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Objective: To assess the postnatal persistence of fetal cardiovascular remodelling associated with assisted reproductive technologies (ART) in children at 3 years of age.Design: A cohort study of children conceived by ART.Setting: Maternal-Fetal Medicine Unit, Hospital Clinic Barcelona, Spain.Population Sample: Eighty singleton pregnancies conceived by ART and 80 spontaneously conceived (controls) followed from fetal life up to childhood.Methods: Cardiovascular evaluation was performed at 3 years of corrected age, including echocardiography, carotid intima-media (cIMT) by ultrasound, and blood pressure.Main Outcome Measures: Postnatal persistence of cardiovascular changes in children conceived by ART.Results: Compared with controls, children conceived by ART showed larger atria (right atrial area: control 4.9 cm2 (0.9) versus ART 5.5 cm2 (0.9), P < 0.001), more globular ventricles (right ventricular sphericity index: control mean 1.8 (SD 0.5) versus ART 1.6 (0.2), P < 0.001), and signs of systolic (tricuspid annular plane systolic excursion: control 18 mm (2) versus ART 16 mm (3), P < 0.001) and diastolic dysfunction (isovolumic relaxation time: control 68 ms (12) versus ART 79 ms (12), P < 0.001). ART children also presented increased systolic blood pressure (control 90 mmHg (6) versus ART 94 mmHg (5), P < 0.003) and cIMT (control 0.52 μm (0.14) versus ART 0.60 μm (0.16), P < 0.001) as compared with those spontaneously conceived.Conclusions: Cardiovascular changes previously reported in ART fetuses persist postnatally at 3 years of age. These results underscore the importance of future studies for assessing the long-term cardiovascular health associated with ART.Tweetable Abstract: Cardiovascular changes described in fetuses conceived by ART, persist in children at 3 years of age. [ABSTRACT FROM AUTHOR]

Loess deposits cover 10% of the world continental surface and larger parts in Eurasia but are really limited in Mediterranean areas. In the Iberian Peninsula it has been described mainly in the central Tagus basin and in the Eastern Ebro basin besides other minor outcrops (Andalucia, la Mancha, Girona). These loess deposits have a great potential for climate interpretation that can illustrate environmental changes during the glacial cycles and record past global atmospheric mineral dust dynamics and palaeoenvironmental changes in the Mediterranean. The contribution of this work is to identify with more detail the distribution of loess in the Eastern Ebro basin to the boundary with the Prelitoral Catalan System, as a first step to locate their source areas and to understand their formation conditions and pedogenesis. The spatial distribution of loess outcrops is highly discontinuous over a surface of 2500 km2, and therefore it may be considered as the largest loess region in the Iberian Peninsula. These loess deposits overly the Tertiary sediments and the Quaternary terraces of the Central Ebro Valley and the Eastern Móra d'Ebre basin. Representative profiles with primary loess have been determined for the macromorphological characterization of the deposit. Samples were obtained for physico-chemical, particle-size, micromorphological analyses and OSL dating. From several possible source areas, samples were collected from terrace T2 of the Ebro River and from nearby tributaries (Cinca, Segre). Samples were also taken from Tertiary materials for textural analysis, grain-size distribution and heavy mineral analysis, to be compared with loess samples. The studied deposits are very sandy, formed by homogeneous silt and fine sands, are very porous and they form highly stable slopes. The particlse are composed of quartz (40-50%), calcite (30-40%) and other minerals as feldspars, biotites and muscovites besides accessory minerals. These sediments are carbonated (around 38% calcite) and contain very little organic matter (<0.05%). To the West of the area some outrcops contain gypsum (up to 28%). The relatively coarse grain size, mineralogy, distribution and depth indicate that the potential source areas are not very far, with a W-NW wind direction. They are probably found at alluvial valleys of the Central basin or at Chiprana endorheic basins and surrondings, where deflaction areas are found. The age of the deposits can be classified into two groups. Most of them were formed between 17-34 ky, which correspond to the cold Heinrich phases 1, 2 and 3 of the last Maximum (LGM). In a few cases older outcrops, with ages older than 115 ky, were probably deposited at the end of the penultimate glacial period and underwent pedogenesis during the Eemian warmer period. [ABSTRACT FROM AUTHOR]

