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We have performed a longitudinal study of the hypothalamic-pituitary-ovary axis and adrenal function during the menstrual cycle in 26 women with inactive or quiescent systemic lupus erythematosus (SLE) and in 21 healthy women as controls. In all women studied, the menstrual cycle was proved to be ovulatory by ultrasound imaging and detection of an appropriately elevated value of peak serum progesterone. Blood samples were obtained for hormonal assay on several days of the menstrual cycle studied. Patients with SLE had lower peak and day-7 postovulation serum progesterone concentrations which were both significantly lower than those found in controls, whereas no major differences were observed for any of the other hormones analysed. Although the significance of the inadequate production of progesterone we have observed in SLE women with inactive disease is not clear, our data seem to indicate that a relative deficiency of progester one might be considered among the potential predisposing factors for development of SLE in women. [ABSTRACT FROM PUBLISHER]

Introduction: To assess the recommendations of open angle glaucoma Clinical Practice Guidelines (CPG) addressing Minimally Invasive Glaucoma Surgery (MIGS) or MIGS procedures CPG. Methods: A scoping review of CPG was conducted, based on an ongoing systematic review (CRD42024510656). A systematic literature search of CPG was carried out in November 2023, with an update in January 2024. CPG published in the last 8 years, full text available and addressing MIGS were selected. CPG details and recommendations concerning MIGS were extracted. Results: 13 CPG addressing MIGS were selected (8 recovered from databases and 5 from registers). Four health Technology Assessments were assessed but recommendations were not considered. Finnish and Swedish guidelines, published in 2024, and Japanese guidelines, published in 2023, are English versions of their native language guidelines, but none of them make specific recommendations about MIGS. The Spanish Glaucoma Society - Advanced Glaucoma guideline (2023) describes the available techniques but does not make recommendations about MIGS. The European Glaucoma Society (2023) guideline only makes recommendations for 4 devices and the National Institute for Health and Care Excellence Interventional procedures guidance makes recommendations both for specific procedures and devices. Conclusion: MIGS is a relevant topic that has not been adequately addressed in terms of updated evidence, available procedures, and recommendations in open angle glaucoma CPG or MIGS procedures CPG., Competing Interests: Declaration of conflicting interestsJGO has received speaker fees of Novelty Technology Care, Angelini and Esteve. JGO has received Travel and meeting support from Esteve, Bausch and Lomb, Thea, Equipsa, Alcon, Zeiss, Angelini and Brudylab. CBM has received Travel and meeting support from Bausch and Lomb. ISO, SBU and TGO have nothing to disclose.

Toll-like receptor (TLR)7 is a pattern recognition receptor that critically contributes to the pathogenesis of systemic lupus erythematosus (SLE). DS-7011a is an anti-TLR7 monoclonal antibody that prevents TLR7 from signaling. The aim of this first-in-human, double-blind, randomized, and placebo-controlled study was to evaluate the safety, pharmacokinetics, immunogenicity, and pharmacodynamics of single ascending intravenous (IV) and subcutaneous (SC) doses of DS-7011a in healthy subjects (HS) (NCT05203692). On day 1, 80 HS received DS-7011a or placebo 6:2 in 10 cohorts (7 treated IV and 3 SC) of 8 each and were followed for 8 weeks until day 57. Safety was evaluated by recording treatment-emergent adverse events (TEAEs), pharmacokinetics by measuring plasma DS-7011a, immunogenicity by measuring plasma anti-drug antibodies (ADAs), and pharmacodynamics by evaluating the suppression of interleukin-6 production ex vivo in whole blood. DS-7011a was safe and well tolerated across all cohorts. TEAEs were mostly mild in severity and not drug-related. DS-7011a exposure increased with the dose but was not dose proportional, as the elimination of lower doses was accelerated by target-mediated drug disposition. Terminal half-life was about 15-17 days and T max upon SC administration was about 5 days. DS-7011a induced ADAs in about half of HS but with no impact on clinical findings and pharmacokinetics. Pharmacodynamic (PD) response also increased with the dose and at the higher doses was of large extent (>90%), early onset, and lasting duration. DS-7011a showed favorable safety, pharmacokinetics, immunogenicity, and PD properties that support its development for the treatment of SLE., (© 2024, The American College of Clinical Pharmacology.)

