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Lillelund Thompson posted an update 5 days, 14 hours ago
The aim is to report a case of spontaneous uterine rupture in the first trimester of pregnancy and to review the literature on the topic. METHODS A literature search was performed using PubMed and Scopus. Relevant English articles were identified without any time or study limitations. The data were aggregated, and a summary statistic was calculated. RESULTS A 35-year-old gravida 5, para 2 was admitted at our department because of fainting and abdominal pain. The woman had a first-trimester twin pregnancy and a history of two previous cesarean sections (CSs). Suspecting a uterine rupture, an emergency laparotomy was performed. The two sacs were completely removed, and the uterine rupture site was closed with a double-layer suture. The patient was discharged from hospital four days later in good condition. On the basis of this experience, a total of 76 case reports were extracted from PubMed and included in the review. Fifty-three patients out of 76 (69.74%) underwent previous surgery on the uterus. Most women (67.92%) had a CS, and in this group a cesarean scar pregnancy (CSP) or a placenta accreta spectrum (PAS) disorder was found to be the etiology in 77.78% of cases. click here Furthermore, 35.85% of the women had hysterectomy after uterine rupture. Twenty-three patients out of 76 (30.26%) had an unscarred uterus. Of this group, most women presented a uterine anomaly (43.48%). Moreover, 17.39% of these women had a hysterectomy. CONCLUSION According to the literature, the current pandemic use of CS explains most cases of first-trimester uterine rupture.The human epidermal growth factor receptor 2 (HER2) is a clinically validated target for cancer therapy, and targeted therapies are often used in regimens for patients with a high HER2 expression level. Despite the success of current drugs, a number of patients succumb to their disease, which motivates development of novel drugs with other modes of action. We have previously shown that an albumin binding domain-derived affinity protein with specific affinity for HER2, ADAPT6, can be used to deliver the highly cytotoxic protein domain PE25, a derivative of Pseudomonas exotoxin A, to HER2 overexpressing malignant cells, leading to potent and specific cell killing. In this study we expanded the investigation for an optimal targeting domain and constructed two fusion toxins where a HER2-binding affibody molecule, ZHER22891, or the dual-HER2-binding hybrid ZHER22891-ADAPT6 were used for cancer cell targeting. We found that both targeting domains conferred strong binding to HER2; both to the purified extracellular domain and to the HER2 overexpressing cell line SKOV3. This resulted in fusion toxins with high cytotoxic potency toward cell lines with high expression levels of HER2, with EC50 values between 10 and 100 pM. For extension of the plasma half-life, an albumin binding domain was also included. Intravenous injection of the fusion toxins into mice showed a profound influence of the targeting domain on biodistribution. Compared to previous results, with ADAPT6 as targeting domain, ZHER22891 gave rise to further extension of the plasma half-life and also shifted the clearance route of the fusion toxin from the liver to the kidneys. Collectively, the results show that the targeting domain has a major impact on uptake of PE25-based fusion toxins in different organs. The results also show that PE25-based fusion toxins with high affinity to HER2 do not necessarily increase the cytotoxicity beyond a certain point in affinity. In conclusion, ZHER22891 has the most favorable characteristics as targeting domain for PE25.The severity of obstructive sleep apnoea (OSA) is diagnosed with polysomnography (PSG), during which patients are monitored by over 20 physiological sensors overnight. These sensors often bother patients and may affect patients’ sleep and OSA. This study aimed to investigate a method for analyzing patient snore sounds to detect the severity of OSA. Using a microphone placed at the patient’s bedside, the snoring and breathing sounds of 22 participants were recorded while they simultaneously underwent PSG. We examined some features from the snoring and breathing sounds and examined the correlation between these features and the snore-specific apnoea-hypopnea index (ssAHI), defined as the number of apnoea and hypopnea events during the hour before a snore episode. Statistical analyses revealed that the ssAHI was positively correlated with the Mel frequency cepstral coefficients (MFCC) and volume information (VI). Based on clustering results, mild snore sound episodes and snore sound episodes from mild OSA patients were mainly classified into cluster 1. The results of clustering severe snore sound episodes and snore sound episodes from severe OSA patients were mainly classified into cluster 2. The features of snoring sounds that we identified have the potential to detect the severity of OSA.Any piece of information is a selection from a set of possibilities. In this paper, this set is called a “domain”. Digital information consists of number sequences, which are selections from a domain. At present, these number sequences are defined contextually in a very variable way, which impairs their comparability. Therefore, global uniformly defined “domain vectors” (DVs), with a structure containing a “Uniform Locator” (“UL”), referred to as “UL plus number sequence”, are proposed. The “UL” is an efficient global pointer to the uniform online definition of the subsequent number sequence. DVs are globally defined, identified, comparable, and searchable by criteria which users can define online. In medicine, for example, patients, doctors, and medical specialists can define DVs online and can, therefore, form global criteria which are important for certain diagnoses. This allows for the immediate generation of precise diagnostic specific statistics of “similar medical cases”, in order to discern the best therapy. The introduction of a compact DV data structure may substantially improve the digital representation of medical information.Breast cancer survivors need to undergo adjuvant endocrine therapy after completion of curative treatments to prevent disease recurrence. These individuals often experience symptoms which are detrimental to their quality of life (QOL). Implementation of interventions for effective symptom management among these survivors is warranted. This review provides an overview of studies on the effectiveness of the previously developed interventions for breast cancer survivors undergoing adjuvant endocrine therapy on symptom alleviation and enhancement of QOL or health-related QOL (HRQOL). Five electronic databases were employed in the literature search. Study selection, data extraction and critical appraisal of the included studies were conducted by three authors independently. Twenty-four studies were included. Both pharmacological and non-pharmacological interventions are effective in addressing the symptoms associated with adjuvant endocrine therapy among the breast cancer survivors, and in improving their QOL, although discrepancies were noted between the studies in terms of the significance of these effects.