scholarly journals Διερεύνηση του ρόλου των κατασταλτικών αυτοαντισωμάτων έναντι του υποδοχέα της θυρεοτρόπου ορμόνης ως αίτιου αποβολών στις εγκύους με θυρεοειδική αυτοανοσία

2013 ◽  
Author(s):  
Κωνσταντίνος Τουλής

Σκοπός Με βάση περιπτώσεις μοριακού μιμητισμού μεταξύ των γλυκοπρωτεϊνών και των υποδοχέων τους, διατυπώσαμε την υπόθεση ότι αυτοαντισώματα έναντι του υποδοχέα της θυρεοτροπίνης (TSH-Rab) κατασταλτικού τύπου (blocking) πιθανά να έχουν δραστικότητα αποκλειστή επί του υποδοχέα της ανθρώπινης χοριακής γοναδοτροπίνης (LH/hCG-R) στο ωχρό σωμάτιο, το τελικό βιολογικό αποτέλεσμα της οποίας θα ήταν η απώλεια κύησης κατά το πρώτο τρίμηνο. Ο σκοπός της μελέτης ήταν η κλινική διερεύνηση της παραπάνω υπόθεσης και συγκεκριμένα η διερεύνηση της παρουσίας και εκτίμηση των συγκεντρώσεων bTSH-Rab στις γυναίκες με θυρεοειδίτιδα Hashimoto και ιστορικό καθ’ έξιν αποβολών (ασθενείς) και η σύγκριση τους με γυναίκες με θυρεοειδίτιδα Hashimoto και φυσιολογικό αναπαραγωγικό ιστορικό (μάρτυρες). Ασθενείς και Μέθοδοι Συνολικά επιλέχθηκαν 86 γυναίκες (46 ασθενείς και 46 μάρτυρες με ηλικιακή εξομοίωση) από εξωτερικά ιατρεία και κλινικές του Νομού Θεσσαλονίκης στο πλαίσιο αναδρομικής μελέτης τύπου ασθενών-μαρτύρων. Για τη συμπερίληψη στην ομάδα των ασθενών, η γυναίκα έπρεπε να είχε ηλικία μικρότερη των 35 ετών στην τελευταία αποβολή και κάτω των 50 ετών κατά την επιλογή, χωρίς να εντοπίζονταν από το ιστορικό, την κλινική εξέταση και τον κατά περίπτωση παρακλινικό έλεγχο, δευτεροπαθείς αιτίες καθ’ έξιν αποβολών. Σε υπο-ομάδα των ασθενών (n=15) πραγματοποιήθηκε ορμονολογική εκτίμηση υποφυσιακής λειτουργίας, διακολπικό υπερηχογράφημα πυέλου, καρυότυπο, ανίχνευση μεταλλάξεων του παράγοντα V, μέτρηση επιπέδων ομοκυστεΐνης, αυτοαντισωμάτων έναντι της διπλής έλικας του DNA, αντιπηκτικού του λύκου, β2-γλυκοπρωτείνης και αντικαρδιολιπινικών αντισωμάτων. Η στατιστική ανάλυση πραγματοποιήθηκε με το λογισμικό Stata 10.0 Αποτελέσματα Δεν ανιχνεύθηκε σημαντική διαφορά στον επιπολασμό (Fisher’s exact test, p-value = 1.00) ή στους τίτλους TSH-Rab μεταξύ των ασθενών και των μαρτύρων (Mann-Whitney test, p = 0.59). Οι αναλύσεις ευαισθησίας με βάση τους ορισμούς των καθ’ έξιν αποβολών, των αυτόματων αποβολών, της θυρεοειδίτιδας Hashimoto και της θετικότητας των TSH-Rab δεν τροποποίησαν την κατεύθυνση των ευρημάτων. Η απουσία συσχέτισης μεταξύ TSH-Rab και αναπαραγωγικού ιστορικού επιβεβαιώθηκε σε μονομεταβλητό μοντέλο λογαριθμικής παλινδρόμησης [OR = 1.00, 95% CI = 0.19-5.25], είτε όταν χρησιμοποιήθηκε ο τίτλος των TSH-Rab (OR = 0.77, 95% CI = 0.29 - 2.08). Η παρουσία των TSH-Rab δεν προέβλεψε με στατιστικώς σημαντικό τρόπο τον αριθμό των αυτόματων αποβολών στις ασθενείς (Coef = -0.4, 95% CI = -1.15 - 0.34, p = 0.285) και απουσία συσχέτισης επιβεβαιώθηκε όταν χρησιμοποιήθηκε ο τίτλος τους (Coef = -.0.53, 95% CI = -1.08 - 0.10, p = 0.054). Τα παραπάνω ευρήματα παρέμειναν ανθεκτικά στην ιεραρχική στάθμιση με την ηλικία και το ΒΜΙ κατά την τελευταία κύηση ή αποβολή σε πολυμεταβλητά μοντέλα παλινδρόμησης. Συμπεράσματα Στην παρούσα μελέτη, δεν προέκυψαν ενδείξεις ότι τα TSH-Rab έχουν σημαντικό ρόλο στην παθογένεια των αυτόματων αποβολών και δεν μπορεί να υποστηριχθεί η κλινική και ερευνητική χρησιμότητα της ανίχνευσής τους στις γυναίκες με θυρεοειδίτιδα Hashimoto και ιστορικό καθ’ έξιν αποβολών.

