bluuebunny/crossref_metadata_2025 huggingface dataset:
The Use of Magnetic Resonance Imaging in Diagnostics of Radix Paramolaris: A Case Report
Authors: Golež Aljaž , Ovsenik Maja , Romarić Katja , Cankar Ksenija
Published: January 2022

Background and Objectives:

This case report aims to present a rare morphological variation of Radix Paramolaris (RP) diagnosed using Magnetic Resonance Imaging (MRI) to discuss its morphological associations and possible implications on dental treatment. Radix paramolaris is a buccally located supernumerary root of the permanent mandibular molars. It is very rare in the European population, with a prevalence below 4%.

Case Presentation:

A 7-year-old boy with severe Class II malocclusion is presented. The first phase of orthodontic treatment consisted of therapy with a removable activator appliance. Before the second phase of treatment, unilateral radix paramolaris on the second right permanent mandibular molar was discovered.

Results:

Supernumerary root was diagnosed using a 3T whole-body MRI system. This case confirmed the association between supernumerary roots and increased buccal crown cusps in a mandibular molar. Furthermore, it demonstrated the effectiveness of non-invasive MRI as a complementary diagnostic tool, offering clear advantages in diagnosing rare morphological variations such as supernumerary roots. Unlike conventional radiography, MRI is able to distinguish the soft tissues, including the dental pulp, and does not emit ionizing radiation.

Conclusion:

To diagnose a supernumerary root and the state of its pulpal tissue, a precise radiographic and clinical examination is required since awareness of exact root morphology can be of paramount importance in clinical decision-making for several dental procedures.
Improved Production of HIV-1 Subtype C Protease from Transgenic E. Coli
Authors: Ramlucken Uraisha , Babu Naidu Krishna Suresh , Govender Patrick
Published: January 2022

Background:

Human Immunodeficiency Virus 1 (HIV-1) subtype C is responsible for the majority of infections of patients in Southern Africa. The HIV protease is a primary target for the development of highly efficient anti-retroviral pharmaceuticals because of its pivotal role in the maturation of the virus in the host cell. For target validation of novel HIV protease inhibitors, there is a need for the availability of an abundance of this protease.

Objective:

This study reports an optimized method to produce HIV-1 protease derived from HIV-1 subtype C.

Methods:

It involves the use of a transgenicE. colistrain that overexpresses the native form of the enzymeviainclusion bodies. A stringent method for the isolation, purification, and renaturation resulted in the production of highly pure active HIV-1 protease. In order to facilitate an increase in protease yields, an optimized growth strategy was developed. In this regard, a chemically defined medium with lower glucose content and devoid of essential amino acids of the TCA cycle was used as an alternative to the widely used nutrient-rich Luria Bertani (LB) medium.

Results:

Results indicated an increase in protease yield up to twice the amount, thereby making this medium an attractive alternative for increasing biomass and HIV protease production for future research.

Conclusion:

An optimized method for HIV-1 protease derived from HIV-1 subtype C production using chemically defined media was established. This was achieved using a known method to isolate and purify the enzyme with the use of a specialized feeding strategy.
The Impact of Islamic-Based Disaster Response Competencies Program on Nurses: A Computer-based Training Randomized Controlled Trial
Authors: Husna Cut , Yahya Mustanir , Kamil Hajjul , Tahlil Teuku
Published: January 2022

Introduction:

Disasters have a significant impact on physical, psychological, psychosocial, and spiritual conditions. Indonesia, a predominately Muslim country, is a country of high vulnerability and risk for disasters. The nurses are frontliners and care providers need sufficient competencies in handling the survivors in health service centers. Local government regulations in the Aceh Province required Islamic-based health services.

Objective:

The study aims to identify the effectiveness of the Islamic-based disaster response competencies on nurses at the Banda Aceh Hospitals.

Methods:

A randomized controlled trial with a pre- and post-tests with a control group design was used in this study. The population was all nurses at three hospitals in four wards: emergency department, intensive care, medical, and surgical wards. The samples were selected using cluster random sampling and assigned into three groups: evidence = 50, Islamic = 49, and control = 48. Data were analyzed using parametric and non-parametric tests.

