Combination of myasthenia gravis and HELLP Syndrome in pregnancy: case report and literature review

Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction. Preeclampsia/HELLP Syndrome is a potentially life-threatening pregnancy complication. The combination of HELLP Syndrome and MG is challenging because the preferred treatment regimens for both conditions generally contradict each other. Our aim is to describe the management options when these two diseases occur simultaneously. We present a case in which a woman with an established diagnosis of MG developed HELLP Syndrome at 31 weeks gestation. Magnesium sulfate prophylaxis was not utilized because of the patient’s MG diagnosis. A cesarean delivery was performed. Reported cases with combined diagnoses of MG and preeclampsia/HELLP Syndrome are reviewed and adjustments to treatment plans are discussed. Management of such patients should be done with a multidisciplinary approach in advanced medical centers with careful consideration of the medications used

Znaczenie badania krwi pobranej z żył tarczowych górnych i dolnych w rozpoznawaniu raka tarczycy

Introduction: We aimed to determine whether levels of thyroglobulin measured in blood from the inferior-superior thyroid veins and the peripheral antecubital vein could predict the presence of thyroid carcinoma in patients undergoing surgery for thyroid diseases. Material and methods: Sixty-one patients were prospectively enrolled in the study. Levels of thyroglobulin were analysed. Sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) of these markers were investigated. Results: Twenty-six out of 61 patients (42.6%) with malignancy were diagnosed. The levels of thyroglobulin in the inferior-superior thyroid veins were higher than those in the peripheral antecubital vein (p = 0.001). The levels of thyroglobulin in the blood taken from the antecubital vein and the inferior-superior thyroid veins did not differ between benign and malignant thyroid disorders. For thyroglobulin, sensitivity was 33.3%, specificity 60.6%, PPV 27.8%, and NPV 66.7% respectively. Conclusion: Thyroglobulin levels in the antecubital vein compared to the inferior-superior thyroid veins were not significant either in benign or malignant disorders.Wstęp: Celem badania było ustalenie, czy oznaczenie stężeń tyreoglobuliny we krwi pobranej z żył tarczowych górnych i dolnych oraz z żyły przedłokciowej ma wartość prognostyczną w wykrywaniu nowotworów tarczycy u chorych poddawanych zabiegom chirurgicznym z powodu chorób tarczycy. Materiał i metody: Do tego prospektywnego badania włączono 61 chorych. Analizowano wartości stężeń tyreoglobuliny. Badano czułość, swoistość oraz wartość prognostyczną dodatnią (PPV) i ujemną (NPV) tych wskaźników. Wyniki: U 26 spośród 61 chorych (42,6%) rozpoznano chorobę nowotworową. Stężenia tyreoglobuliny w żyłach tarczowych dolnych i górnych były wyższe niż stężenia mierzone we krwi pobranej z żyły przedłokciowej (p = 0,001). Stężenia tyreoglobuliny w próbkach krwi pobranych z żyły przedłokciowej i żył tarczowych nie różniły się istotnie między osobami z łagodnymi i złośliwymi guzami tarczycy. Oznaczenie tyreoglobuliny cechowało się czułością wynoszącą 33,3%, swoistością równą 60,6%, PPV — 27,8% i NPV — 66,7%. Wnioski: Porównanie stężeń tyreoglobuliny w żyle przedłokciowej i w żyłach tarczowych górnych i dolnych nie miało istotnego znaczenia diagnostycznego w wykrywaniu zarówno zmian łagodnych, jak i złośliwych

Common Methylenetetrahydrofolate Reductase Polymorphisms (A1298C & C677T) in Ectopic Trophoblasts and Methotrexate Treatment Failure in Tubal Pregnancies

Objectives: The success rate of methotrexate (MTX) therapy varies among tubal ectopic pregnancies. Commonmethylenetetrahydrofolate reductase (MTHFR) polymorphisms (C677T&A1298C) have been suggested to alter MTX effect. This study aimed to assess and compare MTX treatment failure rates with respect to MTHFR polymorphisms in trophoblasts of ectopic tubal pregnancies.Material and methods: A retrospective chart review of tubal ectopic pregnancies was conducted and 34 eligible cases were found. Paraffinized blocks of ectopic trophoblastic tissues were retrieved from the archives of pathology department.Common MTHFR polymorphisms were studied on microdissected trophoblastic tissues. Sixteen cases with history of failed MTX therapy (study group) and 18 control cases were compared for their pertinent clinical characteristics and common MTHFR polymorphisms (C677T&A1298) data.Results: In the study group, there were 8 (50%) C677T single nucleotide polymorphisms (SNP) and 9 (56.7%) A1298C SNP. Polymorphism rates were not found to be different between two groups for neither polymorphism (p > 0.05 for both). Number of compound heterozygotes was 3 (18.7%) in study group and 5 (27.7%) in controls (p = 0.693). In addition, MTHFR polymorphism presence seemed to have no effect on interval serum β-hCG concentration change in MTX-fail group (p=0.693).Conclusions: Our data implied that common MTHFR polymorphisms of ectopic trophoblastic tissue are not associated with MTX failure in patients with tubal pregnancies. Additionally, serum β-hCG concentration changes caused by MTX treatment and studied MTHFR polymorphisms are likely independent

A comparison of pelvic organ prolapse and sexual function after abdominal and laparoscopic hysterectomy

