Subarachnoid hemorrhage: tests of association with apolipoprotein E and elastin genes

<p>Abstract</p> <p>Background</p> <p>Apolipoprotein E (<it>APOE</it>) and elastin (<it>ELN</it>) are plausible candidate genes involved in the pathogenesis of stroke. We tested for association of variants in <it>APOE </it>and <it>ELN </it>with subarachnoid hemorrhage (SAH) in a population-based study. We genotyped 12 single nucleotide polymorphisms (SNPs) on <it>APOE </it>and 10 SNPs on <it>ELN </it>in a sample of 309 Caucasian individuals, of whom 107 are SAH cases and 202 are age-, race-, and gender-matched controls from the Greater Cincinnati/Northern Kentucky region. Associations were tested at genotype, allele, and haplotype levels. A genomic control analysis was performed to check for spurious associations resulting from population substructure.</p> <p>Results</p> <p>At the <it>APOE </it>locus, no individual SNP was associated with SAH after correction for multiple comparisons. Haplotype analysis revealed significant association of the major haplotype (Hap1) in <it>APOE </it>with SAH (<it>p </it>= 0.001). The association stemmed from both the 5' promoter and the 3' region of the <it>APOE </it>gene. <it>APOE </it>ε2 and ε 4 were not significantly associated with SAH. No association was observed for <it>ELN </it>at genotype, allele, or haplotype level and our study failed to confirm previous reports of <it>ELN </it>association with aneurysmal SAH.</p> <p>Conclusion</p> <p>This study suggests a role of the <it>APOE </it>gene in the etiology of aneurysmal SAH.</p

Gene–diet interactions on metabolic disease-related outcomes in Southeast Asian populations: a systematic review

Diabetes and obesity are chronic diseases that are a burden to low- and middle-income countries. We conducted this systematic review to understand gene–diet interactions affecting the Southeast Asian population’s risk of obesity and diabetes. The literature search was performed on Google Scholar and MEDLINE (PubMed) search engines independently by four reviewers who evaluated the eligibility of articles based on inclusion criteria. Out of 19,031 articles, 20 articles examining gene–diet interactions on obesity and/or diabetes-related traits met the inclusion criteria. Three (Malaysia, Indonesia, and Singapore) out of eleven Association of Southeast Asian Nations (ASEAN) countries have conducted studies on gene–diet interactions on obesity and diabetes. From the 20 selected articles, the most common interactions were observed between macronutrients and genetic risk score (GRS) on metabolic disease-related traits in the Malay, Chinese, and Indian ethnicities. Overall, we identified 29 significant gene–diet interactions in the Southeast Asian population. The results of this systematic review demonstrate ethnic-specific gene–nutrient interactions on metabolic-disease-related traits in the Southeast Asian population. This is the first systematic review to explore gene–diet interactions on obesity and diabetes in the Southeast Asian population and further research using larger sample sizes is required for better understanding and framing nutrigenetic approaches for personalized nutrition

