AND THE PATIENT LEVEL WHERE WE HAVE TRIED TO DISCRIMINATE BENIGN FROM MALIGNANT CASES. THERE HAVE BEEN USED THREE DIFFERENT TYPES OF NEURAL NETWORKS, SPECIFICALLY THE BACK PROPAGATION OF THE ERROR (BP) NEURAL NETWORK, THE LEARNING VECTOR QUANTIZER (LVQ) AND THE RADIAL BASIS FUNCTIONS (RBF) TYPE NEURAL NETWORK. RESULTS: THE RESULTS BOTH AT THE CELLULAR/NUCLEAR LEVEL AND AT THE PATIENT LEVEL, INDICATE THAT IT IS POSSIBLE TO ACHIEVE EXCELLENT DIAGNOSTIC ACCURACY. THESE RESULTS ARE ENCOURAGING AND INDICATE THAT OUR METHODOLOGY COULD BE USEFUL IN THE EVERYDAY PRACTICE OF THE CYTOLOGICAL LABORATORY. DESPITE THE PROPOSED METHOD INTRODUCES AND OBJECTIVITY TO THE DECISION MAKING PROCESS, DUE TO THE MEASUREMENTS, IT IS OBVIOUS THAT EVEN IN THE SUB-MICROSCOPIC LEVEL THERE IS AN OVERLAP IN THE CHARACTERISTICS OF THE FEATURE SPACE. THIS CONFIRMS THE SHORTCOMING OF THE HUMAN VISION AND INTELLIGENCE TO CORRECTLY DISCRIMINATE THE NEOPLASTIC NATURE OF A LESION USING ONLY THE CYTOLOGICAL-MORPHOLOGICAL CHARACTERISTICS.DISCUSSION: IN SHORT THE PROPOSED METHOD IS AN NEW “TOOL” IN THE SCIENTIFIC “QUIVER” OF CYTOLOGY, BECAUSE:1.REDUCES THE CONTROVERSIAL CYTOLOGICAL DIAGNOSES2.IMPROVES THE DIAGNOSTIC ACCURACY OF THE CYTOLOGICAL DIAGNOSIS.3.INTRODUCES OBJECTIVITY INTO THE DIAGNOSTIC METHODOLOGY. 