YG1699 is a novel inhibitor of sodium-glucose cotransporter 1 (SGLT1) and SGLT2. This double-blind, 3-way crossover trial compared YG1699 to dapagliflozin as an adjunct to insulin in people with type 1 diabetes (T1D) on insulin pump therapy. Treatment periods included four mixed meal tolerance tests (MMTTs) and insulin withdrawal tests per person. Nineteen adults with T1D were randomized to YG1699 10 mg, YG1699 25 mg, and dapagliflozin 10 mg once daily for 1 week in different orders. The primary end point was the difference in area under the curve (AUC) in plasma glucose (AUC 0-120min ) after an MMTT between treatment groups. Mean change in plasma glucose after an MMTT (AUC 0-120min ) was lower for YG1699 10 mg vs. dapagliflozin (89.51% of baseline vs. 102.13%, 90% confidence interval (CI) vs. dapagliflozin, -6% to -16%, P = 0.0003) and for YG1699 25 mg (84.83% vs. 102.13%, 90% CI vs. dapagliflozin -13% to -22%, P < 0.0001). At 120 minutes, mean glucose values on no treatment, dapagliflozin, YG1699 10 mg, and YG1699 25 mg were 149 (SE 7.6), 141 (SE 6.1), 128 (SE 6.9), and 115 (SE 7.8) mg/dL, respectively. Insulin dose requirements were lower for YG1699 10 mg and 25 mg vs. dapagliflozin for bolus insulin, and for YG1699 10 mg vs. dapagliflozin for total daily insulin. Safety profiles were similar between treatment groups. YG1699 reduced post-prandial glucose more than dapagliflozin in people with T1D on insulin pump therapy. The results were consistent with dual SGLT1/SGLT2 inhibition by YG1699., (© 2024 Youngene Therapeutics Co., Ltd. Clinical Pharmacology & Therapeutics published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.)

Introduction: Excess body fat is linked to higher risks for metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease (CV), among other health conditions. However, it is not only the level but also the distribution of body fat that contributes to increased disease risks. For example, an increased level of abdominal fat, or visceral adipose tissue (VAT), is associated with a higher risk of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)., Methods: A review of the most relevant primary and secondary sources on body composition from the last 25 years was conducted. Relevant articles were identified using PUBMED and Google Scholar. Narrative synthesis was performed as statistical pooling was not possible due to the heterogeneous nature of the studies., Results: The body mass index (BMI) is commonly used as a proxy measure of body fatness. However, BMI does not reflect the level and distribution of body fat. Other anthropometric methods such as waist circumference measurement and waist-hip ratio, as well as methodologies like hydro densitometry, bioelectrical impedance, and isotope dilution are also limited in their ability to determine body fat distribution. Imaging techniques to define body composition have greatly improved performance over traditional approaches. Ultrasound (US), computed tomography (CT), dual-energy X-ray absorptiometry (DXA), magnetic resonance imaging (MRI), are now commonly used in clinical research. Of these, MRI can provide the most accurate and high-resolution measure of body composition. In addition, MRI techniques are considered the best for the determination of fat at the organ level. On the other hand, imaging modalities require specialized, often expensive equipment and expert operation., Conclusions: Anthropometric methods are suitable for rapid, high-volume screening of subjects but do not provide information on body fat distribution. Imaging techniques are more accurate but are expensive and do not lend themselves for high throughput. Therefore, successful trial strategies require a tiered approach in which subjects are first screened using anthropometric methods followed by more sophisticated modalities during the execution of the trial. This article provides a brief description of the most clinically relevant adipose tissue measurement techniques and discusses their value in obesity, diabetes, and NAFLD/NASH clinical research., (© 2022 The Authors. Endocrinology, Diabetes & Metabolism published by John Wiley & Sons Ltd.)

