[Anti-Müllerian hormone: A brief review of the literature].

BACKGROUND: Anti-Müllerian hormone (AMH) is a dimeric glycoprotein, which was originally identified because of its role in male sexual differentiation. In fact, AMH is expressed by the Sertoli cellsof the foetal testes and induces the regression of the Müllerian ducts. In the absence of AMH, the Müllerian ducts evolve in the uterus, fallopian tubes and in the upper part of the vagina. In women AMH is produced by granulose cells, pre-antral and antral follicles and its major physiological role in the ovaries seems to be limited to inhibiting the development of the earliest stages of follicular development. AMH has been studied because of its potential clinical utility: the diagnosis of intersexuality in children, the diagnosis of criptorchism and anorchia, the diagnosis of early or delayed puberty, the diagnosis of granulosa cell tumours, ovarian function in women who have undergone chemotherapy, the determination of female ovary function and the diagnosis and follow-up of polycystic ovarian disease. AIM: The objective of this brief review is to ascertain the current status of studies on AMH and potential future prospects. METHODS: Review the most recent literature. RESULTS: There are still several points that need to be clarified with regard to all of the activities of AMH. The techniques for handling serum samples and hormone assays need to be made even more uniform. DISCUSSION: In recent years, it has been found that AMH is not only a male hormone, but it is being proven to be a valuable tool to better understand ovarian function, both in young people and in adult females. At the moment, the clinical use of serum assays for AMH still faces technical problems.

[Essay of sex hormone binding protein in internal medicine:a brief review].

The sex hormone binding globulin(SHBG) is a protein produced mainly in the liver that binds sex steroid hormones and thereby regulates their bioavailability. Many studies do correlate low levels in many diseases including diabetes mellitus and the metabolic syndrome with associated risks to the development of cardiovascular diseases. According to some jobs low SHBG can predict the onset of diabetes mellitus; based on other study that a healthy lifestyle can increase SHBG values.

Pollution, the thyroid and neurodevelopment.

The global prevalence of neurodevelopmental diseases is on the rise. The number of autistic babies in the US has jumped from 1 in 68 to 1 in 42. Plus more and more children have attention disorders or hyperactivity disorders. The genetic causes of these disorders of neurological development cannot explain such radical increases in the incidence and this leads one to look for the culprit in other elements, many of which have been shown to disrupt normal thyroid function. For instance, many polluting chemical substances can interfere with thyroid hormone (TH) metabolism and this might lead to abnormalities in the neurological development of the fetus or the child.

[Digoxin-like immunoreactive factors. Review of the literature]. / Digoxin-like immunoreactive factor. Revisione della letteratura.

It is confirmed by several studies that in normal subjects a substance recognized by antibodies anti digoxin exists. Such a substance can be found at increased concentration in pregnant women, neonates, in liver or kidney diseases. A limited increase in concentration has been also registered in patients with essential hypertension and in normotensive patients with a family history of hypertension. Serum or urines rich in such a substance show an increased capacity of inhibiting in vitro the sodium-potassium pump and therefore in reducing also in vivo the capacity of reabsorption of sodium and with it, of water. The investigators interest for this substance has two main reasons: 1) the interference that such a substance has in dosages of digitalis in therapeutic monitorizing; 2) the possibility that such a substance has an important physiological role in hydroelectrolytic metabolism.

HIV-1: absence of infection in subjects with indeterminate western blot.

The search for specific antibodies against the Human Immunodeficiency Virus type-1 (Ab anti HIV 1), using an immunoenzymatic test and a subsequent confirmation test (Western Blot-WB) in patients who were previously positive or borderline at the first test, singled out from about 12500 tested subjects, fifteen patients with indeterminate WB (WBi) for the presence of an abnormal band. The presence of p24 was predominant in those WBi (about 50%); generally p24 was the only band found. In all serum samples with WBi, the viral antigen p24 (Ag p24) was absent. In 3 subjects with WBi, after at least six months from the first test, not only did the same pattern persist but also the search for VIH-1 DNA sequence using the polymerase chain reaction (PCR) gave a negative result. According to our experience and the literature on the subject, we suggest that patients with low risk of infection and whose WBi does not modify with time have a remote possibility of being infected by HIV.

[Obstetric complications associated with DIC. Importance of D-dimer in the diagnosis and treatment. A clinical case]. / Complicanze ostetriche associate a DIC. Importanza del D-dimero nella diagnosi e nel trattamento. Caso clinico.

The case of a 32-year old woman with 36-week pregnancy presented at hospital because of spontaneous vaginal bleeding, anemia and mild hypotension is reported. Fetal mors in utero, abruptio placentae and diffuse intravascular coagulation were diagnosed. The patient subsequently underwent cesarean section and large retroplacental hematoma was removed and obviously fetum. The DIC was easily controlled by means of recently introduced method of determination of fibrin D-dimer.