4.PROVIDES SUPPORT TO THE DECISION MAKING PROCESS OF YOUNG CYTOLOGISTS NOT HAVING EXPERTISE FOR SPECIFIC HUMAN ORGANS.FINALLY IT SEEMS THAT THE INTRODUCTION OF THIS METHODOLOGY IN THE EVERY DAY ROUTINE OF THE CYTOLOGICAL LABORATORY COULD IMPROVE THE PRE-OPERATIONAL CONTROL OF PATIENTS AND COULD EVENTUALLY REDUCE THE NOT NECESSARY SURGERIES.ΣΤΟΧΟΣ: Η ΔΙΕΡΕΥΝΗΣΗ ΤΩΝ ΕΠΙΔΟΣΕΩΝ ΕΜΠΕΙΡΩΝ ΣΥΣΤΗΜΑΤΩΝ ΣΤΗ ΔΙΑΓΝΩΣΗ ΚΥΤΤΑΡΟΛΟΓΙΚΩΝ ΑΛΛΟΙΣΕΩΝ, ΣΕ ΚΥΤΤΑΡΙΚΟ ΕΠΙΠΕΔΟ ΚΑΙ ΣΕ ΕΠΙΠΕΔΟ ΠΕΡΙΣΤΑΤΙΚΟΥ. ΥΛΙΚΟ ΚΑΙ ΜΕΘΟΔΟΣ: ΜΕ ΤΗ ΒΟΗΘΕΙΑ ΕΝΟΣ ΕΙΔΙΚΑ ΔΙΑΣΚΕΥΑΣΜΕΝΟΥ ΣΥΣΤΗΜΑΤΟΣ ΑΝΑΛΥΣΗΣ ΕΙΚΟΝΩΝ ΜΕΤΡΗΘΗΚΑΝ 25 ΠΑΡΑΜΕΤΡΟΙ ΠΟΥ ΧΑΡΑΚΤΗΡΙΖΟΥΝ ΤΟ ΣΧΗΜΑ ΤΟ ΜΕΓΕΘΟΣ ΚΑΙ ΤΗΝ ΥΦΗ ΤΗΣ ΧΡΩΜΑΤΙΝΗΣ ΤΩΝ ΠΥΡΗΝΩΝ ΚΑΛΟΗΘΩΝ ΚΑΙ ΚΑΚΟΗΘΩΝ ΚΥΤΤΑΡΩΝ. ΜΕΛΕΤΗΘΗΚΑΝ ΠΕΡΙΣΤΑΤΙΚΑ ΚΑΛΟΗΘΩΝ ΚΑΙ ΚΑΚΟΗΘΩΝ ΑΛΛΟΙΩΣΕΩΝ ΑΠΟ ΤΡΙΑ ΔΙΑΦΟΡΕΤΙΚΑ ΟΡΓΑΝΑ. ΣΥΓΚΕΚΡΙΜΕΝΑ ΑΝΑΛΥΘΗΚΑΝ ΚΥΤΤΑΡΟΛΟΓΙΚΑ ΕΠΙΧΡΙΣΜΑΤΑ ΑΛΛΟΙΩΣΕΩΝ ΤΟΥ ΣΤΟΜΑΧΟΥ, ΤΟΥ ΜΑΣΤΟΥ ΚΑΙ ΤΟΥ ΚΑΤΩΤΕΡΟΥ ΟΥΡΟΠΟΙΗΤΙΚΟΥ ΣΥΣΤΗΜΑΤΟΣ. ΓΙΑ ΤΟ ΣΥΝΟΛΟ ΤΩΝ ΠΕΡΙΣΤΑΤΙΚΩΝ ΠΛΗΝ ΤΗΣ ΚΥΤΤΑΡΟΛΟΓΙΚΗΣ ΔΙΑΓΝΩΣΗΣ ΥΠΗΡΧΕ ΙΣΤΟΛΟΓΙΚΗ ΚΑΙ ΚΛΙΝΙΚΗ ΕΠΙΒΕΒΑΙΩΣΗ.ΓΙΑ ΚΑΘΕ ΟΡΓΑΝΟ ΕΠΙΧΕΙΡΗΘΗΚΕ ΔΙΑΧΩΡΙΣΜΟΣ ΤΗΣ ΚΑΛΟΗΘΕΙΑΣ ΑΠΟ ΤΗΝ ΚΑΚΟΗΘΕΙΑ ΤΟΣΟ ΣΕ ΚΥΤΤΑΡΙΚΟ ΕΠΙΠΕΔΟ ΟΣΟ ΚΑΙ ΣΕ ΕΠΙΠΕΔΟ ΠΕΡΙΣΤΑΤΙΚΟΥ, ΜΕ ΤΗ ΒΟΗΘΕΙΑ ΤΡΙΩΝ ΔΙΑΦΟΡΕΤΙΚΩΝ ΜΕΘΟΔΩΝ ΤΕΧΝΗΤΗΣ ΝΟΗΜΟΣΥΝΗΣ, ΣΥΓΚΕΚΡΙΜΕΝΑ ΤΟΥ ΝΕΥΡΩΝΙΚΟΥ ΔΙΚΤΥΟΥ ΟΠΙΣΘΟΔΡΟΜΙΚΗΣ ΔΙΑΔΟΣΗΣ ΤΟΥ ΣΦΑΛΜΑΤΟΣ, ΤΟΥ ΕΚΠΑΙΔΕΥΟΜΕΝΟΥ ΚΒΑΝΤΙΣΤΗ ΔΙΑΝΥΣΜΑΤΩΝ ΚΑΙ ΝΕΥΡΩΝΙΚΩΝ ΔΙΚΤΥΩΝ ΜΕ ΑΚΤΙΝΙΚΕΣ ΣΥΝΑΡΤΗΣΕΙΣ ΒΑΣΗΣ.