The fate of dietary protein in the gut is determined by microbial and host digestion and utilization. Fermentation of proteins generates bioactive molecules that have wide-ranging health effects on the host. The type of protein can affect amino acid absorption, with animal proteins generally being more efficiently absorbed compared with plant proteins. In contrast to animal proteins, most plant proteins, such as pea protein, are incomplete proteins. Pea protein is low in methionine and contains lower amounts of branched-chain amino acids (BCAAs), which play a crucial role in muscle health. We hypothesized that probiotic supplementation results in favorable changes in the gut microbiota, aiding the absorption of amino acids from plant proteins by the host. Fifteen physically active men (24.2 ± 5.0 years; 85.3 ± 12.9 kg; 178.0 ± 7.6 cm; 16.7 ± 5.8% body fat) co-ingested 20 g of pea protein with either AminoAlta™, a multi-strain probiotic (5 billion CFU L. paracasei LP-DG® (CNCM I-1572) plus 5 billion CFU L. paracasei LPC-S01 (DSM 26760), SOFAR S.p.A., Italy) or a placebo for 2 weeks in a randomized, double-blind, crossover design, separated by a 4-week washout period. Blood samples were taken at baseline and at 30-, 60-, 120-, and 180-min post-ingestion and analyzed for amino acid content. Probiotic administration significantly increased methionine, histidine, valine, leucine, isoleucine, tyrosine, total BCAA, and total EAA maximum concentrations (Cmax) and AUC without significantly changing the time to reach maximum concentrations. Probiotic supplementation can be an important nutritional strategy to improve post-prandial changes in blood amino acids and to overcome compositional shortcomings of plant proteins. ClinicalTrials.gov Identifier: ISRCTN38903788.

Background: A limited amount of research has demonstrated beneficial effects of caffeine and theanine supplementation for enhancement of mental performance. The purpose of this investigation was to determine whether the acute ingestion of a supplement containing caffeine, theanine and tyrosine improves mental and physical performance in athletes., Methods: Twenty current or former male collegiate athletes (age: 20.5 ± 1.4 y; height: 1.82 ± 0.08 m; weight: 83.9 ± 12.6 kg; body fat: 13.8 ± 5.6%) completed this randomized, double-blind, placebo-controlled crossover trial. After familiarization, each participant completed two identical testing sessions with provision of a proprietary dietary supplement (SUP) containing caffeine theanine and tyrosine or a placebo (PL). Within each testing session, participants completed assessments of mental and physical performance before and after provision of SUP or PL, as well as after two rounds of exercise. Assessments were performed using a performance testing device (Makoto Arena) that evaluated multiple aspects of mental and physical performance in response to auditory and visual stimuli. Testing was performed both with the body in a static position and during dynamic movement. General linear models were used to evaluate the effects of SUP and PL on performance., Results: Changes in movement accuracy during performance assessment were greater following SUP ingestion as compared to PL for both static and dynamic testing (SUP: + 0.4 to 7.5%; PL: - 1.4 to 1.4% on average; p < 0.05). For dynamic testing, the change in number of targets hit was higher and the change in average hit time was lower with SUP as compared to PL (p < 0.05). However, there were no differences between conditions for the changes in number of targets hit or average hit time during static testing. There were no differences in changes of subjective variables during either condition, and performance measures during the two rounds of exercise did not differ between conditions (p > 0.05)., Discussion: The present results indicate that a combination of a low-dose of caffeine with theanine and tyrosine may improve athletes' movement accuracy surrounding bouts of exhaustive exercise without altering subjective variables. Based on this finding, supplementation with caffeine, theanine and tyrosine could potentially hold ergogenic value for athletes in sports requiring rapid and accurate movements., Trial Registration: NCT03019523. Registered 24 January 2017.

Numerous popular "detoxification" supplements claim to promote the removal of harmful compounds from the body, thereby alleviating gastrointestinal symptoms, improving body composition, and enhancing overall health. The present double-blind, randomized, placebo-controlled trial was conducted to examine the effects of a purported detoxification supplement in healthy young adult females. Participants were randomly assigned to consume a multi-ingredient supplement or placebo daily for four weeks. The supplement contained 1,350 mg/serving of a proprietary blend of papaya leaf, cascara sagrada bark, slippery elm bark, peppermint leaf, red raspberry leaf, fenugreek seed, ginger root, and senna leaf. Body composition, waist circumferences, symptoms of gastrointestinal distress, and blood safety markers were evaluated before and after supplementation. Twenty-two participants completed the study, and data were analyzed via two-way mixed ANOVA and t tests. No beneficial or harmful effects of supplementation were found for body composition, waist circumference, gastrointestinal symptoms, or blood markers. These results indicate that consuming a commercially available dietary supplement that purportedly provides detoxification and body composition benefits is apparently safe in healthy young adult females but does not provide any beneficial effects for body composition or gastrointestinal symptoms.

