4 compared with 9.0 femtoliter (fl); P=.02). First-trimester concentrations (multiples of the median) of ADAM-12 (1.14 compared with 1.04; P=.003), pregnancy-associated Selleckchem Linsitinib plasma protein-A (0.94 compared with 0.98; P=.04), and placental growth factor (0.83 compared with 1.04; P<.001) were significantly different in women who had development of preeclampsia compared with women in the control group. The optimal multivariable model included African American race, systolic blood pressure, BMI, education level, ADAM-12, pregnancy-associated plasma protein-A, and placental growth factor, and yielded an area under the curve of
0.73 (95% confidence interval 0.69-0.77) and a sensitivity of 46.1% (95% confidence interval 38.3-54.0) for 80% specificity.
CONCLUSION: A multivariable analysis of clinical data
and biochemical markers in the first trimester did not identify a model that had clinical utility for predicting preeclampsia in a nulliparous population at low risk. (Obstet Gynecol 2012; 119: 1234-42) DOI: 10.1097/AOG.0b013e3182571669″
“Background: Little information is available on the effect of second cytotoxic therapy in steroid-dependent children with minimal change nephrotic syndrome (MCNS).
Methods: Response to second cytotoxic therapy and side effects were reviewed in 33 steroid-dependent and cyclophosphamide-resistant children with MCNS who received chlorambucil (n=11, group 1) or cyclophosphamide (n=22, group 2).
Results: Age at onset of nephrosis, beginning of first and second therapy, sex ratio, duration of nephrosis CDK inhibitor before first cytotoxic therapy, interval between first and second cytotoxic therapy, number of relapses, cumulative doses of steroids and length of remission off steroids before second therapy were STA-9090 similar between groups. Four patients (36.4%, p<0.05) in group 1 remained in remission for a median 34.0 months, whereas only 1 patient (4.5%) in group 2 did for 53.0 months. Two patients
in group 1 and 1 patient in group 2 became infrequent relapsers. Total number of nonrelapsers and infrequent relapsers was higher in group 1 (54.5%, p<0.05) than in group 2 (9.1%). Number of relapses and cumulative doses of steroids were reduced and length of remission off steroids was longer in group 1 than in group 2 (p<0.05). There was no difference between groups in frequency of side effects, and none had serious toxicity. However, the short period of follow-up in our study does not exclude the risk of azoospermia.
Conclusions: Our data suggest a superior effect of chlorambucil over cyclophosphamide in steroid-dependent and cyclophosphamide-resistant children with MCNS. A future randomized controlled clinical trial is required to confirm our findings.