ΑΠΟΤΕΛΕΣΜΑΤΑ: ΤΑ ΠΟΣΟΣΤΑ ΔΙΑΧΩΡΙΣΜΟΥ ΤΗΣ ΚΑΛΟΗΘΕΙΑΣ ΑΠΟ ΤΗΝ ΚΑΚΟΗΘΕΙΑ, ΣΕ ΚΥΤΤΑΡΙΚΟ ΕΠΙΠΕΔΟ ΚΑΙ ΣΕ ΕΠΙΠΕΔΟ ΤΩΝ ΠΕΡΙΣΤΑΤΙΚΩΝ, ΕΔΕΙΞΑΝ ΠΩΣ ΕΙΝΑΙ ΔΥΝΑΤΟΝ ΝΑ ΕΠΙΤΕΥΧΘΟΥΝ ΥΨΗΛΑ ΠΟΣΟΣΤΑ ΔΙΑΓΝΩΣΤΙΚΗΣ ΑΚΡΙΒΕΙΑΣ. ΜΟΛΟΝΟΤΙ Η ΠΡΟΤΕΙΝΟΜΕΝΗ ΜΕΘΟΔΟΣ ΑΝΤΙΚΕΙΜΕΝΟΠΟΙΕΙ ΤΑ ΚΡΙΤΗΡΙΑ ΜΕ ΒΑΣΗ ΤΑ ΟΠΟΙΑ ΤΙΘΕΤΑΙ Η ΜΟΡΦΟΛΟΓΙΚΗ ΔΙΑΓΝΩΣΗ ΦΑΙΝΕΤΑΙ ΟΤΙ ΑΚΟΜΑ ΚΑΙ ΣΕ ΥΠΟΜΙΚΡΟΣΚΟΠΙΚΟ ΕΠΙΠΕΔΟ ΥΠΑΡΧΕΙ ΜΙΑ ΑΛΛΗΛΟΕΠΙΚΑΛΥΨΗ ΧΑΡΑΚΤΗΡΙΣΤΙΚΩΝ ΠΟΥ ΕΠΙΒΕΒΑΙΩΝΕΙ ΤΗΝ ΑΔΥΝΑΜΙΑ ΤΗΣ ΑΝΘΡΩΠΙΝΗΣ ΟΡΑΣΗΣ ΚΑΙ ΝΟΗΜΟΣΥΝΗΣ ΓΙΑ ΟΡΘΗ ΤΑΞΙΝΟΜΗΣΗ ΤΗΣ ΝΕΟΠΛΑΣΜΑΤΙΚΗΣ ΦΥΣΗΣ ΜΙΑΣ ΑΛΛΟΙΩΣΗΣ ΜΕ ΒΑΣΗ ΜΟΝΟ ΤΑ ΚΥΤΤΑΡΟΜΟΡΦΟΛΟΓΙΚΑ ΧΑΡΑΚΤΗΡΙΣΤΙΚΑ.ΣΥΜΠΕΡΑΣΜΑΤΑ: ΣΥΝΟΠΤΙΚΑ Η ΠΡΟΤΕΙΝΟΜΕΝΗ ΜΕΘΟΔΟΣ ΑΠΟΤΕΛΕΙ ΕΝΑ ΝΕΟ «ΟΠΛΟ» ΣΤΗΝ ΕΠΙΣΤΗΜΟΝΙΚΗ ΦΑΡΕΤΡΑ ΤΗΣ ΚΥΤΤΑΡΟΛΟΓΙΑΣ, ΕΠΕΙΔΗ ΣΥΝΕΙΣΦΕΡΕΙ:1.ΣΤΗ ΜΕΙΩΣΗ ΑΜΦΙΛΕΓΟΜΕΝΩΝ ΔΙΑΓΝΩΣΤΙΚΑ ΠΕΡΙΠΤΩΣΕΩΝ2.ΣΤΗ ΒΕΛΤΙΩΣΗ ΤΗΣ ΔΙΑΓΝΩΣΤΙΚΗΣ ΑΚΡΙΒΕΙΑΣ ΤΗΣ ΚΥΤΤΑΡΟΛΟΓΙΚΗΣ ΔΙΑΓΝΩΣΗΣ.3.ΣΤΗΝ ΑΝΤΙΚΕΙΜΕΝΟΠΟΙΗΣΗ ΤΗΣ ΔΙΑΓΝΩΣΤΙΚΗΣ ΜΕΘΟΔΟΥ ΜΕ ΤΗΝ ΕΙΣΑΓΩΓΗ ΜΟΡΦΟΜΕΤΡΙΚΩΝ ΚΑΙ ΠΥΚΝΟΜΕΤΡΙΚΩΝ ΠΟΣΟΤΙΚΩΝ ΧΑΡΑΚΤΗΡΙΣΤΙΚΩΝ. 4.ΣΤΗ ΠΑΡΟΧΗ ΔΙΑΓΝΩΣΤΙΚΗΣ ΥΠΟΒΟΗΘΗΣΗΣ ΝΕΩΝ ΚΥΤΤΑΡΟΛΟΓΩΝ ΠΟΥ ΔΕΝ ΔΙΑΘΕΤΟΥΝ ΤΗΝ ΑΠΑΡΑΙΤΗΤΗ ΕΜΠΕΙΡΙΑ ΚΑΙ ΕΞΕΙΔΙΚΕΥΣΗ ΣΕ ΣΥΓΚΕΚΡΙΜΕΝΑ ΟΡΓΑΝΑ.Η ΕΙΣΑΓΩΓΗ ΑΥΤΗΣ ΤΗΣ ΜΕΘΟΔΟΛΟΓΙΑΣ ΣΤΗΝ ΚΑΘΗΜΕΡΙΝΗ ΔΙΑΓΝΩΣΤΙΚΗ ΠΡΑΚΤΙΚΗ ΤΩΝ ΚΥΤΤΑΡΟΛΟΓΙΚΩΝ ΕΡΓΑΣΤΗΡΙΩΝ ΘΑ ΜΠΟΡΟΥΣΕ ΝΑ ΟΔΗΓΗΣΕΙ ΣΕ ΚΑΛΥΤΕΡΟ ΠΡΟΕΓΧΕΙΡΗΤΙΚΟ ΕΛΕΓΧΟ ΤΩΝ ΑΣΘΕΝΩΝ ΚΑΙ ΜΕΙΩΣΗ ΤΟΥ ΑΡΙΘΜΟΥ ΤΩΝ ΜΗ ΑΝΑΓΚΑΙΩΝ ΔΙΑΓΝΩΣΤΙΚΩΝ ΕΓΧΕΙΡΗΤΙΚΩΝ ΕΠΕΜΒΑΣΕΩΝ