Dietary supplementation is commonly employed by individuals seeking to improve body composition and exercise performance. The purpose of the present study was to examine the safety and effectiveness of a commercially available dietary supplement designed to promote thermogenesis and fat loss. In a randomized double-blind trial, participants were assigned to consume placebo or a multi-ingredient supplement containing caffeine, green tea extract, l-carnitine, evodiamine and other ingredients that purportedly enhance thermogenesis. The study included acute baseline testing, a 6-week progressive resistance training and supplementation intervention, and post-intervention testing. Laboratory assessments included resting energy expenditure responses to acute supplement ingestion, evaluation of body composition and muscular performance, and analysis of blood variables (metabolic panel, testosterone, estrogen and cortisol). Dependent variables were analyzed using ANOVA with repeated measures. No unfavorable effects of supplementation were reported, and the supplement did not adversely affect safety markers. However, the supplement did not reduce fat mass or increase lean mass relative to placebo. In the supplement group, lower body maximal strength was increased relative to placebo (+18%, d=1.1 vs. +10%, d=0.5), and cortisol concentrations were decreased relative to placebo (-16%; d=-0.4 vs. +15%, d=.75). However, no differences were observed for upper body maximal strength or muscular endurance. REE increased in response to both supplement and placebo ingestion (placebo: +5%; supplement: +11.5%), but the difference between conditions was not statistically significant. Overall, some select parameters may have been beneficially modified by supplementation, but this did not result in superior weight or fat loss over 6 weeks of supplementation and resistance training.

Purpose: To determine the accuracy of unenhanced magnetic resonance (MR) imaging in the detection of acute appendicitis in patients younger than 50 years who present to the emergency department with right lower quadrant (RLQ) pain., Materials and Methods: The institutional review board approved this retrospective study of 403 patients from August 1, 2012, to July 30, 2014, and waived the informed consent requirement. A cross-department strategy was instituted to use MR imaging as the primary diagnostic modality in patients aged 3-49 years who presented to the emergency department with RLQ pain. All MR examinations were performed with a 1.5- or 3.0-T system. Images were acquired without breath holding by using multiplanar half-Fourier single-shot T2-weighted imaging without and with spectral adiabatic inversion recovery fat suppression without oral or intravenous contrast material. MR imaging room time was measured for each patient. Prospective image interpretations from clinical records were reviewed to document acute appendicitis or other causes of abdominal pain. Final clinical outcomes were determined by using (a) surgical results (n = 77), (b) telephone follow-up combined with review of the patient's medical records (n = 291), or (c) consensus expert panel assessment if no follow-up data were available (n = 35). Logistic regression analysis was performed to evaluate the sensitivity and specificity of MR imaging in the detection of acute appendicitis, and corresponding 95% confidence intervals were determined., Results: Of the 403 patients, 67 had MR imaging findings that were positive for acute appendicitis, and 336 had negative findings. MR imaging had a sensitivity of 97.0% (65 of 67) and a specificity of 99.4% (334 of 336). The mean total room time was 14 minutes (range, 8-62 minutes). An alternate diagnosis was offered in 173 (51.5%) of 336 patients., Conclusion: MR imaging is a highly sensitive and specific test in the evaluation of patients younger than 50 years with acute RLQ pain that uses a rapid imaging protocol performed without intravenous or oral contrast material., ((©) RSNA, 2016 Online supplemental material is available for this article.)

Background: Theacrine (1,3,7,9-tetramethyluric acid) is a purine alkaloid found in certain coffee (Coffea) species, fruits (Cupuacu [Theobroma grandiflorum]), and tea (Camellia assamica, var. kucha) that has anti-inflammatory, analgesic, and neuro-locomotor properties. Recent preliminary research has also reported increased feelings of energy, reduced fatigue, and strong effects on improving focus, concentration, and motivation to exercise. The purpose of this study was to examine the safety and non-habituating effects of TeaCrine®, a nature-identical, chemically equivalent bioactive version of theacrine., Methods: Sixty healthy men (mean ± SD age, height, weight: 22.9 ± 4.7 years, 183.5 ± 9.2 cm, 86.5 ± 13.7 kg) and women (22.3 ± 4.5 years, 165.2 ± 12.3 cm, 69.0 ± 17.4 kg) were placed into one of three groups: placebo (PLA, n = 20), 200 mg TeaCrine® (LD, n = 19) or 300 mg Teacrine® (HD, n = 21) and ingested their respective supplement once daily for 8 weeks. Primary outcomes were fasting clinical safety markers (heart rate, blood pressure, lipid profiles, hematologic blood counts, biomarkers of liver/kidney/immune function) and energy, focus, concentration, anxiety, motivation to exercise, and POMS measured prior to daily dosing to ascertain potential tachyphylactic responses and habituation effects. Data were analyzed via two-way (group × time) ANOVAs and statistical significance was accepted at p < 0.05., Results: All values for clinical safety markers fell within normal limits and no group × time interactions were noted. No evidence of habituation was noted as baseline values for energy, focus, concentration, anxiety, motivation to exercise, and POMS remained stable in all groups across the 8-week study protocol., Conclusions: These findings support the clinical safety and non-habituating neuro-energetic effects of TeaCrine® supplementation over 8 weeks of daily use (up to 300 mg/day). Moreover, there was no evidence of a tachyphylactic response that is typical of neuroactive agents such as caffeine and other stimulants.