Results:

The results showed a significant increase in nurses’ knowledge, skills, and attitudes of disaster response in the evidence and Islamic groups with the mean and SD of the Islamic group in post-test 1 and 2 (knowledge = 15.9±2.9 and 15.8±2.9, skills = 19.0±1.4 and 18.9±1.4, attitude = 108.1±6.9 and 108.2±6.9) were higher than the evidence group (knowledge = 15.6±2.7 and 15.5±2.7, skills = 18.7±1.5 and 18.8±1.5, attitudes = 107.5±7.4 and 107.4±7.3) and the control group (knowledge=13.8±4.0 and 13.9±4.0, skills = 17.9±1.9 and 17.9±1.9, attitude = 104.5±8.8 and 104.6±8.8), respectively.

Conclusion:

The results indicate the Islamic group is more effective in increasing the disaster response competencies of nurses. This finding suggests the importance of developing regulations including policies, guidelines, emergency and disaster training, and public health services to support the implementation of an appropriate Islamic-based disaster nursing responses for hospitals in the Aceh Province and other regions with the implementation of Islamic law. Request number ANZCTR 378930
A Systematic Survey of Multiprocessor Real-Time Scheduling and
Synchronization Protocol
Authors: Kumar Ajitesh , Gupta Sanjai Kumar
Published: January 2022

Background:

Nowadays, there is an immense increase in the demand for high power computation
of real-time workloads and the trend towards multi-core and multiprocessor CPUs. The realtime
system needs to be implemented upon multiprocessor platforms.

Introduction:

The nature of processors in an embedded real-time system is changing day by day. The
two most significant challenges in a multiprocessor environment are scheduling and synchronization.
The popularity of real-time multi-core systems has exploded in recent years, driving the rapid development
of a variety of methods for multiprocessor scheduling of essential tasks; on the other hand;
these systems have constraints when it comes to maintaining synchronization in order to access shared
resources.

Method:

This research work presents a systematic review of different existing scheduling algorithms
and synchronization protocols for shared resources in a real-time multiprocessor environment. The
manuscript also presents a study based on various metrics of resource scheduling and comparison
among different resource scheduling techniques.

Result and Conclusion:

The survey classifies open issues, key challenges, and likely useful research directions. Finally,
we accept that there is still a lot of capacity in developing better resource management and further
maintaining the overall quality. The paper considers such a future path of research in this field.
Neuroinflammation and Behavioral Deficit in Rotenone-Induced Neurotoxicity
in Rats and the Possible Effects of Butanolic Extract of Centaurea
africana
Authors: Hadjira Sabrina , Mansour Amira , Seghiri Ramdane , Menad Ahmed , Benayache Fadila , Benayache Samir , Ameddah Souad
Published: January 2022

Background:

Many studies have used rotenone (ROT) to create an experimental animal
model of Parkinson's disease (PD) because of its ability to induce similar behavioral and motor deficits.
PD is the most common age-related motoric neurodegenerative disorder. Neuroinflammation
and apoptosis play an important role in the pathogenesis of this disease.

Objective:

This study investigated the effect of butanolic (n-BuOH) extract of Centaurea africana
(200 mg/kg, 16 days) on a ROT-induced neurotoxicity model in male Wistar albino rats.

Methods:

Estimation of Tumor Necrosis Factor (TNF-α) and Nitric Oxide (NO) levels along with
the myeloperoxidase (MPO) activity in brains was carried out in order to evaluate neuro-inflammation.
Oxidative stress, Caspase 3 activity (apoptosis), and behavioral alterations were also evaluated.

Results:

In behavior assessment, using Ludolph Movement Analysis Scale, all ROT treated animals
showed a decreased locomotor activity. The mitochondrial dysfunction induced by ROT was
expressed by a decreased activity of complex I of the mitochondrial respiratory chain and increased
lipid peroxidation and caspase 3. Co-treatment with the n-BuOH extract significantly restored the
activity of complex I (65.41 %) compared to treatment with ROT alone. The n-BuOH extract also
reduced the neuroinflammation in rat brains by reducing MPO activity (75.12 %), NO levels
(77.43 %), and TNF-α (71.48 %) compared to the group treated with ROT.

