Efficacy of selenium supplementation on autoantibody titers in Graves' ophthalmopathy

BACKGROUND: Selenium (Se) shows potential benefit in Graves' disease (GD) especially those with active Graves' ophthalmopathy(GO).   OBJECTIVES: To evaluate the efficacy of Se supplementation among patients with GD and GO. METHODOLOGY: We performed a meta-analysis of trials evaluating the efficacy of Se supplementation among adult patients with GD and active GO, versus either placebo or an alternative drug, and on top of standard therapy. Results were presented as mean differences, standard errors, and 95% confidence intervals,and graphically presented as forest plots.Estimates were calculated using the inverse variance method for continuous variables and pooled using the fixed effects model. I2 and Chi2 tests were used to assess heterogeneity.RESULTS: Only  two  trials  were  ultimately  included  in  the  analysis. Both studies totaled 197 participants with GD and non-severe  GO  on  standard  therapy,  and  compared  Se  supplementation to placebo. The only common outcomes of  interest  were  changes  in  TSH  receptor  antibody  (TRAB)  and thyroid peroxidase antibody (TPOAB) titers. We found no statistically significant difference in either TRAB (95% CI,-1.38  [-3.19,  0.44],  p=0.14)  or  TPOAB  (95%  CI,  36.66  [-32.56, 105.88], p=0.30) titers between Se and placebo groups on follow  up.However,our analysis was limited by the small number of included studies, a small sample size, and lack of other synthesizable outcomes.CONCLUSION: This is the  first  meta-analysis  summarizing  the available data on Se supplementation in patients with GD and  non-severe  GO.We found no statistically significant differences in both TRAB and TPOAB titers between Se and placebo groups. We recommend larger studies to validate these findings. 

Sexual Dysfunction among Filipino breast cancer patients

INTRODUCTION: Sexual function is an important aspect of quality of life, and can be drastically affected in ill patients. Very few studies (and apparently none among Filipinas) looked into sexual dysfunction among females with breast cancer (BrCa); prevalence also is not well defined. This study evaluates the prevalence of sexual dysfunction among Filipino patients with BrCa, and assesses which treatment or if duration of illness, age, BMI, smoking history, diabetes, hypertension significantly contributed to the dysfunction.METHODS: A cross sectional study was conducted among BrCa patients consulting at the outpatient medical oncology clinic of a government tertiary hospital. Study population included those diagnosed and was with breast cancer over a 3-months period, with a calculated sample size of 60 (within 81±10% prevalence rate, Cl 95%). A validated translated version of the Female Sexual Function Index (FSFI) 19-item questionnaire that looked into 6 domains (arousal, lubrication, desire, pain, orgasm, and satisfaction) was used. Sexual dysfunction was defined as an FSFI score of RESULTS: Of the 97 respondents, mean age was 49.4 years old and mean BMI of 24.8. About 78% received chemotherapy, 26% hormonal therapy. 15% radiotherapy, 82% modified radical mastectomy (MRM), and 71% received both MRM and chemotherapy at the time of interview. Duration of cancer wasmonths in 72% of subjects. There were 97.9% who had sexual dysfunction which is similar to prevalence rates (64-98%) in other studies. Age, BMI, smoking history, hypertension, diabetes mellitus, chemotherapy, surgery, hormonal therapy, radiation therapy, and duration of illness were shown not to be significant predictors of sexual dysfunction among Filipinas with BrCa by bivariate analysis.CONCLUSION: Sexual dysfunction is highly prevalent among female Filipino BrCa patients. Knowing such high prevalence should prompt health care providers to include interventions to improve quality of life of BrCa patients, including their sexual life.