Background: Increasing metabolism is a primary focus of many commercially available dietary supplements marketed to support weight management. Caffeine (e.g. anhydrous and herbal) and green tea are key ingredients in such products, augmenting resting energy expenditure (REE) and improving reported mood states (alertness, fatigue, focus, etc.). The purpose of this study was to evaluate the effects of a thermogenic dietary supplement (DBX) on REE, respiratory exchange ratio (RER), reported measures of alertness, focus, energy, concentration, fatigue, and hunger, as well as the general safety of the product based on electrocardiogram (ECG) and hemodynamic responses in habitual caffeine consumers., Methods: Six male and six female subjects (mean ± SD; 22.50 ± 3.22 years; 76.94 ± 14.78 kg; 22.7 ± 9.5% body fat), physically active (≥12 months), and moderate habitual caffeine consumers (<200 mg/day) received either two capsules of DBX containing 340 mg of total caffeine plus green tea extract, yerba mate extract, carnitine tartrate and other active ingredients or a placebo (PLC) in a double-blinded, crossover design. Heart rate (HR), blood pressure (BP), REE, RER and perceived mood states were measured at baseline and then hourly for four hours after ingesting either treatment., Results: Resting energy expenditure was significantly increased at all four time points and significant increases were determined for perceived alertness (p = 0.026) and focus (p = 0.05) at hour 1 and for energy at 1 and 2 hours after treatment for the DBX group (p = 0.008 and p = 0.017, respectively). Additionally, perceived fatigue was decreased at the hour 1 assessment (p = 0.010). No significant differences were seen between DBX and placebo for hunger, anxiety, HR, BP, ECG patterns or RER., Conclusions: The results of this investigation support that the proprietary blend of this thermogenic aid is capable of increasing REE for four hours post-ingestion while supporting increased focus, alertness, and energy as well as decreasing fatigue without promoting anxiety or causing significant changes in HR, BP, or ECG measurements in habitual caffeine consumers.

Two of the most popular forms of protein on the market are whey and casein. Both proteins are derived from milk but each protein differs in absorption rate and bioavailability, thus it is possible that each type of protein may contribute differently to the adaptations elicited through resistance training. Therefore, the purpose of this study was to investigate the potential effects of ingestion of two types of protein in conjunction with a controlled resistance training program in collegiate female basketball players. Sixteen NCAA Division III female basketball players were matched according to body mass and randomly assigned in a double-blind manner to consume 24 g whey protein (WP) (N = 8, 20.0 ± 1.9 years, 1.58 ± 0.27 m, 66. 0 ± 4.9 kg, 27.0 ± 4.9 %BF) or 24 g casein protein (CP) (N = 8, 21.0 ± 2.8 years, 1.53 ± 0.29 m, 68.0 ± 2.9 kg, 25.0 ± 5.7 %BF) immediately pre- and post-exercise for eight weeks. Subjects participated in a supervised 4-day per week undulating periodized training program. At 0 and 8 weeks, subjects underwent DXA body composition analysis, and at 0 and 8 weeks underwent one repetition maximum (1RM) strength, muscle endurance, vertical jump, 5-10-5 agility run, and broad jump testing sessions. Data were analyzed using repeated measures ANOVA, and presented as mean ± SD changes from baseline after 60 days. No significant group x time interaction effects were observed among groups in changes in any variable (p > 0.05). A significant time effect was observed for body fat (WP: -2.0 ± 1.1 %BF; CP: -1.0 ± 1.6 %BF, p < 0.001), lean mass (WP: 1.5 ± 1.0 kg; CP: 1. 4 ± 1.0 kg, p < 0.001), fat mass (WP: -1.3 ± 1.2 kg; CP: -0.6 ± 1.4 kg, p < 0.001), leg press 1RM (WP: 88.7 ± 43.9 kg; CP: 90.0 ± 48.5 kg, p < 0.001), bench press 1RM (WP: 7.5 ± 4.6 kg; CP: 4.3 ± 4.5 kg, p = 0.01), vertical jump (WP: 4.1 ± 1.8 cm; CP: 3.5 ± 7.6 cm, p < 0.001), 5-10-5 (WP: -0.3 ± 0.2 sec; CP: -0.09 ± 0.42 sec, p < 0.001), and broad jump (WP: 10.4 ± 6.6 cm; CP: 12. 9 ± 7.1 cm, p < 0.001). The combination of a controlled undulating resistance training program with pre- and post-exercise protein supplementation is capable of inducing significant changes in performance and body composition. There does not appear to be a difference in the performance- enhancing effects between whey and casein proteins. Key pointsFemales can experience and increase in performance makers from consuming protein after resistance training.Females can have a decreased body fat composition when ingesting protein with daily resistance training and conditioning.There was no significant difference in performance markers between whey and casein.

