Ekspresi Enzim 1 Alfa-Hidroksilase Plasenta yang Rendah sebagai Faktor Risiko Terjadinya Preeklamsia Berat

Abstrak Tujuan: Untuk mengetahui ekspresi enzim 1-alfa-hidroksilase (CYP27B1) pada plasenta yang rendah sebagai faktor risiko terjadinya preeklamsia (PE) berat.Metode: Penelitian ini merupakan studi kasus-kontrol yang tak berpasangan, dengan total sampel 44 kasus dan kontrol. Sampel berupa plasenta yang diproses secara imunohistokimia, untuk melihat ekspresi enzim berdasarkan histoscore kumulatif (H-score) sebagai ekspresi rendah (H-score 200). Regresi logistik ganda digunakan untuk memperkirakan rasio odds yang disesuaikan (OR) dengan interval kepercayaan 95% (95% CI).Hasil: Ekspresi enzim 1alfa-hidroksilase plasenta yang rendah merupakan faktor risiko terjadinya PE berat sebesar sembilan kali lebih tinggi dibandingkan dengan ekspresi enzim 1-alfa-hidroksilase yang tinggi pada plasenta (OR 9,148; IK05% 2,072-40,386, p=0,002).Kesimpulan: Ekspresi rendah 1alfa-hidroksilase plasenta meningkatkan risiko terjadinya PE berat.Low Expression of 1 Alpha-Hydroxylase Enzyme in The Placenta as Arisk Factor for Preeclampsia with Severe FeaturesAbstractObjective: This study aims to determine the low expression of the 1-alpha-hydroxylase (CYP27B1) enzyme in the placenta as a risk factor for severe preeclampsia (PE).Methods: This study is an unpaired case-control study, with a total sample of 44 cases and controls. Samples were placentas that were immunohistochemically processed, to see enzyme expression based on the cumulative histoscore (H-score) as low expression (H-score 200). Multiple logistic regression was used to estimate the adjusted odds ratio (OR) and 95% confidence interval (95% CI).Results: Low placental 1-alpha-hydroxylase expression was a risk factor for severe PE which was nine times higher than placental 1-alpha-hydroxylase expression (OR 9,148; 05% CI 2.072-40,386, p=0.002).Conclusions: Low placental 1alpha-hydroxylase expression increases the risk of severe PE.Key words: 1aplha-hydroxylase, expression, placenta, risk factor, severe preeclampsi

Outcome of Applying the ESC 0/1-hour Algorithm in Patients With Suspected Myocardial Infarction.

BACKGROUND The European Society of Cardiology (ESC) recommends the 0/1-h algorithm for rapid triage of patients with suspected non-ST-segment elevation myocardial infarction (MI). However, its impact on patient management and safety when routinely applied is unknown. OBJECTIVES This study sought to determine these important real-world outcome data. METHODS In a prospective international study enrolling patients presenting with acute chest discomfort to the emergency department (ED), the authors assessed the real-world performance of the ESC 0/1-h algorithm using high-sensitivity cardiac troponin T embedded in routine clinical care and its associated 30-day rates of major adverse cardiac events (MACE) (the composite of cardiovascular death and MI). RESULTS Among 2,296 patients, non-ST-segment elevation MI prevalence was 9.8%. In median, 1-h blood samples were collected 65 min after the 0-h blood draw. Overall, 94% of patients were managed without protocol violations, and 98% of patients triaged toward rule-out did not require additional cardiac investigations including high-sensitivity cardiac troponin T measurements at later time points or coronary computed tomography angiography in the ED. Median ED stay was 2 h and 30 min. The ESC 0/1-h algorithm triaged 62% of patients toward rule-out, and 71% of all patients underwent outpatient management. Proportion of patients with 30-day MACE were 0.2% (95% confidence interval: 03% to 0.5%) in the rule-out group and 0.1% (95% confidence interval: 0% to 0.2%) in outpatients. Very low MACE rates were confirmed in multiple subgroups, including early presenters. CONCLUSIONS These real-world data document the excellent applicability, short time to ED discharge, and low rate of 30-day MACE associated with the routine clinical use of the ESC 0/1-h algorithm for the management of patients presenting with acute chest discomfort to the ED

On the relationship between valence and arousal in samples across the globe

Affect is involved in many psychological phenomena, but a descriptive structure, long sought, has been elusive. Valence and arousal are fundamental, and a key question–the focus of the present study–is the relationship between them. Valence is sometimes thought to be independent of arousal, but, in some studies (representing too few societies in the world) arousal was found to vary with valence. One common finding is that arousal is lowest at neutral valence and increases with both positive and negative valence: a symmetric V-shaped relationship. In the study reported here of self-reported affect during a remembered moment (N = 8,590), we tested the valence-arousal relationship in 33 societies with 25 different languages. The two most common hypotheses in the literature–independence and a symmetric V-shaped relationship–were not supported. With data of all samples pooled, arousal increased with positive but not negative valence. Valence accounted for between 5% (Finland) and 43% (China Beijing) of the variance in arousal. Although there is evidence for a structural relationship between the two, there is also a large amount of variability in this relation