Conclusion:

The obtained results indicated that C. africana n-BuOH extract exhibited a protective
effect in rats.
“Eu não quero palmas, eu quero almas” crenças e pertenças no rap evangélico da Grande Lisboa
Authors: Tuna Cátia
Published: January 2022

This paperis based oninterviewswithfive rappers belonging to evangelical Christian communities and residing in Greater Lisbon and on the lyrics,they write and sing. Different subjects will be coveredas the identity they formulate in a double belonging to the street and tothe church,or the insertion of the repertoire and interviewsin the theological map of neo-Pentecostalism
ATTENTION DEFICIT HYPERACTIVITY DISORDER SYMPTOMS IN ADULTS WITH ESSENTIAL TREMOR
Authors: Oguzturk Omer , Alpua Murat , Kasim Ulusoy Ersin
Published: January 2022

Background: Essential tremor is the most common movement disorder. İn this disease, which is characterized by tremor that increases with action and passes at rest, different accompanying symptoms can also be seen. Objective: The purpose of this study was to investigate attention deficit hyperactivity symptoms in adults with ET. Methods: Fifty six essential tremor patients and 56 controls were included in the study. Patients were recruited from outpatient clinic at Kirikkale University Medicine Faculty. An informed consent form was signed by each patient after detailed information. Institutional ethics committee approval was obtained. Patients’ characteristics such as education level, gender, age and disease duration were recorded. Symptoms of ADHD in patients and controls were determined by using the Adult Report Deficit / Hyperactivity Disorder Self Report Scale. Short Form-36 and Hospital Anxiety and Depression Scale were also performed. Essential tremor severity was determined by using the Whiget essential tremor scale. Results: Essential tremor patients had significantly higher rate of Adult Attention Disorder Self-Report Scale Deficit/Hyperactivity scores compared to controls. Scores of Adult Attention Deficit/Hyperactivity Disorder Self-Report Scale were associated with depression and anxiety scores and physical and mental component scores of Short Form-36 in bivariate analyses. There was a positive correlation between tremor severity and ASRS scores( ASRS A scores= 17,3±5,5, p=0,032, ASRS B scores= 27,7±6,7,p=0,043, ASRS T scores= 45±12,2, p=0,017) however there was no significant statistical relationship between the duration of disease and ASRS scores. Conclusion: This study showed that ADHD symptoms can be observed in adult essential tremor patients and this may be associated with increased psychosocial morbidity and lowered quality of life in ET patients.
NEURODEGENERATION AS AN EARLY SIGN OF DIABETIC RETINOPATHY
Authors: Artha Dewi Nadia , Arfan Muhammad , Rahmasari Herisa , Kristiani Putri Mutiara , Rosandi Rulli , Nandar Kurniawan Shahdevi
Published: January 2022

Diabetic retinopathy is major cause of visual impairment and blindness in diabetic patients worldwide. The concept of diabetic retinopathy as vascular disease has established into not only microvascular complication but also neurodegeneration problems. Neurodegeneration plays an important role in pathogenesis of diabetic retinopathy. In fact, neuroretinal changes in diabetes can take place even before vasculopathy can be clinically detected. This condition is marked by accelerated loss of neurons due to apoptosis, particularly in the inner retinal layer. The characteristic of neurodegeneration can be detected through retinal imaging and electrodiagnostics. This review is very crucial, because identifying the pathophysiology of diabetic neurodegeneration better, we may be able to provide interventions using the appropriate therapy. We may also be able to utilize these diagnostic tools for early detections of diabetic retinopathy, thus preventing blindness due to diabetes.
THE ROLE OF INTRAOPERATIVE NEUROPHYSIOLOGIC MONITORING TO ENHANCE SUCCESSFUL ORTHOPEDIC SURGERY
Authors: Sananta Panji , Eka Pramana Wijaya Anindita , Anthony Putera Marvin
Published: January 2022

One of the main advance in orthopaedic surgery domain has a goal to investigates the safest and harmless method in surgical procedures. Less complications means a better outcome of surgery. One of the commonest risks at orthopaedic surgery is central and peripheral nerve injury. The modality of Intraoperative Neurophysiologic Monitoring (IONM) which act to limit the risk of nerve injury during operative procedure through the evaluation of nerve integrity and function enable the surgeon to decrease injury to the nerve associated with orthopaedic surgical procedure in the operating room. This article aims to explain and describe the latest modality of IONM, its basic concept and its function at surgery. The last part of the article discussed about orthopaedic surgical techniques which use IONM. The authors hope that this article will enhance the knowledge of all the readers about IONM. This article was written based on literature study searched at Google Scholar, Medline and PubMed. The references were taken from a relatively up to date study ranging from 2013-2018. The article was selected according to the authors inclusion criteria and six articles was chosen as the references for this review. As a conclusion, IONM has an important role to increase successful rate of surgery through minimizing nerve injury risk during surgical procedure.
Tailoring Mobile Data Collection for Intervention Research in a Challenging Context: Development and Implementation in the Malakit Study
Authors: Lambert Yann , Galindo Muriel , Suárez-Mutis Martha , Mutricy Louise , Sanna Alice , Garancher Laure , Cairo Hedley , Hiwat Helene , Bordalo Miller Jane , Gomes José Hermenegildo , Marchesini Paola , Adenis Antoine , Nacher Mathieu , Vreden Stephen , Douine Maylis
Published: January 2022