[Display omitted] • Two red soils in Mediterranean loess showed different genesis. • The oldest dated loess deposits correlate with penultimate glaciation. • Both soils underwent decarbonation, rubefaction, clay illuviation, recarbonation. • Reddening in Chiprana is evidenced by biologically-driven carbonate depletion. Most of the loess in the southeast of the Ebro Valley encompass mostly the Marine Isotope Stage 2 (MIS2) but some exceptions date back to more than 115 ka. Soils formed on these older loess deposits are normally categorised as red soils. We studied the pedogenesis of two of these red soils. Macro-micromorphological, particle size, color-redness rating, and iron form analyses were performed in combination with luminescence and radiocarbon dating. Mas de l'Alerany is a primary loess deposit, 3.15 m thick. Recarbonation is shown as carbonate coatings covering previous clay coatings in a red matrix, besides carbonate nodules and rhizocretions. Its deepest horizon dates back to ca. 140 ka. Chiprana is a 3.2 m loess-like sequence. It also reveal carbonate nodules and rhizocretions throughout the profile, together with a strong bioturbation and frequent queras, which are channel infillings of biosparite surrounded by decarbonated reddish hypocoatings. The bottom of the sequence has an age between 100 and 130 ka and shows residual clay coatings. The age of the upper part is about 30 ka, while the biosparite grains have an age of 26 ka. The genesis of the Mas de l'Alerany red soil, after its deposition, comprises the subsequent processes of decarbonation - rubefaction - clay illuviation - recarbonation. Chiprana presents a similar succession, but with a more recent decarbonation due to the biological activity that generated the queras, which were responsible for revealing the previously rubefacted material. Although Mas de l'Alerany and Chiprana red soils were probably formed from loess of the penultimate glaciation and both underwent a similar cycle of processes, the origin of the red colours in Chiprana is due to micro-site, biologically driven recent decarbonation. Our results suggest that the biological activity may play an important role in the reddening process in similar Mediterranean soils. [ABSTRACT FROM AUTHOR]

