Treatment of Hypertension

Our ideas about the management of hypertension have changed considerably in recent years. There is now general agreement that all patients with accelerated hypertension, as manifested by high diastolic pressure and Group III and IV funduscopic changes, should have their blood pressure reduced with antihypertensive agents. Differences of opinion still exist, however, in respect to the treatment of the less rapidly advancing types of hypertension. It is apparent that the life history of untreated essential hypertension varies widely from those patients whose lives are cut short in a matter of a few years, to those who survive to old age. The problem is further complicated because antihypertensive treatment is neither simple, innocuous, or inexpensive. If we are to approach a solution to this problem we need to know the answers to two questions. The first is: Does antihypertensive treatment prevent the organic complications associated with hypertension? and the second, How can we recognize and differentiate the patient who will develop serious complications from the patient who will live out a normal span of life

Serum periostin levels in early in pregnancy are significantly altered in women with miscarriage

Background: Miscarriage is a common complication in pregnancy and there is still a lack of biomarkers usable in asymptomatic patients before the event occurs. Periostin (PER), whose levels rise particularly during injury or inflammation, has been shown to play an important local role in implantation and early embryonic development. As PER has been described as a biomarker in various medical conditions we intended to evaluate if changes in PER serum levels may help to identify women at risk for spontaneous abortion in the first trimester. Methods: Women between 18 and 42 years without confounding comorbidities who conceived by IVF/ICSI and ovarian hyperstimulation were analysed in the study after informed consent. Maternal serum samples from 41 patients were assessed at the time of pregnancy testing (PT) and the following first ultrasound checkup (US). Patients were subsequently divided in two groups: (1) patients with subsequent miscarriage in the first trimester (n = 18) and (2) patients with ongoing pregnancy (n = 23), allowing for statistical analysis and investigating the change of PER levels per individual. PER levels were measured using enzyme-linked immunosorbent assay. Statistical analysis was performed using the Fisher exact and Student’s t test. p ≤ 0.05 was considered to be significant. Results: There was no significant difference concerning possible confounders between the two groups. We did not find any significant difference in PER levels at the time point of PT or US. By investigating the interindividual changes of PER between the two time points however, we observed that patients with a following miscarriage showed increasing levels of PER at the time point of PT compared to US in contrast to patients with an ongoing pregnancy who demonstrated a decrease in PER levels. These alterations were significant in the absolute as well as in the relative comparison. Conclusion: The relative expression of PER between PT and US is significantly altered in asymptomatic women with subsequent miscarriage compared to women with ongoing pregnancy. Therefore systemic PER levels might represent a potential promising biomarker for the assessment of pregnancy outcome. Trial registration Not applicable

When teleconferencing was the future: the 1970 'Medizin Interkontinental' transmission and West German medicine in the space age

In March 1970, the first ever medical teleconference connected U.S. aeromedical experts in Houston and San Antonio to an audience of 25,000 physicians in congress centres in West Germany, Austria, and Switzerland. As this article shows, the ‘Medizin Interkontinental’ transmission was a costly demonstration of the latest developments in satellite telecommunications and projection technology as well as a stage for space-age visions of the future of medicine in the aftermath of the moon landing. Audio-visual and space technology became, at one at the same time, the medium and the message of medical futurity. As I argue, the teleconference was an audio-visual techno-spectacle that marked the culmination of the German medical community’s infatuation with futurology at the end of the 1960s, but it was also contingent on the concrete interests of the parties involved, which included the German Medical Association, medical futurologists, nasa, the U.S. Air Force, and the Swiss pharmaceutical company Ciba. Decades before teleconferences and telemedicine entered day-to-day medicine, the convergence of new medical and media technology, changes in medical education, Cold War geopolitics, and pharmaceutical sponsorship created a brief glimpse of a technology-based future of medicine that fell apart once these constellations changed in the early 1970s

FMR1 expression in human granulosa cells increases with exon 1 CGG repeat length depending on ovarian reserve