Background

An interventional study named Malakit was implemented between April 2018 and March 2020 to address malaria in gold mining areas in French Guiana, in collaboration with Suriname and Brazil. This innovative intervention relied on the distribution of kits for self-diagnosis and self-treatment to gold miners after training by health mediators, referred to in the project as facilitators.

Objective

This paper aims to describe the process by which the information system was designed, developed, and implemented to achieve the monitoring and evaluation of the Malakit intervention.

Methods

The intervention was implemented in challenging conditions at five cross-border distribution sites, which imposed strong logistical constraints for the design of the information system: isolation in the Amazon rainforest, tropical climate, and lack of reliable electricity supply and internet connection. Additional constraints originated from the interaction of the multicultural players involved in the study. The Malakit information system was developed as a patchwork of existing open-source software, commercial services, and tools developed in-house. Facilitators collected data from participants using Android tablets with ODK (Open Data Kit) Collect. A custom R package and a dashboard web app were developed to retrieve, decrypt, aggregate, monitor, and clean data according to feedback from facilitators and supervision visits on the field.

Results

Between April 2018 and March 2020, nine facilitators generated a total of 4863 form records, corresponding to an average of 202 records per month. Facilitators’ feedback was essential for adapting and improving mobile data collection and monitoring. Few technical issues were reported. The median duration of data capture was 5 (IQR 3-7) minutes, suggesting that electronic data capture was not taking more time from participants, and it decreased over the course of the study as facilitators become more experienced. The quality of data collected by facilitators was satisfactory, with only 3.03% (147/4849) of form records requiring correction.

Conclusions

The development of the information system for the Malakit project was a source of innovation that mirrored the inventiveness of the intervention itself. Our experience confirms that even in a challenging environment, it is possible to produce good-quality data and evaluate a complex health intervention by carefully adapting tools to field constraints and health mediators’ experience.

Trial Registration

ClinicalTrials.gov NCT03695770; https://clinicaltrials.gov/ct2/show/NCT03695770
Assessing COVID-19 Health Information on Google Using the Quality Evaluation Scoring Tool (QUEST): Cross-sectional and Readability Analysis
Authors: Bachu Vismaya S , Mahjoub Heba , Holler Albert E , Crihalmeanu Tudor , Bachu Dheevena M , Ayyaswami Varun , Parker Pearman D , Prabhu Arpan V
Published: January 2022

Background

The COVID-19 pandemic spurred an increase in online information regarding disease spread and symptomatology.

Objective

Our purpose is to systematically assess the quality and readability of articles resulting from frequently Google-searched COVID-19 terms in the United States.

Methods

We used Google Trends to determine the 25 most commonly searched health-related phrases between February 29 and April 30, 2020. The first 30 search results for each term were collected, and articles were analyzed using the Quality Evaluation Scoring Tool (QUEST). Three raters scored each article in authorship, attribution, conflict of interest, currency, complementarity, and tone. A readability analysis was conducted.

Results

Exactly 709 articles were screened, and 195 fulfilled inclusion criteria. The mean article score was 18.4 (SD 2.6) of 28, with 7% (14/189) scoring in the top quartile. National news outlets published the largest share (70/189, 36%) of articles. Peer-reviewed journals attained the highest average QUEST score compared to national/regional news outlets, national/state government sites, and global health organizations (all P<.05). The average reading level was 11.7 (SD 1.9, range 5.4-16.9). Only 3 (1.6%) articles were written at the recommended sixth grade level.