Polymethylmethacrylate (PMMA) plastic fragments have been found abundant in the environment, but the knowledge regarding its effects on the physiology of aquatic animals is still poorly studied. Here the short-term (96 h) effects of waterborne exposure to PMMA nanoplastics (PMMA-NPs) on the muscle of gilthead sea bream (Sparus aurata) fingerlings was evaluated at a concentration range that includes 0.001 up to 10 mg/L. The expression of key transcripts related to cell stress, tissue repair, immune response, antioxidant status and muscle development, together with several biochemical endpoints and metabolic parameters. Results indicate that exposure to PMMA-NPs elicit mildly antioxidant responses, enhanced the acetylcholinesterase (AChE) activity, and inhibited key regulators of muscle development (growth hormone receptors ghr-1/ghr-2 and myostatin, mstn-1 transcripts). However, no effects on pro-inflammatory cytokines (interleukin 1β, il1β and tumor necrosis factor α, tnfα) expression nor on the levels of energetic substrates (glucose, triglycerides and cholesterol) were found., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Pernicious effects of plastic particles, emergent contaminants worldwide, have been described in different species. In teleost species, alterations of immune function after exposure to nanoplastics (NPs) have been reported, but the interaction with cortisol - hypothalamic-pituitary-adrenal (HPI) axis has not yet been explored. Furthermore, the role of dissolved organic matter on the effects of NPs is poorly known. Thus, the aims of this research were to assess if polystyrene NPs (PSNPs) acted as a stressor on juvenile European seabass (Dicentrarchus labrax), interfering with the immune response, as well as to elucidate if humic acids (HA) modulated the potential effects of PSNPs. A short-term exposure to PSNPs and HA elicited an immuno-modulatory response, with an activation of steroidogenic stress-related pathways. An upregulation of anti-inflammatory cytokine (il10, tgfb) and stress-related (mc2r, gr1) transcripts were observed after exposure to HA and PSNPs both individually and in co-exposure. No notable alteration of inflammatory markers was consistently found, which may reflect a protective anti-inflammatory effect of HA in the presence of PSNPs. Nevertheless, there seems to be a more complex interaction between both components. Overall, data show that understanding the interaction of NPs with dissolved organic substances is key to deciphering their environmental risks., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Myogenic regulators of muscle development, metabolism and growth differ between fish species in a context-specific manner. Commonly, the analysis of environmental influences on the expression of muscle-related gene regulators in teleosts is based on differences in swimming performance, feeding behaviour and stress-resistance, but the evaluation of behavioural phenotyping of immune and stress-related responsiveness in skeletal muscle is still scarce. Here we challenge proactive and reactive fingerlings of gilthead sea bream (Sparus aurata), one of the most commonly cultured species in the Mediterranean area, with highly pathogenic O1, O2α and O2β serotypes of Vibrio anguillarum, a widespread opportunistic pathogen of marine animals, to analyse skeletal muscle responses to bath vaccination. Transcripts related to inflammation (interleukin 1β, il1β; tumour necrosis factor-α, tnfα; and immunoglobulin M, igm), and muscle metabolism and growth (lipoprotein, lpl; myostatin, mstn-1; myogenin; and growth hormone receptors type I and II, ghr1 and ghr2, respectively) were analysed. Biochemical indicators of muscle metabolism and function (creatine kinase, CK, aspartate aminotransferase, AST; esterase activity, EA; total antioxidant status, TAC and glucose) were also determined. Our results indicate that proactive, but not reactive, fish respond to Vibrio vaccination by increasing the expression levels of mstn-1, myogenin and ghr2 transcripts at short-/medium- term (1 to 3 days' post vaccination). No effect of vaccination was observed in immune indicators or biochemical parameters in either phenotypes, except for elevated levels of EA in reactive fish one-week post vaccination. This suggests that behavioural divergence should be taken into account to evaluate the crosstalk between immune, metabolic and growth processes in muscle of immune-challenged fish., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Introduction: Recent reports consider endometriosis to be an immunological disorder, thus suggesting potential efficacy of immunomodulators for its treatment. The aim of this study was to assess the effects of oral administration of pentoxifylline on endometriosis-like lesions in a heterologous mice model., Study Design: Human endometrial tissue obtained from women (n = 5) undergoing surgery for benign conditions was implanted in nude female mice (n = 30). The animals were distributed into 3 experimental groups receiving: saline 0.1 mL/d (control, group 1); pentoxifylline 100 mg/kg/d (group 2), and pentoxifylline 200 mg/kg/d (group 3). After 28 days, the number of implants and the total volume of surgically extracted tissue were recorded. Immunohistochemical analysis was performed to assess the area of endometriosis and vascularization of endometriosis-like lesions. Cytokine levels in peritoneal fluid samples were measured., Results: Macroscopic quantification showed a trend to dose-dependent reduction in the number of the endometriosis-like lesions after 28 days. The volume was significantly reduced in group 3 versus group 2 and controls (399.10 ± 120.68 mm 3 vs 276.75 ± 94.30 mm 3 and 145.33 ± 38.20 mm 3 , respectively; P = .04). Similarly, the mean area of endometriosis was significantly lower in group 3 (0.12 ± 0.08 mm 2 ) versus group 2 (1.35 ± 0.43 mm 2 ) and control (2.84 ± 0.60 mm 2 ; P = .001). Vascularization and cytokine levels were also reduced posttreatment., Conclusion: Our results suggest that the oral administration of pentoxifylline may be an alternative to current therapies for endometriosis. Nonetheless, further studies are required.

Objective: The purpose of the study was to develop an easily applicable predictive model to predict deep infiltrating endometriosis in patients with ovarian endometrioma., Study Design: We performed a retrospective analysis of 178 consecutive women with ovarian endometrioma who underwent surgery, with histological confirmation and complete removal of endometriosis in the Hospital Clinic of Barcelona. Several markers were prospectively obtained and compared between the group of patients presenting deep infiltrating endometriosis associated with ovarian endometrioma and women with only ovarian endometrioma. Multiple logistic regression analysis was performed to create a model to predict the presence of deep infiltrating endometriosis and internal validation was later performed., Results: Of the 178 patients studied, 80 (45%) were classified in the ovarian endometrioma group and 98 (55%) in the group of patients presenting deep infiltrating endometriosis associated with ovarian endometrioma. The independent variables to predict deep infiltrating endometriosis were: at least one previous pregnancy, a past history of surgery for endometriosis and the mean endometriosis-associated pelvic pain score. The area under the ROC curve was 0.91 (95% confidence interval: 0.86-0.94), with an optimal cut-off of the predicted probability of 0.54. The sensitivity of the model was 80% and the specificity 84%., Conclusions: This model predicts the development of deep infiltrating endometriosis in patients with ovarian endometriomas allowing prioritization of women for referral to specialized centers., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Objectives To examine perinatal outcomes in pregnancies conceived by different methods: fertile women with spontaneous pregnancies, infertile women who achieved pregnancy without treatment, pregnancies achieved by ovulation induction (OI) and in vitro fertilization or intra-cytoplasmic sperm injection (IVF/ICSI). Methods Retrospective single-center cohort study including 200 fertile and 748 infertile women stratified according to infertility treatment. The outcome measurements were preterm delivery (PTD), small-for-gestational-age (SGA), gestational diabetes, placenta previa or preeclampsia. Results The overall rate of pregnancy complications was significantly increased in all infertility groups regardless of the infertility treatment (adjusted odds ratio (OR): infertile without treatment 2.3 versus OI 2.2 versus IVF/ICSI 3.4). While PTD was mainly associated to IVF/ICSI (adjusted OR: infertile without treatment 1.3 versus OI 1.6 versus IVF/ICSI 3.3), SGA was significantly associated to both OI and IVF/ICSI (adjusted OR: infertile without treatment 1.9 versus OI 2.7 versus IVF/ICSI 2.6). All these associations remained statistically significant after adjusting by maternal age and twin pregnancy. Conclusions This study confirms the higher prevalence of pregnancy complications in infertile women irrespectively of receiving infertility treatment or not, and further describes a preferential association of prematurity with IVF/ICSI, and SGA with treated infertility (OI and IVF/ICSI).

