25-Hydroxyvitamin D Serum Levels and Endometriosis: Results of a Case-Control Study.

The immunomodulatory, anti-inflammatory, and antiproliferative properties of vitamin D have laid the basis for a possible function of this prohormone in the pathogenesis of endometriosis. The aim of this case-control study was to investigate vitamin D status, by measuring 25-hydroxyvitamin D [25(OH)D] serum levels, in women with and without endometriosis. Only Italian women of Caucasian origin aged between 18 and 45 years were deemed eligible. Enrollment was limited to the period October to May. Cases and controls were matched for month of recruitment and secondarily for age and parity. Overall, 434 women were enrolled (endometriosis n = 217; controls n = 217). The group of cases included 127 women with ovarian endometrioma and 90 patients with deep endometriosis. Mean (standard deviation) levels of 25(OH)D in women with and without endometriosis were 17.9 (7.0) ng/mL and 18.4 (7.6) ng/mL, respectively ( P = .46). Analyzing the two endometriosis subgroups separately, no statistically significant differences emerged (18.7 [7.4] ng/mL in deep endometriosis group vs 17.3 [6.6] ng/mL in women with ovarian endometrioma; P = .14). Comparing the subgroup of women with deep endometriosis with paired controls, no differences occurred (18.7 [7.4] ng/mL vs 18.5 [7.7] ng/mL, P = .80). Similar data emerged when performing the same analysis for ovarian endometriomas (17.4 [6.6] ng/mL vs 18.3 [7.6] ng/mL, P = .23). The results of the present case-control study do not support an association between serum vitamin D levels and different phenotypes of endometriosis.

A real-life evaluation of two platelet cross-matching programmes for the treatment of patients refractory to platelet transfusions.

BACKGROUND AND OBJECTIVES: Strategies for overcoming alloimmune refractoriness to random donor platelets are based on the use of compatible platelets selected from large panels of HLA-typed donors or cross-matching (XM). The aim of this study was to review the effectiveness of a platelet XM programme for treating refractory haematological patients at Milan's Policlinico Hospital (PHM) 2002-2014 and Spedali Civili in Brescia (SCB) 2013-2016. MATERIALS AND METHODS: A commercially available solid-phase antibody detection system was used for platelet antibody detection and XM. Forty-nine alloimmune refractory patients at PHM and 13 at SCB, respectively, received a median [IQR] of 12 [6-13] and 18 [13-15] XM compatible platelet transfusions after the detection of refractoriness. The absolute increases in post-transfusion platelet counts obtained using random, and XM platelets were retrieved from the patients' hospital records. RESULTS: The critical review at SCB showed that the median [IQR] 1 h post-transfusion increase in platelet counts was 3 × 109 /L [1-5] after 47/47 random platelet transfusions, and 10 × 109 /L [2-25] after 325/326 XM compatible platelet transfusions. The documentation concerning the outcomes of XM platelet transfusions at PHM was incomplete, and so the findings of the review were inconclusive. CONCLUSION: This retrospective analysis confirmed the effectiveness of the XM programme at SCB, but revealed defective data collection and retrieval methods at PHM, thus underlining the importance of such methods. The literature review accompanying this retrospective analysis identified a recently described algorithm for ensuring platelet support in refractory patients that optimally integrates the combined use of XM and HLA typing.