Conclusions

COVID-19–related articles are vastly varied in their attributes and levels of bias, and would benefit from revisions for increased readability.
Peer Review of “Continuous User Experience Monitoring of a Patient-Completed Preoperative Assessment System in the United Kingdom: Cross-sectional Study” (Preprint)
Authors: Mahnke Andrea N
Published: January 2022

UNSTRUCTURED

This is a peer review report for ms#31679.
HIV Surveillance and Research for Migrant Populations: Protocol Integrating Respondent-Driven Sampling, Case Finding, and Medicolegal Services for Venezuelans Living in Colombia (Preprint)
Authors: Wirtz Andrea L , Page Kathleen R , Stevenson Megan , Guillén José Rafael , Ortíz Jennifer , López Jhon Jairo , Ramírez Jhon Fredy , Quijano Cindy , Vela Alejandra , Moreno Yessenia , Rigual Francisco , Case James , Hakim Avi J , Hladik Wolfgang , Spiegel Paul B
Published: January 2022

BACKGROUND

Epidemiologic research among migrant populations is limited by logistical, methodological, and ethical challenges, but it is necessary for informing public health and humanitarian programming.

OBJECTIVE

We describe a methodology to estimate HIV prevalence among Venezuelan migrants in Colombia.

METHODS

Respondent-driven sampling, a nonprobability sampling method, was selected for attributes of reaching highly networked populations without sampling frames and analytic methods that permit estimation of population parameters. Respondent-driven sampling was modified to permit electronic referral of peers via SMS text messaging and WhatsApp. Participants complete sociobehavioral surveys and rapid HIV and syphilis screening tests with confirmatory testing. HIV treatment is not available for migrants who have entered Colombia through irregular pathways; thus, medicolegal services integrated into posttest counseling provide staff lawyers and legal assistance to participants diagnosed with HIV or syphilis for sustained access to treatment through the national health system. Case finding is integrated into respondent-driven sampling to allow partner referral. This study is implemented by a local community-based organization providing HIV support services and related legal services for Venezuelans in Colombia.

RESULTS

Data collection was launched in 4 cities in July and August 2021. As of November 2021, 3105 of the target 6100 participants were enrolled, with enrollment expected to end by February/March 2022.

CONCLUSIONS

Tailored methods that combine community-led efforts with innovations in sampling and linkage to care can aid in advancing health research for migrant and displaced populations. Worldwide trends in displacement and migration underscore the value of improved methods for translation to humanitarian and public health programming.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/36026
Evaluation of 2 Artificial Intelligence Software for Chest X-Ray Screening and Pulmonary Tuberculosis Diagnosis: Protocol for a Retrospective Case-Control Study (Preprint)
Authors: Mohd Hisham Muhammad Faiz , Lodz Noor Aliza , Muhammad Eida Nurhadzira , Asari Filza Noor , Mahmood Mohd Ihsani , Abu Bakar Zamzurina
Published: January 2022

BACKGROUND

According to the World Bank, Malaysia reported an estimated 97 tuberculosis cases per 100,000 people in 2021. Chest x-ray (CXR) remains the best conventional method for the early detection of pulmonary tuberculosis (PTB) infection. The intervention of artificial intelligence (AI) in PTB diagnosis could efficiently aid human interpreters and reduce health professionals’ work burden. To date, no AI studies have been evaluated in Malaysia.

OBJECTIVE

This study aims to evaluate the performance of Putralytica and Qure.ai software for CXR screening and PTB diagnosis among the Malaysian population.

METHODS

We will conduct a retrospective case-control study at the Respiratory Medicine Institute, National Cancer Institute, and Sungai Buloh Health Clinic. A total of 1500 CXR images of patients who completed treatments or check-ups will be selected and categorized into three groups: (1) abnormal PTB cases, (2) abnormal non-PTB cases, and (3) normal cases. These CXR images, along with their clinical findings, will be the reference standard in this study. All patient data, including sociodemographic characteristics and clinical history, will be collected prior to screening via Putralytica and Qure.ai software and readers’ interpretation, which are the index tests for this study. Interpretation from all 3 index tests will be compared with the reference standard, and significant statistical analysis will be computed.

RESULTS

Data collection is expected to commence in August 2023. It is anticipated that 1 year will be needed to conduct the study.

CONCLUSIONS

This study will measure the accuracy of Putralytica and Qure.ai software and whether their findings will concur with readers’ interpretation and the reference standard, thus providing evidence toward the effectiveness of implementing AI in the medical setting.