Objective: To evaluate the long-term safety, satisfaction and tolerability of flutamide therapy for female hyperandrogenism., Design: A 20-year surveillance study., Methods: Setting: Gynecology Department in a teaching hospital., Patients: Hyperandrogenic women complaining for hirsutism treatment were followed between February 1995 and April 2015., Interventions: Women received flutamide 125 or 250 mg/day alone (n = 55) or combined with oral contraceptives (n = 65)., Main Outcome Measures: Adverse events, safety, tolerability satisfaction and efficacy were assessed every 6 months during all the follow-up. Lab tests including liver and lipid profiles were also recorded in each control., Results: Patients under flutamide therapy showed significant improvements in hirsutism scores after 6 months of treatment with a maximum effect at 12 months that was maintained during all the therapy time. Satisfaction reported by patients with the efficacy of the drug in a visual scale was also high. A total of 54.2 % women presented one or more adverse effects during the follow-up; 33.3% showed at least one adverse effect possibly related with the study drug; and 24.1% withdrew from the study because of adverse effects. During the follow-up, as many as 89.9 % of patients abandoned flutamide. Reasons include: questions linked to medical problems (50%), attempt pregnancy (4%) and significant improvement in the symptomatology (35.8%)., Conclusions: Flutamide is very effective for hirsutism treatment; however, adverse effects are very frequent and affect compliance.

Cell-derived microparticles (cMPs) are small membrane vesicles that are released from many different cell types in response to cellular activation or apoptosis. Elevated cMP counts have been found in almost all thrombotic diseases and pregnancy wastage, such as recurrent spontaneous abortion and in a number of conditions associated with inflammation, cellular activation and angiogenesis. cMP count was investigated in patients experiencing unexplained recurrent implantation failure (RIF). The study group was composed of 30 women diagnosed with RIF (RIF group). The first control group (IVF group) (n = 30) comprised patients undergoing a first successful IVF cycle. The second control group (FER group) included 30 healthy women who had at least one child born at term and no history of infertility or obstetric complications. cMP count was significantly higher in the RIF group compared with the IVF and FER groups (P < 0.05 and P < 0.01, respectively) (RIF group: 15.8 ± 6.2 nM phosphatidylserine equivalent [PS eq]; IVF group: 10.9 ± 5.3 nM PS eq; FER group: 9.6 ± 4.0 nM PS eq). No statistical difference was found in cMP count between the IVF and FER groups. Increased cMP count is, therefore, associated with RIF after IVF and embryo transfer., (Copyright © 2016. Published by Elsevier Ltd.)