2019 ◽  
Vol 9 (2) ◽  
pp. 142-147
Author(s):  
I Gusti Ayu Putu Sri Wahyuni ◽  
Fitra Arsy Nur Cory'ah

Based on research by the World Health Organization (WHO), around the world there are 10,000,000 infant deaths per year in Indonesia, among ASEAN countries, is the country with the highest perinatal mortality rate, meaning that the ability to provide health services still requires improvements that are comprehensive and of higher quality. Integrated ANC  services are also related to effective counseling activities in an effort to improve maternal knowledge about pregnancy care, especially the activity of calculating gesture). The purpose of this study is to determine the effect of experimental counseling fetal motion in third-trimester primigravida. The design in this study was pregnant post nonequivalent control group test. The study was conducted in Meninting Community Health Center, West Lombok Regency. The population of this study was the third trimester of pregnant women, namely 80 people. The sample of this study was 34 people. Test statistics using the Mann Whitney test and Fisher's Exact Test with confidence levels specified α = 0.05 and 95% confidence intervals. The results of the study with the Mann Whitney test P = 0,000 means that there is a significant difference between knowledge about calculating fetal motion in the case group compared to the control group and the Fisher's Exact Test P = 0,000 shows there is an influence of experimental counseling on the activity of calculating fetal movement. The recommendations of this study are to examine the effectiveness of calculating fetal motion for fetal distress.


2020 ◽  
Vol 9 (1) ◽  
pp. 111-118
Author(s):  
Lumastari Ajeng Wijayanti ◽  
Eny Sendra ◽  
Ratih Novitasari ◽  
Tanti Dwi Pujaningsih

This research used cross sectional design. The population was 194 respondents and the sample was 54 respondents which are taken by using simple random sampling technique. Independent variable in this research was demographic status that was measured by questionnaire and nutritional status that was measured based on Body Mass Index (BMI). Meanwhile, dependent variable in this research was the occurrence of anemia that was measured by using spectrophotometry. Data analysis used Fisher's Exact test and Two-Sample Kolmogorov-Smirnov test (α = 0,05). Result of Fisher's Exact test was obtained that p value = 1,000 > 0,05, which meant that there was no significant correlation between demographic status and the occurrence of anemia. Meanwhile, result of Two-Sample Kolmogorov-Smirnov test was obtained that p value = 0,017 < 0,05, which meant that there was a significant correlation between nutritional status and the occurrence of anemia.