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/36121
Measured and Perceived Exercise Intensity During the Performance of Single-Task, Cognitive-Motor Dual-Task, and Exergame Training: Transversal Study (Preprint)
Authors: Gallou-Guyot Matthieu , Perrochon Anaick , Marie Romain , Bourgeois Maxence , Mandigout Stephane
Published: January 2022

BACKGROUND

The physical and cognitive loads borne during exergaming may differ from more conventional cognitive-motor dual-task trainings.

OBJECTIVE

The aim of this pilot transversal study was to compare objectively measured and perceived exercise intensity during exergame, cognitive-motor dual-task, and single-task training sessions.

METHODS

We recruited apparently healthy young adults who carried out one session of each type of training: exergaming, cognitive-motor dual-tasking, and single-tasking. We used a custom-made exergame as support. The sessions lasted 30 minutes, were spaced at least 24 hours apart, and took place in random order for each group of 4 participants. We used heart rates to assess exercise intensity and the modified Borg scale to assess perception of intensity. In all, 16 apparently healthy young participants carried out all sessions.

RESULTS

There was no difference between the different types of training in mean heart rates (P=.27), peak heart rates (P=.50), or Borg scale scores (P=.40). Our custom-made exergame’s objectively measured and perceived physical load did not differ between cognitive-motor dual-task and single-task training.

CONCLUSIONS

As a result, our exergame can be considered to be as challenging as more traditional physical training. Future studies should be conducted in older adults with or without cognitive impairments and incorporate an assessment of cognitive performance.
The Associations of COVID-19 Lockdown Restrictions With Longer-Term Activity Levels of Working Adults With Type 2 Diabetes: Cohort Study (Preprint)
Authors: Brakenridge Christian John , Salim Agus , Healy Genevieve Nissa , Grigg Ruth , Carver Alison , Rickards Kym , Owen Neville , Dunstan David Wayne
Published: January 2022

BACKGROUND

Lockdown restrictions reduce COVID-19 community transmission; however, they may pose challenges for noncommunicable disease management. A 112-day hard lockdown in Victoria, Australia (commencing March 23, 2020) coincided with an intervention trial of reducing and breaking up sitting time in desk workers with type 2 diabetes who were using a provided consumer-grade activity tracker (Fitbit).

OBJECTIVE

This study aims to compare continuously recorded activity levels preceding and during COVID-19 lockdown restrictions among working adults with type 2 diabetes participating in a sitting less and moving more intervention.

METHODS

A total of 11 participants (n=8 male; mean age 52.8, SD 5 years) in Melbourne, Australia had Fitbit activity tracked before (mean 122.7, SD 47.9 days) and during (mean 99.7, SD 62.5 days) citywide COVID-19 lockdown restrictions. Regression models compared device (Fitbit Inspire HR)–derived activity (steps; metabolic equivalent tasks [METs]; mean time in sedentary, lightly, fairly, and very active minutes; and usual bout durations) during restrictions to prerestrictions. Changes in activity were statistically significant when estimates (Δ%) did not intercept zero.

RESULTS

Overall, there was a decrease in mean steps (–1584 steps/day; Δ% –9%, 95% CI –11% to –7%); METs (–83 METs/day; Δ% –5%, 95% CI –6% to –5%); and lightly active (Δ% –4%, 95% CI –8% to –1%), fairly active (Δ% –8%, 95% CI –21% to –15%), and very active (Δ% –8%, 95% CI –11% to –5%) intensity minutes per day, and increases in mean sedentary minutes per day (51 mins/day; Δ% 3%, 95% CI 1%-6%). Only very active (+5.1 mins) and sedentary (+4.3 mins) bout durations changed significantly.

CONCLUSIONS

In a convenience sample of adults with type 2 diabetes, COVID-19 lockdown restrictions were associated with decreases in overall activity levels and increases in very active and sedentary bout durations. A Fitbit monitor provided meaningful continuous long-term data in this context.

CLINICALTRIAL

Australian New Zealand Clinical Trials Registry ACTRN12618001159246; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12618001159246
The Roles of Pentraxin-3 to Predict In-Hospital and Three Months Major Adverse Cardiac Event in Acute Myocardial Infarction
Authors: Bestara Adi , Wasyanto Trisulo , Purwaningtyas Niniek
Published: January 2022

Background: Pentraxin-3 (PTX3) was a useful marker for localized vascular inflammation and damage in the cardiovascular system. Recent studies have shown that plasma PTX3 is elevated in patients with myocardial infarction; however, its prognostic value still remains unclear.

