Objectives: This study aims to assess the value of FLT-PET as a non-invasive tool to differentiate between patients with ET and Pre-PMF. This study is a pilot study to have a proof of concept only. Methods: This is a prospective, interventional study where a total of 12 patients were included. Each patient underwent FLT PET imaging as well as bone marrow examination (gold standard). In addition, semi-quantitative (SUVmax and SUVmean) measurements of FLT uptake in the liver, spleen, and Lspine, SUVmean, as well as the Total Lesion Glycolysis (TLG) of the Lspine were performed. Results from the two patient cohorts were compared using = Kruskal-Wallis statistical test. A P-value of <.05 is considered to be statistically significant. Results: The differences in FLT SUVmax and SUVmean measurements in the three organs (liver, spleen, and LSpine) between the ET and Pre-PMF patients were not statistically significant ( P > .05). In contrast, TLG measurements in the LSpine were statistically different ( P = .013), and therefore, compared to gold standard bone marrow results, TLG can separate ET and Pre-PMF patients. Conclusion: This study is a proof of concept about the potential to discriminate between ET and pre-PMF patients in a non-invasive way. TLG of the LSpine in FLT PET images is a potential quantitative parameter to distinguish between ET and pre-PMF patients.

Background Infertility is a common health issue worldwide. In Jordan, the burden of infertility is understudied, and the prevalence is likely underestimated. We aimed to assess the perceptions and level of awareness of Jordanian women concerning infertility and its health and social implications. Study design: 429 women living in Jordan were invited to fill out an online questionnaire evaluating their knowledge of infertility, attitudes, and related perceptions. Linear regression was conducted to screen for variables affecting participants’ knowledge of infertility. Results The diagnosis of infertility was reported by 13% of participants. The majority of the participants reported that infertility adds strain to the marriage, and about 40% agreed that it is a valid reason for divorce. Almost half of the participants agreed that the community’s view of them would change had they learned of their infertility. Moreover, three-quarters of the participants (73%) believed that neither males nor females are to blame for infertility. Even though about ninety percent (88.1%) agreed that infertility should be treated, less than half of the participants (45.7%) considered it a disease. The majority preferred to discuss gynecologic and infertility-related issues and concerns with a female physician (57.8%, n = 248). Knowledge of infertility was found to be inadequate among the study population (average knowledge score of 51.8%). Furthermore, having a higher household income, carrying a healthcare-related degree and previously visiting an infertility clinic were significantly associated with a higher knowledge score. Conclusion In the setting of the lacking literature regarding infertility in Jordan, this study offers valuable insight into the knowledge, attitudes, and practices that are common among women residing in Jordan. Results from this study highlight negative trends in the help-seeking behavior of women, and gaps in infertility-related knowledge. This should prompt the adoption of educational programs as part of a nationwide approach addressing infertility and encouraging people to seek help when needed, emphasizing the role of primary healthcare in managing fertility issues. Official efforts are needed to collect data at a national level.

Pro-adrenomedullin (proADM) involved in cardiovascular hemostasis, has shown promise as a prognostic biomarker in heart failure (HF). However, it's precise role in predicting HF outcomes has yet to be defined. We conducted a systematic review and meta-analysis to determine whether proADM can effectively predict outcomes in patients with HF. We systemtically searched Pubmed, Cochrane, Web of Science, and Scopus for studies on proADM levels in adults (≥18 years) diagnosed with HF. Cohort studies, case-control studies, and randomized controlled trials were considered. The primary outcomes were mortality and hospitalization, with the risk of bias assessed using the QUIPs tool. A random effects meta-analysis was conducted to report pooled hazard ratio (HR) and 95% confidence intervals. Our search identified 956 studies, of which 25 met the inclusion criteria after full-text screening, encompassing a total of 13,915 patients. ProADM emerged as a robust predictor of mortality (HR = 2.46, 95% CI [2.02–3.01]) and combined mortality/hospitalization (HR = 2.96, 95% CI [2.17–4.04]). Notably, each 1-log-unit (nmol/L) increase in proADM was associated with a 196% higher risk of mortality or hospitalization and a 146% higher risk of mortality. ProADM shows significant potential as a prognostic biomarker for HF, with elevated levels linked to a higher risk of mortality and hospitalization. Future research should focus on integrating proADM into risk assessment tools for predicting worsening HF events, as this could influence management guidelines and reshape our approach to treating HF patients.

Background Psoriasis is a chronic inflammatory disease that is debilitating, particularly in its more severe forms. Multiple systemic therapies are used in moderate-to-severe psoriasis, but the development of biological interventions has revolutionized its management and improved its outcomes. Aim To compare the effectiveness and safety of the different biological interventions approved for use in moderate-to-severe plaque psoriasis. Methods Multiple databases were searched for relevant articles and a prospectively planned network meta-analysis was conducted on randomized controlled trials that assessed biological treatments in moderate-to-severe psoriasis. Results The search yielded 84 trials that encompassed 39798 patients. Infliximab 5mg/kg had the highest probability of achieving 75% reduction on PASI scale in comparison to placebo (RR = 18.76, 95%CI = [12.31; 28.57], high certainty), while Ixekizumab 80mg and Brodalumab 210mg had the highest probability in achieving PASI90 and PASI100 (37.81, [28.57; 50.03] and 81.04, [26.16; 251.01], respectively, with moderate certainty) On the other hand, Risankizumab 150mg and Ustekinumab 90mg were the only regimens with significantly less withdrawal rates due to adverse events (0.41, [0.18 To 0.96], and 0.57, [0.35 To 0.91], respectively with High certainty) compared to placebo. Conclusion Anti-IL17 and Infliximab were among the most effective in ameliorating the symptoms of psoriasis, however, anti-IL17 were better in achieving full or almost full improvement on the PASI scale. Real life decision-making is not so clear-cut and should remain patient centered, taking into consideration factors such as safety, comorbidities, biologic naivety, dosing preferences and insurance considerations.