SWAGINA-SAMPANA-RUPASAMPANNA Desa Swabudaya Penglipuran

HATUR PIUNING KETUA TIM DESA ADAT PENGLIPURAN Om Swastiastu, Namobudaya, Salam Kebajikan, Rahayu Terima kasih dihaturkan ke hadapan Hyang Widi Wasa atas asung kertha waranugraha-Nya, pelaksanaan Nata Citta Swabudaya (NCS) Desa Adat Penglipuran dapat terlaksana dengan lancar, sukses, dan bermakna. CS merupakan pelaksanaan pengabdian kepada masyarakat yang diselenggarakan Lembaga Penelitian, Pengabdian Kepada Masyarakat, dan Pengembangan Pendidikan (LP2MPP) Institut Seni Indonesia (ISI) Denpasar bermitra dengan Desa Adat Penglipuran, Kecamatan Bangli, Kabupaten Bangli. Desa Adat Penglipuran dipilih sebagai mitra NCS karena potensi desa yang layak dikembangkan dalam bidang seni budaya. Adapun kegiatan NCS di Desa Adat Penglipuran terdiri atas rekonstruksi tari dan iringan Baris Presi, pembuatan film dokumenter tari Baris Jojor, pelatihan berbusana adat Bali, tata rias dan sanggul Bali, pelatihan menggambar, membuat ornamen alat-alat upacara, pelatiahan MC, pelatihan pembuatan merchandise melalui cetak resin dan cetak saring, peletakan prasasti NCS ISI Denpasar dan buku monografi Desa Adat Penglipuran. Kegiatan NCS dilaksanakan dengan saling bersinergi dan bekerja sama dengan seluruh elemen masyarakat yang ada di Desa Adat Penglipuran. Buku monografi Desa Adat Penglipuran dengan judul Swagina-Sampana-Rupasampanna memberikan gambaran mengenai Desa Adat Penglipuran dengan potensi sumber daya alam yang dikelilingi oleh hutan bambu dan tanah perkebunan, sehingga suasana desa sangat sejuk, tenang dan nyaman. Secara visual desa adat Penglipuran sangat unik dan menarik, karena Masingmasing pekarangan memiliki angkul-angkul unik sebagai pintu rumah masuk dan memiliki bentuk yang sama antara yang satu dengan yang lainnya. Bentuk angkul-angkul yang seragam dan atapnya terbuat dari tumpukan bambu merupakan identitas dari wajah desa yang sangat artistik. Masyarakat Penglipuran sangat menjunjung tinggi nilai-nilai tradisi yang ada, baik secara fisik maupun non fisik, sehingga Desa adat Penglipuran menjadi destinasi desa wisata yang sangat terkenal di manca negara. Masyarakat Penglipuran sangat makmur karena sangat produktif, selain mengembangkan IKM loloh cemcem dan kunyit, juga banyak terjun sebagai peternak, perajin, dan seniman serta ekonomi masyarakat sangat didukung oleh pariwisata yang semakin meningkat. Selain terkenal karena keunikan permukimannya, Desa Adat Penglipuran juga sebagai desa yang bersejarah. Hal ini dibuktikan dengan adanya monumen perjuangan Anak Agung Anom Mudita yang terletak di bagian selatan desa, dan masyarakat menyebutnya sebagai Pura Dalem Mudita. Melihat Potensi Desa Adat Penglipuran sebagai desa Wisata yang berbasis lingkungan dan adat budaya, maka pelaksanaan NCS sangat tepat sebagai upaya mendorong pemajuan seni budaya masyarakat setempat yang sejalan visi NCS, yakni mewujudkan ekosistem seni budaya berkelanjutan. Seluruh tim NCS Desa Adat Penglipuran menghaturkan terima kasih kepada seluruh prajuru dan masyarakat karena telah memberikan perhatian yang besar dan berkontribusi dalam pelaksanaan NCS ini secara maksimal. Denpasar, 16 Juni 2022 Dr. Drs. I Wayan Suardana, M.S

Increased platelet activation and fibrinogen in Asian Indians. Potential implications for coronary risk

AIMS: To determine whether Asian Indians (Indians), a group known to have high rates of coronary heart disease, have increased platelet activation and fibrinogen levels relative to white Americans of European origin (whites). METHODS AND RESULTS: Forty healthy, non-smoking Indians, aged 25-45, were matched with 40 healthy whites for age (within 3 years) and gender. Platelet activation was tested in blood exiting a bleeding time wound at 1 and 2 min post-incision (wound-induced activation), as well as in venous blood stimulated in vitro with collagen, using whole blood flow cytometry. Other risk factors, including fibrinogen levels, family history of diabetes or coronary heart disease, fasting insulin and lipid levels, and Lp(a) were also assessed. Fibrinogen levels were higher among Indians than whites, even after adjustment for gender or family history of coronary heart disease (P \u3c 0.05). Indians had higher levels of wound-induced glycoprotein IIb/IIIa binding and platelet secretion (P-selectin expression) than whites, with the greatest differences found when comparing the upper quintile of activation for each group (Ps \u3c 0.05). Indians with a family history of coronary heart disease (n = 15) had higher levels of platelet secretion (wound-induced and in vitro) than Indians without a family history (Ps \u3c 0.05), while the relationship was reversed among whites. Platelet activation measures were not consistently related to other coronary risk factors, while fibrinogen was related to triglyceride and insulin levels among Indians. CONCLUSION: Indians have elevated fibrinogen and platelet activation levels relative to whites. These factors may contribute to the increased coronary risk observed in Indians

Effect of Primary Prophylactic Antiseizure Medication for Seizure Prevention Following Intracerebral Hemorrhage in the ERICH Study