Aims: This study aimed to investigate the relationship between PTX3 and in-hospital and three months of a major adverse cardiac event (MACE) in acute ST-elevation and non-ST-elevation myocardial infarction patients.

Methods: This cohort study conducted from September 1st, 2018 to October 31st, 2019 in Dr. Moewardi Hospital. A 144 patient were observed during hospitalization and 130 survived patient were follow up for three months. The admission PTX3 was compared between the patient with and without MACE. Higher levels of PTX3 were defined as concentrations greater than the optimal cut-off value derived from the Receiver Operating Characteristic (ROC) curve.

Results: Among patients, 43.75% was anterior STEMI, 35.42% was inferior STEMI, and 20.38% was NSTEMI with median PTX3 level was 8.16 (0.21-69.35) ng/mL. The in-hospital MACE occurred in 52% of patients, while three months of MACE occurred in 17% patient. Patients with MACE had a higher level of PTX3 compared without MACE (p<0.001) during hospitalization, but not in three months follow up (p=0.408). Multivariate analysis also shown PTX3 was as a predictor of in-hospital MACE (OR 1.127; p=0.001), along with heart rate (OR 1.025; p=0.015). There are different of in-hospital MACE between the patient with high (≥8.247 ng/mL) and low (<8.225 ng/mL) PTX3 level with a hazard ratio (HR) 2.142 (95%CI 1.315-3.487; p=0.002), but the result did not similar after three months follow up (p=0.373).

Conclusion: The PTX3 can be used as a predictor of in-hospital MACE but not for three months follow up.
Revascularization of Acute Limb Ischemia
Authors: Setianto Budi Yuli , Faisal Ahmad
Published: January 2022

Acute limb ischemia (ALI) is a medical emergency which can lead to loss of limb and even death. The outcomes are depending on the immediacy and completeness of revascularization or reperfusion. Generally, the considered a golden period in the management ALI is 6 hours. Unfortunately, the handling of patients with ALI is often too late. Currently there are several methods of revascularization such as thrombolysis (catheter directed thrombolysis), percutaneous and open surgical mechanical thrombectomy. The selection method where is the best revascularization remains controversial. Some research suggest that outcomes did not differ between thrombolysis and surgical therapy.
The use of Tisdale risk score during hydroxychloroquine/chloroquine treatments on COVID-19 patients
Authors: Hartopo Anggoro Budi , Trisnawati Ika , Budiono Eko , Jhundy Brilliant Winona , Anggraeni Vita Yanti
Published: January 2022

Background: The SARS-CoV-2 infection or COVID-19 disease caused significant morbidity and mortality. Early reports showed clinical improvement with hydroxychloroquine (HCQ) and chloroquine (CQ). However, due to the concern of QTc interval prolongation, the strict electrocardiogram monitoring was needed. The use of risk stratification score may help the decision of this monitoring.

Aims: The study purpose is to describe the use of Tisdale risk score in patients with COVID-19 who received HCQ/CQ treatment.

Methods: This was a prospective observational study. Subjects were patients with the diagnosis of high-probability-COVID-19 and confirmed-COVID-19 receiving HCQ/CQ as one of the treatments. The demographic, medical history and laboratory data were recorded. The Tisdale score was calculated based on baseline parameters and the risk categories were divided into three categories: low risk (score <7), moderate risk (score 7-10) and high risk (score ≥11). The HCQ/CQ daily dose, cumulative dose, time of administration, and duration were recorded.

Result: Forty-five subjects were analysed. Most subjects were males (66.7%) at mean age 50.9 years. Most subjects were hospitalized due to severe illness (44.4%). Medical comorbidity was mostly hypertension (31.1%). Most subjects had HCQ treatment (95.6%). Electrocardiogram showed mostly sinus rhythm (97.8%). Mean QTc interval based Bazett formula was 413.1 ms. Tisdale risk categories were low risk (57.8%), moderate risk (31.1%) and high risk (11.1%). Tisdale high risk had significantly lower cumulative dose of HCQ/CQ and shorter duration of HCQ/CQ treatment as compared to Tisdale moderate and low risks counterparts. The premature HCQ/CQ stop occurred in 1 subject (6.7%) with Tisdale moderate risk and 1 subject (6.7%) with Tisdale high risk. 