Background: Fragile-X-Mental-Retardation-1- (FMR1)-gene is supposed to be a key gene for ovarian reserve and folliculogenesis. It contains in its 5’-UTR a triplet-base-repeat (CGG), that varies between 26 and 34 in general population. CGG-repeat-lengths with 55–200 repeats (pre-mutation = PM) show instable heredity with a tendency to increase and are associated with premature-ovarian-insufficiency or failure (POI/POF) in about 20%. FMR1-mRNA-expression in leucocytes and granulosa cells (GCs) increases with CGG-repeat-length in PM-carriers, but variable FMR1-expression profiles were also described in women with POI without PM-FMR1 repeat-length. Additionally, associations between low numbers of retrieved oocytes and elevated FMR1-expression levels have been shown in GCs of females with mid-range PM-CGG-repeats without POI. Effects of FMR1-repeat-lengths-deviations (n < 26 or n > 34) below the PM range (n < 55) on ovarian reserve and response to ovarian stimulation remain controversial. Methods: We enrolled 229 women undergoing controlled ovarian hyperstimulation for IVF/ICSI-treatment and devided them in three ovarian-response-subgroups: Poor responder (POR) after Bologna Criteria, polycystic ovary syndrome (PCO) after Rotterdam Criteria, or normal responder (NOR, control group). Subjects were subdivided into six genotypes according to their be-allelic CGG-repeat length. FMR1-CGG-repeat-length was determined using ALF-express-DNA-sequencer or ABI 3100/3130 × 1-sequencer. mRNA was extracted from GCs after follicular aspiration and quantitative FMR1-expression was determined using specific TaqMan-Assay and applying the ΔΔCT method. Kruskall-Wallis-Test or ANOVA were used for simple comparison between ovarian reserve (NOR, POR or PCO) and CGG-subgroups or cohort demographic data. All statistical analysis were performed with SPSS and statistical significance was set at p ≤ 0.05. Results: A statistically significant increase in FMR1-mRNA-expression-levels was detected in GCs of PORs with heterozygous normal/low-CGG-repeat-length compared with other genotypes (p = 0.044). Conclusion: Female ovarian response may be negatively affected by low CGG-alleles during stimulation. In addition, due to a low-allele-effect, folliculogenesis may be impaired already prior to stimulation leading to diminished ovarian reserve and poor ovarian response. A better understanding of FMR1 expression-regulation in GCs may help to elucidate pathomechanisms of folliculogenesis disorders and to develop risk-adjusted treatments for IVF/ICSI-therapy. Herewith FMR1-genotyping potentially provides a better estimatation of treatment outcome and allows the optimal adaptation of stimulation protocols in future

Gereja Yang Bermisi Bagi Kaum Perempuan di Era Post Modern

The postmodern era presents challenges as well as opportunities for the church in carrying out relevant missions, especially for women. This article aims to explore how the church can become an agent of social transformation that is inclusive and responsive to women's needs amidst the dynamics of postmodern culture. This research uses qualitative methods with a theological approach and social analysis, including literature study. The main results of the research show that churches that implement a holistic approach, such as empowering theological education, community-based service programs, and social justice advocacy, are able to increase gender awareness and women's participation in church life and wider society. The main conclusion confirms that a church with a mission for women not only fulfills the call of faith, but also becomes a witness to God's love and justice in an ever-changing world. The Church needs to continue to adapt its mission strategy to remain relevant and impactful in facing the challenges of the postmodern er

Fear and Loathing in Post 9/11 America: Public Perceptions of Terrorism as Shaped by News Media and the Politics of Fear

The politics of fear have deeply divided the United States of America. Decades of propaganda portray Muslims as a terrorist threat to the dominant US culture and society. The War on Terror and its consequences, including the rise of ISIL and the 2015 Syrian refugee crisis, resulted in the destabilization of democracy in both the US and Europe. I argue that the US public’s fear of terrorism is not just a fear of violence but instead reflects racial tensions and anxieties in a rapidly changing world. These tensions and anxieties are fueled by media coverage leveraging a general fear and distrust of non-white foreigners. The result of this is a pervasive fear of violent victimization at the hands of minorities, shaped by mass media content, which politicians capitalize on for their own gain. In this dissertation, I study the media effects of agenda setting, framing, and reinforcing spirals on public fear of terrorism with data from the Granite State Poll (GSP), Gallup’s Most Important Problem (MIP), and a content analysis of broadcast news transcripts from NexisUni. I expand on current research by examining the fear of terrorism from the perspectives of criminological theory, critical media studies, and racial formation theory

Political Violence and Unemployment: Socio-Economic Strain as a Potential Source of Terrorism

Why do some people commit acts of violence which are politically or ideologically motivated? Furthermore, why does the United States see such great variation in the number of terrorist incidents from year to year? To help answer these questions, Robert Agnew\u27s (2010) General Strain Theory of Terrorism lays out a foundational model to explain what might cause terrorism. In contrast to previous strain theories, General Strain Theory of Terrorism argues that the strains most likely to result in terrorism are collective strains which are (a) high in magnitude, with civilians affected; (b) perceived as unjust; and (c) inflicted by more powerful \u27others\u27. Collective strains affect groups or entire societies, rather than specific individuals. Collective strains increase negative emotions and attitudes, radicalize groups and individuals, contribute to a collective orientation and response, and facilitate the social learning of terrorism, while also reducing social control and access to legal coping means.;To test this theory, I argue that economic strains constitute collective strains. From this point I tested a portion of GST, focusing my analysis within the US, and examining the conduit from economic strain to increasing negative emotions to domestic terrorism using a path analysis of macro-level data collected from public sources. The analysis showed moderate support for theoretical assumptions. Some macroeconomic indicators such as unemployment can lead to domestic terrorism, while others such as poverty do not. As unemployment in the US rises, so do negative emotions and attitudes, and through this, incidents of domestic terrorism. Of course, economic factors are only one possible source of strain, and negative emotions are only one mediator in Agnew\u27s model. From this we can conclude that General Strain Theory of Terrorism may be a worthwhile avenue for future research