Objective: To analyze natural cycle IVF (NC-IVF) results according to patient age, ovarian reserve status following the Bologna criteria, cause of infertility, and modification of the cycle with the use of GnRH antagonist., Design: Retrospective cohort study., Setting: Tertiary-care university hospital., Patient(s): Nine hundred forty-seven natural cycles carried out in 320 patients., Intervention(s): Analysis of 947 NC-IVF outcomes performed in one single center between January 2010 and December 2014., Main Outcome Measure(s): Pregnancy rates per cycle started, per ET, and per patient, as well as ongoing pregnancy rate at a minimum of 12 weeks of gestation., Result(s): Among the three age groups analyzed (≤35 years, 36-39 years, and ≥40 years), pregnancy rates per cycle were significantly lower in the older group of patients (11.4% vs. 11.6% vs. 5.9%). In addition, miscarriage rate (7.7% vs. 34.4% vs. 50%) and ongoing pregnancy rate (10.6% vs. 7.6%vs. 3.0%) were negatively affected by patient age. However, no differences were observed according to patient ovarian reserve status, cause of infertility, or modification of the cycle with GnRH antagonist. The multivariate logistic regression confirmed that patient age was the only variable that could predict pregnancy in NC-IVF cycles (odds ratio, 0.93; 95% confidence interval, 0.88-0.98)., Conclusion(s): NC-IVF is a feasible and "patient-friendly" option to be offered to young patients, independent of their ovarian reserve status., (Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)

Study Objective: To compare the effects of anesthesia maintenance drugs (inhaled sevoflurane versus intravenous propofol) used in general anesthesia on the absorption of glycine 1.5% solution during hysteroscopy., Design: Prospective comparative study., Setting: Tertiary care university hospital., Patients: One hundred fifteen women undergoing hysteroscopy., Interventions: Women were assigned to receive general anesthesia with inhaled sevoflurane (n = 77) or intravenous propofol (n = 38) to maintain anesthesia., Measurements: The primary endpoint was clinically relevant glycine 1.5% absorption (>1000 mL), while secondary endpoints were the median of glycine absorption, operative time, complications and the incidence of discontinuation of the hysteroscopic procedure due to excessive glycine 1.5% absorption., Main Results: Maintenance with sevoflurane produced significantly increased absorption of glycine 1.5% solution compared to intravenous anesthesia (264 vs 202 mL, P = .007). Clinically relevant absorption rates (>1000 mL) were observed in the sevoflurane group (P = .04) while none of the women receiving intravenous anesthesia reached this absorption level. No cases of severe post-operative hyponatremia (Na(1+)<125 mmol/L) or adverse events derived from glycine 1.5% absorption were reported. No major complications (such as perforations, severe hemorrhage or infection) were presented during the interventions., Conclusions: The results of the present study show that the use of inhaled sevoflurane is associated with significantly increased glycine 1.5% absorption compared to intravenous propofol for the maintenance of anesthesia. However, further randomized controlled trials are needed to assess the possible mechanisms and risk factors involved in the higher absorption induced by sevoflurane., (Copyright © 2016 Elsevier Inc. All rights reserved.)

Introduction: Our objective was to compare the feasibility and safety of surgical procedures to treat gynecological pathologies with intestinal involvement performed by skilled gynecological surgeons and by a multidisciplinary team of gynecologists plus colorectal surgeons., Material and Methods: We performed a comparative, observational, prospective study at a tertiary referral center. The population included all women undergoing bowel surgery for gynecological pathologies over a 3-year period. Cases were analyzed by the specialty of the main surgeon performing the intestinal procedure. The main outcome measures were surgical procedure characteristics and postoperative outcomes and complications., Results: A total of 65 women were included. Surgery was exclusively performed by a subspecialized gynecologist in 30.8% of the women, and undertaken by a multidisciplinary team (colorectal surgeons and gynecologists) in 69.2%. The main demographic and clinical characteristics were comparable in both groups. Main indications for bowel resection in gynecological surgery were advanced ovarian cancer and deep infiltrating endometriosis. In addition to the standard gynecological surgical procedures, a total of 135 intestinal segments were resected, with sigmoid colon the most frequent intestinal segment resected in both groups (53% in the gynecologist group and in 60% in the multidisciplinary group). No significant differences were observed between the two groups in the distribution and frequency of surgical techniques used, rate of complications, mean hospitalization time or frequency of re-intervention., Conclusion: Skilled gynecological surgeons appear to be equally good at handling common intestinal problems as a team of gynecologist and colorectal surgeons., (© 2015 Nordic Federation of Societies of Obstetrics and Gynecology.)