Conclusion: The Tisdale risk score stratification was easily implemented in hospital as a tool to guide in treatment decision and monitoring while dealing with drugs potentially cause QTc prolongation, such as HCQ/CQ, in COVID-19 patients.
Deterioration of heart rhythm during short-term hydroxychloroquine therapy for COVID-19: report of two cases
Authors: Hartopo Anggoro Budi , Jhundy Brilliant Winona , Rachman Afik Maulana , Anggraeni Vita Yanti , Maharani Erika , Trisnawati Ika , Budiono Eko , Pratama Billy Aditya
Published: January 2022

The rapid spread of the coronavirus disease 2019 (COVID-19) has resulted in significant morbidity and mortality globally. Hydroxychloroquine is one of the medications for eradicating COVID-19. Despite concerns due to its potential cardiac toxicity, hydroxychloroquine is widely used in treating mild and moderate COVID-19 pneumonia. In this case report, we report two cases of Indonesian adult patients with suspected COVID-19 pneumonia who received hydroxychloroquine as part of the medications and experienced deterioration of cardiac conduction which required stopping the drug prematurely. This case report highlights the need for risk stratification, electrocardiogram monitor and QTc evaluation before and during hydroxychloroquine therapy.
Prevalence and Risk Factors of Arterio-Venous Fistula Obstruction on Patient with Chronic Kidney Disease
Authors: Ismail Muhamad Taufik , Hariawan Hariadi , Wardhani Yulia , Puspitasari Metalia , Artayasa I Putu Aditio , Ramadhan Galih , Tarigan Tinanda , Triatmaja Rizkan
Published: January 2022

Prevalence and Risk Factors of Arterio-Venous Fistula Obstruction on Patient with Chronic Kidney Disease

Ismail MT1, Hariawan H1, Wardhani Y2, Puspitasari M2, Artayasa IPA1, Ramadhan G1, Tarigan T1, Triatmaja R1

 

1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, 55284, Indonesia

2Department of Internal Medicine Faculty of Medicine Universitas Gadjah Mada-RSUP Dr. Sardjito Yogyakarta Indonesia

 

ABSTRACT

Aim:

AV fistula obstruction has become one of the main vascular access complications in patients undergoing haemodialysis. This complications have significant impacts on the morbidity and mortality of dialysis patients while also leading to higher medical costs. Clinical monitoring has been routinely used for early detection of AV fistula stenosis and obstruction, however screening with Doppler ultrasound is still not a routine recommendation. This study aims to know prevalence and risk factors of AV Fistula obstruction detected by Duplex ultrasound examination.

 

Methods:

This study was a hospital-based descriptive analytic study with cross sectional design conducted at the haemodialysis center of National General Hospital Dr. Sardjito, Yogyakarta, Indonesia. Patient demographic and clinical risk factor were recorded using direct interview. AV fistula obstruction were assessed using Duplex ultrasound by professional sonographer.

 

Results:

Seventy four (74) patients are using AV fistula as entry access for hemodialysis in RSUP dr. Sardjito. It is consist of 39 male (53%) and 35 Female (47%). The mean age of patients is 50 years old. Surveillance using Doppler ultrasound found 20 patients (27%) have stenotic AV Fistula. Smoking habits (OR 5.37, 95% CI, 1.760 - 16.431, p=0.002) and diabetes mellitus (OR 5.00, 95% CI, 1.631 – 15.503, p=0.004) increase risk for having stenotic AV fistula. Only 4 patient (20 %) of all 20 patient with stenotic AV fistula were symptomatic, and needed for further vascular intervention

 

Conclusion:

Prevalence of AV fistula obstruction detected by Doppler ultrasound was 27% of all AV fistula patient with only 5% had symptomatic AV fistula failure. Smoking habits and diabetes mellitus are important risk factor for AV fistula obstruction. Asymptomatic AV fistula obstruction often goes undetected by clinical monitoring that can increase of risk of symptomatic AV fistula obstruction in the future. The further study is needed to determine level recommendation of routine AV fistula surveillance with Doppler Ultrasound.

 

Key words: AV Fistula obstruction, CKD, Doppler ultrasound surveillance, Risk factors, Prevalence
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