Objectives: Hysterectomy is one of the risk factors of pelvic organ prolapse (POP). There is no consensus on whether the route of hysterectomy affects the subsequent development of POP. The aim of the study was to assess POP and sexual function 1 year after a hysterectomy when comparing total abdominal hysterectomy (TAH) with total laparoscopic hysterectomy (TLH). The study applied the pelvic organ prolapse quantification (POP-Q) as the measure of POP and a short-form of the POP/Urinary Incontinence Sexual Function Questionnaire (PISQ-12).Material and methods: All patients that underwent either TAH or TLH due to benign causes between March 2016 and March 2017 at the tertiary hospital used for the study were included in our prospective cohort study. POP-Q measurements and PISQ-12 scores were assessed 1 year postoperatively.Results: We included 182 patients in the clinical examinations. There were no statistically significant differences in demographic characteristics between the TAH and TLH groups. Also, there we no differences observed in the objective POP measurements between the two study groups. Results of the two groups’ PISQ-12 scores were also similar. However, postoperative vaginal lengths were found to be significantly shorter in the patients who had undergone TAH compared with those who had undergone TLH.Conclusions: TAH and TLH are comparable regarding short-term objective pelvic organ prolapse. Although we foundstatistically a significant difference in vaginal lengths between the two groups, no clinical significance was found in terms of sexual function

Near-IR absorbing BODIPY derivatives as glutathione-activated photosensitizers for selective photodynamic action

Enhanced spatiotemporal selectivity in photonic sensitization of dissolved molecular oxygen is an important target for improving the potential and the practical applications of photodynamic therapy. Considering the high intracellular glutathione concentrations within cancer cells, a series of BODIPY-based sensitizers that can generate cytotoxic singlet oxygen only after glutathione-mediated cleavage of the electron-sink module were designed and synthesized. Cell culture studies not only validate our design, but also suggest an additional role for the relatively hydrophobic quencher module in the internalization of the photosensitizer. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim

Role of serum metalloproteinases 2 and 9 to assess the severity of COVID-19 in pregnant women: a prospective cross-sectional study

Objectives: To investigate the relationship between blood matrix metalloproteinases -2 and -9 levels and disease severity in pregnant women with COVID-19 infection. Material and methods: A prospective cohort study was conducted at the Kanuni Sultan Suleyman Education and Research Hospital in Istanbul, Turkey. We measured serum MMPs-2 and-9 levels of the healthy pregnant controls and pregnant women with COVID-19 and sought to assess the status of these MMPs in pregnant women with COVID-19, especially in women with a severe form of COVID-19 as diagnosed by abnormal computed tomography (CT) findings in addition to severe clinical and laboratory findings. Results: Of the healthy pregnant controls and pregnant women with COVID-19, the serum MMP-2 levels were comparable, but the MMP-9 level was lower in the pregnant women with COVID-19. Although the serum MMP2 level was somewhat lower in the women with COVID-19 with abnormal CT findings. The serum MMP-9 level of pregnant women with COVID-19 with abnormal CT was meaningfully lower. Conclusions: In the pregnant women, COVID-19 decreases the serum MMP-9 but does not change the serum MMP-2. COVID-19 with abnormal CT findings causes minimal decrease in the serum MMP-2 but decreases the serum MMP-9 with abnormal CT findings. Considering the study variables of current study, the probability of LMWH-related MMP alterations needs to be a study topic to clarify the possible contribution of LMWH to the status of serum MMPs in pregnant women with COVİD-19 especially in the women with COVID-19 with abnormal CT findings

Effects of adrenalin on ovarian injury formed by ischemia reperfusion in rats

In this study, the impacts of adrenalin on ovarian injury caused by ischemia reperfusion were investigated in rats. In addition, it’s been investigated whether there is a correlation between adrenergic receptors and oxidant/anti-oxidant and COX1/COX-2 levels. It’s been observed that the COX-2 level that is responsible for MDA and inflammatory reaction (which are the indicators of oxidative stress in ovarian tissue to which ischemia reperfusion was applied) increased and the COX-1 levels that are responsible for GSH (an endogenic anti-oxidant with protective impact) were depressed. Adrenalin has prevented an increase in MDA and COX-2 activity in the ovarian tissue, to which I/R was applied, and prevented a reduction in GSH and COX-1 activity. However, adrenalin failed to prevent an MDA increase in ovarian tissue, to which alpha-2 adrenergic receptor blocker yohimbine was given (I/R formed), and also failed to prevent a GSH and COX-1 decrease. Adrenalin also failed to inhibit the COX-2 activity increase in ovarian tissue, to which beta blocker was applied. As a result, stimulation of the alpha-2 adrenergic receptors in an ovarian tissue causes an anti-oxidant and protective effect, while stimulation of beta-2 adrenergic receptors causes an anti-inflammatory effect. It’s been thought that adrenalin protects the ovarian tissue against ischemia reperfusion by stimulating the alpha-2 and beta-2 adrenergic receptors.Colegio de Farmacéuticos de la Provincia de Buenos Aire

A survey of free software for the design, analysis, modelling, and simulation of an unmanned aerial vehicle

The objective of this paper is to analyze free software for the design, analysis, modelling, and simulation of an unmanned aerial vehicle (UAV). Free software is the best choice when the reduction of production costs is necessary; nevertheless, the quality of free software may vary. This paper probably does not include all of the free software, but tries to describe or mention at least the most interesting programs. The first part of this paper summarizes the essential knowledge about UAVs, including the fundamentals of flight mechanics and aerodynamics, and the structure of a UAV system. The second section generally explains the modelling and simulation of a UAV. In the main section, more than 50 free programs for the design, analysis, modelling, and simulation of a UAV are described. Although the selection of the free software has been focused on small subsonic UAVs, the software can also be used for other categories of aircraft in some cases; e.g. for MAVs and large gliders. The applications with an historical importance are also included. Finally, the results of the analysis are evaluated and discussed—a block diagram of the free software is presented, possible connections between the programs are outlined, and future improvements of the free software are suggested. © 2015, CIMNE, Barcelona, Spain.Internal Grant Agency of Tomas Bata University in Zlin [IGA/FAI/2015/001, IGA/FAI/2014/006