Author(s):  
M Zamzani ◽  
Hamam Hadi ◽  
Dewi Astiti

<p><strong>ABSTRACT</strong></p><p><strong><em>Background</em></strong><strong><em>s</em></strong><strong><em>:</em></strong><em> The increasing prevalence of obesity is caused by imbalance between energy input to energy output. Physical activity in children both at school and at home plays an important role in determining the nutritional status of children, including the risk of obesity. </em></p><p><strong><em>Objectives:</em></strong><em> To determine the relationship between children physical activity with obesity in Ngebel Elementary School, Tamantirto Kasihan Bantul. </em></p><p><strong><em>Methods:</em></strong><em> This study was an observational study with cross sectional design. The study population is all children grades 3, 4, and 5 Ngebel Elementary School, Tamantirto Kasihan Bantul. These samples included 96 children who met the inclusion and exclusion criteria obtained with less total sampling technique. Weight children measured using digital bathroom scales to the nearest 0.1 kg and height was measured using the nearest 0.1 cm microtoice assisted by trained enumerators. Physical activity data were obtained using a physical activity questionnaire was adopted from previous studies. Nutritional status data is calculated using the WHO software Anthro 2005. Univariate analysis using frequency distribution and bivariate analysis using </em><em>Fisher’s Exact Test</em><em>. Data were analyzed using software statistic.</em></p><p><strong><em>Results:</em></strong><em> Results analisis showed physical activity had a significant relationship with the incidence of obesity in children, with p Value 0.015 (&lt;0,05) with OR of 4.78 (95% CI: 1.36 to 16.82), </em><em>in other words children who do moderate to severe activity ≤1 hour/day had 5 times higher chance to be obese than children with moderate to severe activity &gt;1 hour/day.</em></p><p><strong><em>Conclusions:</em></strong><em> Physical activity has a significant association with obesity.</em><em> </em></p><p><strong>KEYWORDS<em>:</em></strong><em> physical activity, obesity, elementary school children</em><em></em></p><p> </p><p><strong>ABSTRAK</strong></p><p><strong><em>Latar belakang: </em></strong><em>Peningkatan prevalensi obesitas disebabkan oleh adanya ketidakseimbangan antara masukan energi dengan keluaran energi. Aktivitas fisik pada anak-anak baik di sekolah maupun di rumah berperan penting dalam penentuan status gizi anak, termasuk risiko terjadinya obesitas.<strong></strong></em></p><p><strong><em>Tujuan: </em></strong><em>Untuk mengetahui </em><em>hubungan antara aktivitas fisik dengan kejadian obesitas pada anak Sekolah Dasar Negeri Ngebel, Tamantirto Kasihan Bantul.</em></p><p><strong><em>Metode: </em></strong><em>Penelitian ini merupakan penelitian observasional dengan rancangan cross sectional. Populasi penelitian adalah semua anak kelas 3, 4, dan 5 SDN Ngebel, Tamantirto Kasihan Bantul. Sampel penelitian berjumlah </em><em>96 </em><em>anak yang memenuhi kriteria inklusi dan eksklusi diperoleh dengn teknik total sampling. Berat anak-anak diukur dengan menggunakan timbangan injak digital dengan ketelitian 0,1 kg, sedangkan tinggi badan diukur menggunakan microtoise dengan ketelitian 0,1 cm dibantu oleh enumerator terlatih. Data aktivitas fisik diperoleh menggunakan kuesioner aktivitas fisik yang diadopsi dari</em><em> penelitian sebelumnya</em><em>. Data status gizi dihitung dengan menggunakan software WHO Anthro 2005. Analisis univariat menggunakan distribusi frekuensi dan analisis bivariat menggunakan</em><em> Fisher’s Exact Test</em><em>. Data dianalisis dengan menggunakan program software statistic.</em></p><p><strong><em>Hasil: </em></strong><em>Hasil a</em><em>nalisis </em><em>menunjukkan aktivitas fisik memiliki hubungan yang signifikan dengan kejadian obesitas pada anak dengan </em><em>nilai p value 0,009 (&lt;0,05) dengan nilai OR 5,69 (95% CI: 1,42-22,65), dengan kata lain anak yang melakukan aktivitas sedang-berat ≤1 jam/hari berpeluang 5 kali lebih besar untuk mengalami obesitas daripada anak dengan aktivitas sedang-berat &gt;1 jam/hari.</em></p><p><strong><em>Kesimpulan: </em></strong><em>Aktivitas fisik memiliki hubungan secara bermakna dengan obesitas.</em><strong><em></em></strong></p><p><strong>KATA KUNCI: </strong><em>aktivitas fisik, obesitas, anak SD</em></p>