Aims: The primary outcome was to evaluate the subjective success rates of two laparoscopic POP operation techniques: uterine-sparing surgery versus a subtotal hysterectomy plus cervicopexy., Methods: Prospective cohort of 45 women with symptomatic POP recruited between January and December 2010 who self-selected surgery group: group A (n = 15), sacral laparoscopic hysteropexy was performed and group B (n = 30), laparoscopically conducted subtotal hysterectomy plus cervicopexy. All patients had a positive answer in the "Epidemiology of prolapse and incontinence" questionnaire (EPIQ, question number 35) and also had a POPQ ≥2nd degree. The primary outcome was the subjective success rate, measured by a negative answer to the Q35 of EPIQ: "Do you have a sensation that there is bulge in vagina or that something is falling out from your vagina" and also by rating their symptoms improvement by the "Patient Global Impression of Improvement". The secondary outcome was the objective success rate assessed by pelvic examination: cure was considered when POPQ <2nd degree in all vaginal compartments at 6 and 12 months., Results: Baseline demographic characteristics were similar between groups. Subjective success rate was significantly superior in group B both after 6 and 12 months (P = 0.001). Similarly, objective pelvic examination led to a significantly higher rate of successful apical outcome in group B after 6 and 12 months (P = 0.009 and P = 0.002, respectively). Neither major complications nor vaginal mesh erosions were registered., Conclusions: The overall success rate was significantly higher in the laparoscopic subtotal hysterectomy plus cervicopexy group, compared with the laparoscopic sacral hysteropexy group., (© 2014 Wiley Periodicals, Inc.)

Background: Back and knee pain (BP; KP), which often accompanies osteoporosis, is a prevalent health problem affecting quality of life (QoL) in middle-aged women., Aim: To compare the effects of calcium carbonate (CC) and ossein-hydroxyapatite complex (OHC) on BP and KP and QoL in perimenopausal osteopenic women., Subjects: 74 perimenopausal women were randomized to receive 1,200 mg/day of CC (n=38) or 1,660 mg/day of OHC (n=36) for 6 months., Methods: This was a randomized, open-label, parallel-group, controlled, prospective study. Back and knee basal pain was recorded using a visual analogue scale (VAS) at each control and exercise-induced pain was recorded using a visual rating system (VRS). Changes in QoL were evaluated using the SF-36 questionnaire., Results: In patients treated with OHC, mean VAS and VRS pain scores decreased significantly after 5 and 6 months of treatment, indicating a significant analgesic effect. In the CC group, however, changes were minor and non-significant. Two-way analysis of variance using treatment group and time as independent variables revealed a significantly greater effect of OHC over CC on VAS and VRS scores. SF-36 showed significant improvement for OHC on the physical component summary score and no changes for CC. Responses to items assessing emotional and social aspects of QoL showed only a significant improvement in vitality for OHC and no significant changes for CC in any of the four dominions constituting the SF-36 mental component., Conclusion: OHC has a significant analgesic effect and improves the physical component of QoL to a greater extent than CC., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

We performed an individual patient meta-analysis to determine whether aspirin has a significant protective effect on the risk of first thrombosis among patients with antiphospholipid antibodies (aPL). Five international cohort studies with available individual patient-level data, reporting on primary prophylaxis with continuous treatment with low-dose aspirin in patients with aPL were included. The main outcome was the occurrence of a first thrombotic in patients with aPL treated with low-dose aspirin compared to those not treated with low-dose aspirin. Pooled Hazard Ratios (HRs) and 95%CIs were calculated using frailty models. We pooled data from 497 subjects and 79 first thrombotic events (3469 patient-years of follow-up). After adjustment on cardiovascular risk factors, aPL profiles, and treatment with hydroxychloroquine, the HR for the risk of a first thrombosis of any type in aPL carriers treated with low-dose aspirin versus those not treated with aspirin was 0.43 (95%CI 0.25-0.75). Subgroup analysis showed a protective effect of aspirin against arterial (HR: 0.43 [95%CI: 0.20-0.93]) but not venous (HR: 0.49 [95%CI: 0.22-1.11]) thrombosis. Subgroup analysis according to underlying disease revealed a protective effect of aspirin against arterial thrombosis for systemic lupus erythematosus (SLE) (HR: 0.43 [95%CI: 0.20-0.94]) and asymptomatic aPL carriers (HR: 0.43 [95%CI 0.20-0.93]). We found no independent protective effect of hydroxychloroquine. This individual patient data meta-analysis shows that the risk of first thrombotic event as well of first arterial thrombotic event is significantly decreased among SLE patients and asymptomatic aPL individuals treated by low-dose aspirin., (Copyright © 2014 Elsevier B.V. All rights reserved.)