The actynomyces infection is a rare cause of chronic pelvic inflammation, which can be manifested in multiple ways. It is caused by the actynomyces bacteria, usually by the israelii type, which can be a part of the normal flora of the genital tract in patients who use intrauterine device (IUD). There is a discussion about the importance of considering this infection disease as part of the differential diagnosis in patients using the IUD, with atypical manifestations and bizarre presentation of infections of the genital tract, severe pelvic adherent syndromes, tubo-ovarian complexes (abscesses) barely symptomatic, and in the case of intraoperatory suspicion of pelvic carcinomatosis among others.

The hypophyseal-adrenal-ovarian axis was studied in 29 women of childbearing age with systemic lupus erythematosus, as well as in a control group of 14 healthy women. Hormonal levels were measured on days 7th and 21st of menstrual cycle. Women with systemic lupus erythematosus had not significatively lower testosterone levels, but progesterone and 17-alfa-hydroxiprogesterone levels were markedly lower when compared to controls. These facts suggest a decrease in progesterone levels, which could act as a predisposing factor for lupic disease.

We have studied the levels of sexual hormones in 45 female patients suffering seropositive rheumatoid arthritis (RA). Patients were classified in two groups. Group 1 (premenopausal), was formed by 26 women and group 11 (postmenopausal) by 19 women. They were compared to 40 control women (20 premenopausal and 20 postmenopausal). Age and body surface as similar in both groups. Mean estradiol, progesterone and androgen plasma levels in group 1 were similar to the premenopausal control group. On the contrary, group 11 patients presented a statistically significant increase in plasma androgen levels when compared to the postmenopausal control group. This seems to indicate that postmenopausal women suffering rheumatoid arthritis present a hyperandrogenic situation, which could have a beneficial effect on the clinical expression of the disease.

The concentrations of sex hormones were studied in 45 women with rheumatoid arthritis (RA). The patients were classified into two groups. Group I (premenopausal) consisted of 26 women and group II (postmenopausal) included 19 women. The two groups were compared with 40 control women (20 premenopausal and 20 postmenopausal). Age and weight were comparable in the 2 groups (controls and patients). The average plasma concentrations of oestradiol, progesterone and androgens were comparable in group I (patients with RA) and the control group (premenopausal women). On the other hand, the plasma concentration of androgens was statistically significantly higher in patients in group II by comparison with the postmenopausal controls. It thus seems that a hyperandrogenic situation may occur in menopausal women with RA, and this might have a beneficial clinical effect on the disease.

The distribution of endogenous cobalamin among serum cobalamin-binding proteins was studied in 30 patients with active rheumatoid arthritis (RA) and 27 in clinical remission. The mean total serum cobalamin concentration (holo-transcobalamin I and II) was similar in both groups of patients, whereas mean apotranscobalamin II was significantly increased in patients with active RA. The clinical significance of this finding is not yet established but it might be a useful parameter for the evaluation of disease activity in RA.

Reviews measurement approaches applied to dream reports and proposes some methodological cautions that may result in more effective utilization of the dream report in research and assessment. Standardization of dream collection techniques and controls for variability in the length of dream reports are suggested. Further investigation of the intraindividual consistency of dream report measures is seen as necessary for a discussion of their validity. Though there are indications that a variety of dream report measures are potentially valid for psychological assessment, measures based on general dream report characteristics show greater promise than specific content analysis. Research on the differences between normal and disturbed subjects highlights the potential, and the problems, inherent in the use of dream reports as tools of psychological inquiry.