Diagnostics ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 255 ◽  
Author(s):  
Enrica Marchionni ◽  
Maria Grazia Porpora ◽  
Francesca Megiorni ◽  
Ilaria Piacenti ◽  
Agnese Giovannetti ◽  
...  

Background: Endometriosis is a widespread multifactorial disease in which environmental, genetic, and epigenetic factors contribute to the phenotype. Single Nucleotide Polymorphisms (SNPs) in genes implicated in pivotal molecular mechanisms have been investigated as susceptible risk factors in distinct populations. Among these, Toll-like receptor 4 (TLR4) represents a good candidate due to its role in the immune/inflammatory response and endometriosis pathogenesis. Methods: The TRL4 gene T399I SNP (C/T transition, rs4986791) was investigated in 236 Italian endometriosis patients and 150 controls by using the PCR-RFLP method. One-tailed Fisher’s exact test was used to compare differences between categorical variables. T399I genotype distribution was evaluated for Hardy–Weinberg equilibrium in both groups using the Chi-squared test for given probabilities. Results: Fisher’s exact test comparing C and T allele frequencies showed a difference in the frequency of T alleles between patients and controls (OR = 1.96, 95% confidence interval 0.91–4.23; p-value = 0.0552). Genotype frequencies did not show any significant difference between patients and controls. The homozygous TT genotype was observed in 2% of endometriosis women and not in controls. Conclusions: Our results show that the TLR4 rs4986791 T variant may be considered a genetic risk factor for endometriosis in Italian women. More extensive studies in other populations are needed to confirm this result.


2012 ◽  
Vol 78 (6) ◽  
pp. 693-697
Author(s):  
Alfred John Colfry ◽  
Xu Zhang ◽  
George M. Fuhrman

We hypothesize that the diminishing role of axillary node dissection (ALND) in early stage breast cancer could be further reduced in patients with advanced disease depending on the response to neoadjuvant chemotherapy (NC). We reviewed records of patients managed with NC and recorded demographics, tumor characteristics, pre/postoperative axillary nodal status, and NC response. We define a response to NC as follows: T2 tumors at least a 50 per cent reduction in the product of the length and width of the tumor and in T3–4 tumors a reduction in tumor size to less than 2 cm. We defined a negative axillary nodal status as either a negative sentinel node biopsy before or after NC or a negative ALND. We defined a positive axillary nodal status as clinical persistence of nodal disease despite NC or involved nodes determined by ALND. Fisher's exact test was used to evaluate the association between response to NC and nodal status. Over the past 4 years, 35 patients have completed NC and surgical treatment including lymph node assessment. Sixteen cancers demonstrated a response to NC and two (12.5%) had positive lymph nodes. Nineteen cancers failed to respond to NC and 13 (68.4%) had involved lymph nodes. Fisher's exact test shows a strong association between NC response and nodal status (two-tailed P value 0.0016). Patients with advanced locoregional breast cancer that respond to NC are unlikely to benefit from ALND. If this study's findings are confirmed in larger trials, ALND could be limited to patients with advanced locoregional breast cancer unresponsive to NC.


