Hubungan Hiperurisemia, Obesitas Dan Riwayat Merokok Dengan Kejadian Hipertensi

Hypertension is a common clinical problem. Hyperuricemia, obesity, and smoking history are assumed to have a relationship with hypertension in adult. This study was conducted to figure out the association between hyperuricemia, obesity and smoking history with hypertension. Observational method with cross-sectional approach was used in this study. The study was conducted in Laboratorium Klinik Prodia Kendari. Sixty-two samples consist of men and women aged 18-65 years were taken by quota sampling. Blood pressure, body mass index, and blood chemistry result were collected during medical check-up. Smoking history data was collected with direct interview. Chi-square and binary logistic regression analysis were used to analyze the data (α=0,05). There were 50% hypertensive subjects and 50% non-hypertensive subjects. Hyperuricemia had a moderate association with hypertension (p=0,000; r=0,455). Obesity had a weak association with hypertension (p=0,020 ; r=0,248). Smoking history also had a weak association with hypertension (p=0,022 ; r=0,279). In multivariate analysis with confounding factors, only hyperuricemia that had an independent influence to hypertension (p= 0,00 ; OR 25,4 ; 95% CI 4,1-156,1), followed by HDL abnormality (p=0,04 ; OR=14,15 ; 95% CI=2,3-84,2) and total cholesterol (p=0,02 ; OR=22,4 ; 95% CI=3,2-153,8). Hyperuricemia, obesity, and smoking history, were associated with hypertension. Only hyperuricemia had the independent influence to hypertension

Training emergency services’ dispatchers to recognise stroke: an interrupted time-series analysis

Background: Stroke is a time-dependent medical emergency in which early presentation to specialist care reduces death and dependency. Up to 70% of all stroke patients obtain first medical contact from the Emergency Medical Services (EMS). Identifying ‘true stroke’ from an EMS call is challenging, with over 50% of strokes being misclassified. The aim of this study was to evaluate the impact of the training package on the recognition of stroke by Emergency Medical Dispatchers (EMDs). Methods: This study took place in an ambulance service and a hospital in England using an interrupted time-series design. Suspected stroke patients were identified in one week blocks, every three weeks over an 18 month period, during which time the training was implemented. Patients were included if they had a diagnosis of stroke (EMS or hospital). The effect of the intervention on the accuracy of dispatch diagnosis was investigated using binomial (grouped) logistic regression. Results: In the Pre-implementation period EMDs correctly identified 63% of stroke patients; this increased to 80% Post-implementation. This change was significant (p=0.003), reflecting an improvement in identifying stroke patients relative to the Pre-implementation period both the During-implementation (OR=4.10 [95% CI 1.58 to 10.66]) and Post-implementation (OR=2.30 [95% CI 1.07 to 4.92]) periods. For patients with a final diagnosis of stroke who had been dispatched as stroke there was a marginally non-significant 2.8 minutes (95% CI −0.2 to 5.9 minutes, p=0.068)reduction between Pre- and Post-implementation periods from call to arrival of the ambulance at scene. Conclusions: This is the first study to develop, implement and evaluate the impact of a training package for EMDs with the aim of improving the recognition of stroke. Training led to a significant increase in the proportion of stroke patients dispatched as such by EMDs; a small reduction in time from call to arrival at scene by the ambulance also appeared likely. The training package has been endorsed by the UK Stroke Forum Education and Training, and is free to access on-line

Mechanical thrombectomy in acute ischemic stroke : Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN

The original version of this consensus statement on mechanical thrombectomy was approved at the European Stroke Organisation (ESO)-Karolinska Stroke Update conference in Stockholm, 16-18 November 2014. The statement has later, during 2015, been updated with new clinical trials data in accordance with a decision made at the conference. Revisions have been made at a face-to-face meeting during the ESO Winter School in Berne in February, through email exchanges and the final version has then been approved by each society. The recommendations are identical to the original version with evidence level upgraded by 20 February 2015 and confirmed by 15 May 2015. The purpose of the ESO-Karolinska Stroke Update meetings is to provide updates on recent stroke therapy research and to discuss how the results may be implemented into clinical routine. Selected topics are discussed at consensus sessions, for which a consensus statement is prepared and discussed by the participants at the meeting. The statements are advisory to the ESO guidelines committee. This consensus statement includes recommendations on mechanical thrombectomy after acute stroke. The statement is supported by ESO, European Society of Minimally Invasive Neurological Therapy (ESMINT), European Society of Neuroradiology (ESNR), and European Academy of Neurology (EAN).Peer reviewe

Cosmological effects of scalar-photon couplings: dark energy and varying-α models

We study cosmological models involving scalar fields coupled to radiation and discuss their effect on the redshift evolution of the cosmic microwave background temperature, focusing on links with varying fundamental constants and dynamical dark energy. We quantify how allowing for the coupling of scalar fields to photons, and its important effect on luminosity distances, weakens current and future constraints on cosmological parameters. In particular, for evolving dark energy models, joint constraints on the dark energy equation of state combining BAO radial distance and SN luminosity distance determinations, will be strongly dominated by BAO. Thus, to fully exploit future SN data one must also independently constrain photon number non-conservation arising from the possible coupling of SN photons to the dark energy scalar field. We discuss how observational determinations of the background temper- ature at different redshifts can, in combination with distance measures data, set tight constraints on interactions between scalar fields and photons, thus breaking this degeneracy. We also discuss prospects for future improvements, particularly in the context of Euclid and the E-ELT and show that Euclid can, even on its own, provide useful dark energy constraints while allowing for photon number non-conservation

Acro-cardio-facial syndrome

Acro-cardio-facial syndrome (ACFS) is a rare genetic disorder characterized by split-hand/split-foot malformation (SHFM), facial anomalies, cleft lip/palate, congenital heart defect (CHD), genital anomalies, and mental retardation. Up to now, 9 patients have been described, and most of the reported cases were not surviving the first days or months of age. The spectrum of defects occurring in ACFS is wide, and both interindividual variability and clinical differences among sibs have been reported. The diagnosis is based on clinical criteria, since the genetic mechanism underlying ACFS is still unknown. The differential diagnosis includes other disorders with ectrodactyly, and clefting conditions associated with genital anomalies and heart defects. An autosomal recessive pattern of inheritance has been suggested, based on parental consanguinity and disease's recurrence in sibs in some families. The more appropriate recurrence risk of transmitting the disease for the parents of an affected child seems to be up to one in four. Management of affected patients includes treatment of cardiac, respiratory, and feeding problems by neonatal pediatricians and other specialists. Prognosis of ACFS is poor