Bayesian Networks to Support the Management of Patients with ASCUS/LSIL Pap Tests

In the majority of cases, cervical cancer (CxCa) develops as a result of underestimated abnormalities in the Pap test. Nowadays, there are ancillary molecular biology techniques providing important information related to CxCa and the Human Papillomavirus (HPV) natural history, including HPV DNA test, HPV mRNA tests and immunocytochemistry tests. However, these techniques have their own performance, advantages and limitations, thus a combinatorial approach via computational intelligence methods could exploit the benefits of each method and produce more accurate results. In this paper we present a risk assessment model based on a Bayesian Network which, by combining the results of Pap test and ancillary tests, may identify women at true risk of developing cervical cancer and support the management of patients with ASCUS or LSIL cytology. The model, following the paradigm of other implemented systems, can be integrated into existing platforms and be available on mobile terminals for anytime/anyplace medical consultation

Single Nucleotide Polymorphisms of Toll-like Receptor 4 in Hepatocellular Carcinoma&mdash;A Single-Center Study

Hepatocellular carcinoma (HCC) is the most common primary liver tumor leading to significant morbidity and mortality; its exact genetic background is largely unrecognized. Toll-like receptor-4 (TLR4) reacts with lipopolysaccharides, molecules found in the outer membrane of Gram-negative bacteria. In damaged liver, TLR4 expression is upregulated, leading to hepatic inflammation and injury. We tried to investigate the role of the two most common single-nucleotide polymorphisms (SNPs) of TLR4 in HCC-genesis. Aged &gt; 18 years old, cirrhotic patients were included in this study. Exclusion criteria were non-HCC tumors and HIV co-infection. TLR4 SNPs association with HCC occurrence was the primary endpoint, and associations with all-cause and liver-related mortality, as well as time durations between diagnosis of cirrhosis and HCC development or death and diagnosis of HCC and death were secondary endpoints. A total of 52 out of 260 included patients had or developed HCC. TLR4 SNPs showed no correlation with primary or secondary endpoints, except for the shorter duration between HCC development and death in patients with TLR4 mutations. Overall, TLR4 SNPs showed no correlation with carcinogenesis or deaths in patients with liver cirrhosis; patients with TLR4 SNPs that developed HCC had lower survival rates, a finding that should be further evaluated

Anti-SARS-CoV-2 Immunoglobulins in Human Milk after Coronavirus Disease or Vaccination—Time Frame and Duration of Detection in Human Milk and Factors That Affect Their Titers: A Systematic Review

Human milk (HM) of mothers infected with or vaccinated against SARS-CoV-2 contains specific immunoglobulins, which may protect their offspring against infection or severe disease. The time frame and duration after infection or vaccination, during which these immunoglobulins are detected in HM, as well as the major factors that influence their levels, have not been fully elucidated. This systematic review aimed to collect the existing literature and describe the immune response, specifically regarding the immunoglobulins in HM after COVID-19 disease or vaccination in non-immune women. We conducted a systematic search of PubMed and Scopus databases to identify studies published up until 19 March 2023. In total, 975 articles were screened, and out of which 75 were identified as being relevant and were finally included in this review. Infection by SARS-CoV-2 virus primarily induces an IgA immune response in HM, while vaccination predominantly elevates IgG levels. These immunoglobulins give HM a neutralizing capacity against SARS-CoV-2, highlighting the importance of breastfeeding during the pandemic. The mode of immune acquisition (infection or vaccination) and immunoglobulin levels in maternal serum are factors that seem to influence immunoglobulin levels in HM. Further studies are required to determine the impact of other factors, such as infection severity, lactation period, parity, maternal age and BMI on immunoglobulin level in HM