2019 ◽  
Vol 10 (2) ◽  
Author(s):  
Nurhayati Nurhayati

Toilet training sangat penting dalam membentuk karakter anak dan membentuk rasa saling percaya dalam hubungan anak dan orang tua. Keberhasilan toilet training dipengaruhi oleh pengetahuan dan pola asuh orang tua dalam mendorong anak mencapai tujuan yang diinginkan. Penelitian ini bertujuan untuk menganalisis hubungan pengetahuan dan pola asuh orang tua dengan kemampuan toilet training pada anak usia toddler di PAUD Asyiyah 2 Provinsi Sulawesi Tengah. Jenis penelitian ini adalah analitik dengan desain cross sectional. Populasi penelitian ini yaitu semua orang tua yang memiliki anak usia toddler di PAUD Aisyah 2 Provinsi Sulawesi Tengah sebanyak 32 orang. Sampel dalam penelitian ini adalah orang tua yang memiliki anak usia toddler di PAUD Aisyah 2 Provinsi Sulawesi Tengah sebanyak 32 orang dengan teknik pengambilan sampel total sampling. Data dianalisis menggunakan Fisher’s Exact test. Hasil uji Fisher’s Exact didapatkan nilai p=0,000 dan nilai p=0,001 (p Value < 0,05), ini berarti secara statistik ada hubungan pengetahuan dan pola asuh orang tua dengan kemampuan toilet training pada anak usia toddler. Berdasarkan hasil penelitian tersebut disarankan bagi orang tua (ibu) yang menerapkan pola asuh kurang baik agar dapat merubah atau menerapkan pola asuh yang tepat kepada anaknya agar mampu melaksanakan toilet training dengan baik. Kata kunci : Pengetahuan, pola asuh, toilet training.


2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Supriyadi Supriyadi ◽  
Susmini Susmini

Gangguan metabolik mampu menyebabkan beberapa penyakit salah satunya ialah diabetes melitus. Gejala umum yang sering muncul pada kasus diabetes melitus yaitu hiperglikemia. Hiperglikemia yang berkepanjangan dapat mengakibatkan berbagai macam komplikasi diantaranya komplikasi mikrovaskuler dan makrovaskuler. Tujuan penelitian ini untuk mengetahui hubungan kadar gula darah sewaktu dengan gejala neuropati perifer penderita diabetes melitus tipe 2. Desain penelitian ini menggunakan cross sectional. Jumlah sampel 32 penderita diabetes melitus yang dipilih melalui teknik simple random sampling, penelitian ini dilakukan di Desa Kedung Dowo Kecamatan Nganjuk. Berdasarkan uji statistik Fisher’s Exact Test didapatkan p value 0.002 (p value < 0.05) yang berarti terdapat hubungan antara kadar gula darah sewaktu dengan gejala neuropati perifer penderita diabetes melitus tipe 2.


2021 ◽  
Vol 4 (1) ◽  
pp. 102-112
Author(s):  
Sriwani Supardin

Ship sanitation is an indicator of vessel cleanliness, vector control in 2017 no high-risk vessels were found, in 2018 there were 7 high-risk vessels and in 2019 there were 15 high-risk vessels. This study aims to determine the relationship between kitchen sanitation, food raft space and warehouse with cockroach density on ships in the Kendari port area. This type of research is an observational, Cross-Sectional Study design. The population is all ships berthed in the Kendari port area as many as 41 ships and a sample of 37 vessels taken by purposive sampling. Data analysis used fisher's exact test. The results showed that of the 37 ships, the highest density of cockroaches met the requirements (75.7%), the rest did not meet the requirements (24.3%). The kitchen sanitation met the requirements (75.7%), the rest did not meet the requirements (24.3%), then the food raft room sanitation met the requirements (83.8%) and did not meet the requirements (16.2%). Furthermore, warehouse sanitation fulfills the requirements (62.2%) and does not meet the requirements (37.8%). The results of Fisher's exact test obtained p value (0,000). The conclusion of this study is that there is a relationship between kitchen sanitation, food raft space and warehouse with cockroach density on ships in the Kendari port area. Suggestions for the KKP to establish policies to prevent cockroach development.