Intracerebral hemorrhage (ICH) has the highest morbidity and mortality rate of any stroke subtype and clinicians often administer prophylactic antiseizure medications (ASMs) as a means of preventing post-stroke seizures, particularly following lobar ICH. However, evidence for ASM efficacy in preventing seizures and reducing disability is lacking given limited randomized trials. Herein, we report analysis from a large prospective observational study that evaluates the effect of primary prophylactic ASM administration on seizure occurrence and disability following ICH. Primary analysis was performed on 1630 patients with ICH enrolled in the ERICH study. A propensity score for administration of prophylactic ASM was developed and patients were matched by the closest propensity score (difference < 0.1). McNemar's test was used to compare occurrence of in-hospital seizure and disability, defined by modified Rankin Score (mRS) ≥ 3 at 3 months post ICH. Of the 815 matched pairs of patients treated with primary prophylactic ASM, there was no significant difference in seizure occurrence (p = 0.4631) or disability (p = 0.4653). Subset analysis of 280 matched pairs of patients with primary lobar ICH similarly revealed no significant difference in seizure occurrence (p = 0.1011) or disability (p = 1.00) between prophylactically treated and untreated patients. Although current guidelines do not recommend primary prophylactic ASM following ICH, clinical use remains widespread. Data from the ERICH study did not find an association between administering primary prophylactic ASM and preventing seizures or reducing disability following ICH, thus providing evidence to influence clinical practice and patient care

Relation of race and sex to the use of reperfusion therapy in Medicare beneficiaries with acute myocardial infarction

BACKGROUND: There are few reports describing the combined influence of the race and sex of a patient on the use of reperfusion therapy for acute myocardial infarction. METHODS: To determine the relation of race and sex to the receipt of reperfusion therapy for myocardial infarction in the United States, we reviewed the medical records of 234,769 Medicare patients with myocardial infarction. From these records we identified 26,575 white or black patients who met strict eligibility criteria for reperfusion therapy. We then performed bivariate and multivariate analyses of prevalence ratios to determine predictors of the use of reperfusion therapy in four subgroups of patients categorized according to race and sex: white men, white women, black men, and black women. RESULTS: Among eligible patients, white men received reperfusion therapy with the highest frequency (59 percent), followed by white women (56 percent), black men (50 percent), and black women (44 percent). After adjustment for differences in demographic and clinical characteristics, white women were as likely as white men to receive reperfusion therapy (prevalence ratio, 1.00; 95 percent confidence interval, 0.98 to 1.03). Likewise, black women were as likely as black men to receive reperfusion therapy (prevalence ratio, 1.00; 95 percent confidence interval, 0.89 to 1.13). However, black women were significantly less likely to receive reperfusion therapy than white men (prevalence ratio, 0.90; 95 percent confidence interval, 0.82 to 0.98), as were black men (prevalence ratio, 0.85; 95 percent confidence interval, 0.78 to 0.93). CONCLUSIONS: After adjustment for differences in clinical and demographic characteristics and clinical presentation, differences according to sex in the use of reperfusion therapy are minimal. However, blacks, regardless of sex, are significantly less likely than whites to receive this potentially lifesaving therapy

Abstract T MP92: Variation of Blood Pressure Response of Antihypertensive Agents in Acute Intracerebral Hemorrhage (ICH)

Objectives: Elevated blood pressure (BP) in ICH often requires urgent treatment. Prior studies have shown racial-ethnic differences in response to chronic antihypertensive treatment. Racial-ethnic differences and specific locations of ICH may impact the response to acute antihypertensive treatment (aHTN) in ICH. The aim of this study was to analyze variation of response to aHTN drugs by race-ethnicity and location of ICH. Methods: We included individuals recruited through the Ethnic/Racial Variations of Intracerebral Hemorrhage study with elevated BP on presentation and received labetalol, nicardipine, or hydralazine as the initial aHTN or who received no treatment despite elevated BP. We excluded individuals treated with multiple aHTN, treated with other aHTN, or lacking documentation of dose. The primary outcome measure was mmHg change in BP per 10 mg of drug administered. Changes in BP were tested using the Wilcoxon rank sum test. Results: A total of 1153 cases were available for analyses (35% white, 34% black, 31% Hispanic). Blacks were most likely to be treated acutely (52%), followed by Hispanics and whites (41%; 34%; p<0.01). For all three aHTN drugs, no significant racial-ethnic difference in systolic (SBP) or diastolic (DBP) response was found (p=0.92 for SBP; p=0.17 for DBP). Neither SBP nor DBP response differed by drug for lobar (p=0.36 SBP; p=0.25 DBP), deep (p=0.99 SBP; p=0.29 DBP) or posterior fossa (p=0.26 SBP, p=0.11 DBP) locations. Conclusion: In this large, multiethnic study of ICH, we are unable to detect a difference in BP response to hydralazine, labetalol, and nicardipine across race-ethnicity or locations of ICH. This finding suggests that the most commonly used aHTN agents in ICH regimens do not need to be tailored to ethnicity or ICH location. A larger cohort may provide greater power to detect a smaller difference between the agents