The Effect of Oral Iron Supplementation/Fortification on the Gut Microbiota in Infancy: A Systematic Review and Meta-Analysis

(1) Background: Iron is an essential metal for the proper growth and neurodevelopment of infants. To prevent and treat iron deficiency, iron supplementation or fortification is often required. It has been shown, though, that it affects the synthesis of gut microbiota. (2) Methods: This paper is a systematic review and meta-analysis of the effect of oral iron supplementation/fortification on the gut microbiota in infancy. Studies in healthy neonates and infants who received per os iron with existing data on gut microbiota were included. Three databases were searched: PUBMED, Scopus, and Google Scholar. Randomized controlled trials (RCTs) were included. Quality appraisal was assessed using the ROB2Tool. (3) Results: A total of six RCTs met inclusion criteria for a systematic review, and four of them were included in the meta-analysis using both the fixed and random effects methods. Our results showed that there is very good heterogeneity in the iron group (I2 = 62%), and excellent heterogeneity in the non-iron group (I2 = 98%). According to the meta-analysis outcomes, there is a 10.3% (95% CI: −15.0–−5.55%) reduction in the bifidobacteria population in the iron group and a −2.96% reduction for the non-iron group. There is a confirmed difference (p = 0.02) in the aggregated outcomes between iron and non-iron supplement, indicative that the bifidobacteria population is reduced when iron supplementation is given (total reduction 6.37%, 95%CI: 10.16–25.8%). (4) Conclusions: The abundance of bifidobacteria decreases when iron supplementation or fortification is given to infants

Identifying the Relation between Fasting Blood Glucose and Glycosylated Haemoglobin Levels in Greek Diabetic Patients

Introduction: Diabetes Mellitus (DM) is associated with long-term damage, dysfunction, and failure of various body organs.Glycosylated haemoglobin (GHbA1c) is a significant biochemical marker in patients with DM which provides an estimation of long-term average glycaemia. The aim of this study was to evaluate the relation between fasting serum glucose (GLU) level and GHbA1c in DM patients and healthy controls, to evaluate the differences between male and female patients and to evaluate the correlation between estimated Average Glucose (eAG) and GLU. Materials and Methods: The study included 800 DM patients (448 male, 352 female), and 200 (100 male, 100 female) healthy control patients. We used statistical modeling and analysis to evaluate the data. Results: Via linear regression we found statistically significant linear relations between GLUand GHbA1c for female and male patients, male patients had higher mean level of GLU than female (+10.7mg/dL p&lt;0.05), similarly for GHbA1c (+0.24% p&lt;0.05). For healthy controls, neither linear relation nor gender difference was identified. Subsequently we calculated eAG on the basis of GLU level, we found a significant correlation Corr.Coeff.=0.56) between GLU and eAG for DM patients and no correlation (Corr.Coeff.=0.026) for healthy controls. These finding were consistent when the analysis was repeated separately for both genders, however with no difference between men and women.Conclusions: eAG and GLU values cannot be used in general population interchangeably. One strategy option could be the use of eAG levels together with GHbA1c values.</p

Why Has Metabolomics So Far Not Managed to Efficiently Contribute to the Improvement of Assisted Reproduction Outcomes? The Answer through a Review of the Best Available Current Evidence

Metabolomics emerged to give clinicians the necessary information on the competence, in terms of physiology and function, of gametes, embryos, and the endometrium towards a targeted infertility treatment, namely, assisted reproduction techniques (ART). Our minireview aims to investigate the current status of the use of metabolomics in assisted reproduction, the potential flaws in its use, and to propose specific solutions towards the improvement of ART outcomes through the use of the intervention. We used published reports assessing the role of metabolomic investigation of the endometrium, oocytes, and embryos in improving clinical outcomes in women undergoing ART. We initially found that there is no evidence to support that fertility outcomes can be improved through metabolomics profiling. In contrast, it may be helpful for understanding and appraising the nutritional environment of oocytes and embryos. The causes include the different infertility populations, the difference between animals and humans, technical limitations, and the great heterogeneity in the variables employed. Suggested steps include the standardization of variables of the method itself, the universal creation of a panel where all biomarkers are stored concerning specific infertile populations with different phenotypes or etiologies, specific bioinformatics contribution, significant computing power for data processing, and importantly, properly conducted trials