Author(s):  
Yeni Lestari ◽  
Dian Roza Adila ◽  
Raja Fitrina Lestari

Tali pusat yang tidak dirawat dengan baik akan menyebabkan infeksi, yang ditandai dengan kemerahan dan bengkak pada tali pusat. Salah satu upaya untuk mencegah terjadinya infeksi tali pusat adalah dengan melakukan tindakan mencuci tangan dalam perawatan tali pusat. Mencuci tangan bertujuan untuk menghilangkan atau mengurangi kuman dan bakteri yang menempel ditangan supaya kuman dan bakteri tersebut tidak masuk kedalam luka tali pusat. Penelitian ini bertujuan untuk mengetahui adanya hubungan tingkat pengetahuan dan sikap ibu terhadap tindakan mencuci tangan dalam perawatan tali pusat bayi baru lahir di wilayah kerja Puskesmas Payung Sekaki. Jenis penelitian ini adalah penelitian kuantitatif dengan desain cross-sectional dengan menggunakan teknik sampling purposive sampling. Hasil univariat terhadap 42 responden didapatkan bahwa mayoritas ibu memiliki tingkat pengetahuan baik sebanyak 27 responden (64,3%), sikap ibu mayoritas baik sebanyak 23 responden (54,8%) dan mayoritas ibu malakukan tindakan mencuci tangan dalam perawatan tali pusat sebanyak 37 responden (88,1%). Hasil bivariat menggunakan uji chi- square dengan uji alternatif fisher’s exact test untuk pengetahuan dan uji kolomogorov-smirnov test untuk sikap, didapatkan hasil terdapatnya hubungan antara tingkat pengetahuan ibu terhadap tindakan mencuci tangan dalam perawatan tali pusat bayi baru lahir dengan p value 0,004 lebih kecil dari 0,05 dan tidak terdapat hubungan antara sikap ibu terhadap tindakan mencuci tangan dalam perawatan tali pusat dengan p value 0,998 lebih besar dari 0,05. Berdasarkan hasil analisa tersebut diharapkan kepada petugas kesehatan dapat mempertahankan dan meningkatkan pengetahuan ibu dengan memberikan pendidikan kesehatan bahwa selalu mencuci tangan dalam tindakan apapun terutama tindakan yang berhubungan dengan bayi baru lahir.          


2021 ◽  
Vol 7 (1) ◽  
pp. 01-06
Author(s):  
Elsarika Damanik ◽  
Christina Roos Etty ◽  
Flora Sijabat ◽  
Rantauli Sibarani

Dukungan suami merupakan suatu bantuan atau pertolongan yang dapat diberikan oleh suami pada istrinya sebagai bentuk perwujudan perhatian dan kasih sayang dalam melakukan kunjungan antenatal care selama kehamilan. Penelitian ini bertujuan untuk mengetahui hubungan dukungan suami terhadap  kunjungan antenatal care di Klinik Wanti Mabar Hilir Kecamatan Medan Deli Tahun 2019. Penelitian ini menggunakan pendekatan Cross Sectional. Data analisis dilakukan dengan menggunakan Fisher's Exact Test, ditemukan p-value (0.032), OR (5,487), CI (95%). Berdasarkan penelitian diperoleh hasil bahwa  suami kurang mendukung (70%), responden kurang teratur melakukan kunjungan antenatal care sebanyak 22 orang (73,3%). Ada hubungan dukungan suami terhadap kunjungan antenatal care. Diharapkan suami berperan aktif dalam memberikan dukungan bagi ibu dalam melakukan kunjungan ANC.


Sign in / Sign up

Export Citation Format

Share Document