Preeclampsia is characterized by increased uPRL excretion. uPRL concentrations and their isoforms appear to be suitable markers to assess the severity of preeclampsia and occurrence of adverse outcomes. PRL and and/or its isoforms might be involved in the pathophysiology of preeclampsia.

Background:The protein:creatinine ratio in random, untimed urine samples correlates with 24-h protein excretion in pregnant women with and without hypertension. Nevertheless, whether this ratio is appropriate as a screening test for proteinuria is still unclear, in part because of the paucity of large studies. Methods: We measured protein:creatinine ratios in random urine samples and protein contents of 24-h urine samples in a cross-sectional study of 927 hospitalized pregnant women at >20-weeks of gestational age and in a 2nd cohort of 161 pregnant women. In the 2nd group, urine specimens were obtained before and after completion of the 24-h collections, avoiding 1st-morning void specimens. Results: Protein excretion was >300 mg/24 h in 282 patients (30.4%). The urine protein:creatinine ratio and the 24-h protein excretion were significantly correlated (r ‫؍‬ 0.98, P <0.001). The protein:creatinine ratio as an indicator of protein excretion >300 mg/24 h was >0.3. The sensitivity and specificity were 98.2% and 98.8%, respectively. Positive and negative predictive values were 97.2% and 99.2%, respectively, and positive and negative likelihood ratios were 79.2 and 0.02, respectively. The diagnostic accuracy of the urinary protein: creatinine ratio was corroborated in the 2nd cohort of patients, which also showed no statistically significant

Changes in circulating concentrations of PlGF, sFlt-1, and in the sFlt-1/PlGF ratio precede the onset of preeclampsia. The risk profile of circulating angiogenic factors for developing preeclampsia distinctly evolves depending on whether this condition is manifested at preterm or term.

The reduced bioactivity of PRL in patients with macroprolactinaemia may further explain the absence of clinical features of hyperprolactinaemia in these individuals. In addition, our findings indicate that species-specificity and sensitivity of the bioassays are determinant factors in the measurement of the intrinsic biological activity of circulating PRL.

Background: Sodium restriction is recommended for patients with heart failure (HF) despite the lack of solid clinical evidence from randomized controlled trials. Whether or not sodium restrictions provide beneficial cardiac effects is not known. Methods:The present study is a randomized, double-blind, controlled trial of stable HF patients with ejection fraction ≤ 40%. Patients were allocated to sodium restriction (2 g of sodium/day) vs. control (3 g of sodium/day). The primary outcome was change in Nterminal pro-B-type natriuretic peptide (NT-proBNP) at 20 weeks. Secondary outcomes included quality of life and adverse safety events (HF readmission, blood pressure or electrolyte abnormalities).Results: Seventy patients were enrolled. Median baseline sodium consumption was 3268 (2225-4537) mg/day. Adherence to the intervention based on 24-hour urinary sodium was 32%. NT-proBNP and quality of life did not significantly change between groups (p > 0.05 for both). Adverse safety events were not significantly different between the arms (p > 0.6 for all). In the per protocol analysis, patients who achieved a sodium intake < 2500 mg/day at the intervention conclusion showed improvements in NT-proBNP levels (between-group difference: -55%, 95% confidence interval -27 to -73%; p = 0.002) and quality of life (between-group difference -11 ± 5 points; p = 0.04). Blood pressure decreased in patients with lower sodium intake (between-group difference -9 ± 5 mmHg; p = 0.05) without significant differences in symptomatic hypotension or other safety events (p > 0.3 for all).Conclusions: Adherence assessed by 24-hour natriuresis and by the nutritionist was poor.The group allocated to sodium restriction did not show improvement in NT-proBNP. However, patients who achieved a sodium intake < 2500 mg/day appeared to have improvements in NT-proBNP and quality of life without any adverse safety signals.ClinicalTrials.gov Identifier: NCT03351283.