bluuebunny/crossref_metadata_2025_split huggingface dataset:
Routine minimalist transcatheter aortic valve implantation with local anesthesia only
Authors: Saia Francesco , Palmerini Tullio , Marcelli Chiara , Chiarabelli Matteo , Taglieri Nevio , Ghetti Gabriele , Negrello Fabio , Moretti Carolina , Bruno Antonio Giulio , Compagnone Miriam , Corsini Anna , Castelli Andrea , Marrozzini Cinzia , Galiè Nazzareno 
Published: August 2020

Aims
Conscious sedation instead of general anesthesia has been increasingly adopted in many centers for transfemoral transcatheter aortic valve replacement (TAVR). Improvement of materials and operators’ experience and reduction of periprocedural complications allowed procedural simplification and adoption of a minimalist approach. With this study, we sought to assess the feasibility and safety of transfemoral TAVR routinely performed under local anesthesia without on-site anesthesiology support.

Methods
The routine transfemoral TAVR protocol adopted at our center includes a minimalist approach, local anesthesia alone with fully awake patient, anesthesiologist available on call but not in the room, and direct transfer to the cardiology ward after the procedure. All consecutive patients undergoing transfemoral TAVR between January 2015 and July 2018 were included. We assessed the rates of actual local anesthesia-only procedures, conversion to conscious sedation or general anesthesia and 30-day clinical outcomes.

Results
Among 321 patients, 6 received general anesthesia upfront and 315 (98.1%) local anesthesia only. Mean age of the local anesthesia group was 83.2 ± 6.9 years, Society of Thoracic Surgery score 5.8 ± 4.8%. A balloon-expandable valve was used in 65.7%. Four patients (1.3%) shifted to conscious sedation because of pain or anxiety; 6 patients (1.9%) shifted to general anesthesia because of procedural complications. Hence, local anesthesia alone was possible in 305 patients (96.8% of the intended cohort, 95% of all transfemoral procedures). At 30 days, in the intended local anesthesia group, mortality was 1.6%, stroke 0.6%, major vascular complications 2.6%. Median hospital stay was 4 days (IQR 3–7).

Conclusion
Transfemoral TAVR can be safely performed with local anesthesia alone and without an on-site anesthesiologist in the vast majority of patients.
Impact of stent thickness on clinical outcomes in small vessel and bifurcation lesions: a RAIN-CARDIOGROUP VII sub-study
Authors: Franchin Luca , Piroli Francesco , D’Ascenzo Fabrizio , Nuñez-Gil Ivan , Wojakowski Wojciech , Imori Yoichi , Trabattoni Daniela , Huczek Zenon , Venuti Giuseppe , Muscoli Saverio , Montabone Andrea , Rognoni Andrea , Parma Radoslaw , Figini Filippo , Mitomo Satoru , Quadri Giorgio , Wańha Wojciech , Cortese Bernardo , De Filippo Ovidio , Ryan Nicola , Varbella Ferdinando , Sheiban Imad , Helft Gerard , De Ferrari Gaetano M. 
Published: August 2020

Background
The clinical impact of stent strut thickness in coronary bifurcation lesions in small vessels has not been assessed in a real-world population.

Methods
All 506 patients enrolled in the RAIN study, undergoing PCI in a vessel with a diameter 2.5 mm or less were retrospectively evaluated and divided into two groups according to stent strut thickness: 74 μm (n = 206) versus 81 μm (n = 300); 87.1% of the lesions involved bifurcations. TLF [defined as a composite of myocardial infarction (MI) and target lesion revascularization (TLR)] was the primary endpoint, with MACE (a composite of death, MI and TLR), its components and stent thrombosis the secondary endpoint.

Results
After 16 (14–18) months, a lower incidence of TLF (4.3 vs. 9.8%, P = 0.026) and ST (1.0 vs. 3.0%, P = 0.042) was seen in the 74 μm group, whereas MACE occurred in 60 of 506 patients, with no statistical difference between the two groups (9.7 vs. 13.3%, P = 0.070). At multivariate analysis, chronic renal failure increased the risk of TLF while thinner strut was an independent protective factor (hazard ratio 0.51, CI 0.17–0.85, P = 0.005).

Conclusion
In this real-world population, patients being treated for small vessels lesions with thinner strut stents had lower rates of TLF, MI and ST.
Inappropriate dose of nonvitamin-K antagonist oral anticoagulants: prevalence and impact on clinical outcome in patients with nonvalvular atrial fibrillation
Authors: Godino Cosmo , Bodega Francesca , Melillo Francesco , Rubino Francesca , Parlati Antonio L.M. , Cappelletti Alberto , Mazzone Patrizio , Mattiello Paolo , Della Bella Paolo , Castiglioni Alessandro , Alfieri Ottavio , De Bonis Michele , Montorfano Matteo , Tresoldi Moreno , Filippi Massimo , Zangrillo Alberto , Salerno Anna , Cera Michela , Margonato Alberto 
Published: August 2020

Background
Limited real-world data are available regarding the outcome of patients treated with inappropriate dose of nonvitamin-K antagonist oral anticoagulants (NOACs).

Objective
To assess the prevalence and factors associated with inappropriate dose prescription of NOACs and to evaluate adverse events that come from this inappropriate prescription.

Methods
Single-center multidisciplinary registry including nonvalvular atrial fibrillation patients treated with NOACs. Based on guidelines criteria for dose reduction, two subcohorts were defined as treated with appropriate or inappropriate NOACs dose. Primary efficacy endpoint was 2-year rate of thromboembolic events. Primary safety endpoint was 2-year rate of major bleeding. Event-free survival curves among groups were compared using Cox–Mantel test.

Results
A total of 760 nonvalvular atrial fibrillation patients were included; 32% patients were treated with dabigatran, 34% with apixaban, 24% with rivaroxaban and 10% with edoxaban. An inappropriate dose was prescribed in 96 patients (12.6%), and in most cases (68%) it was too low. Rivaroxaban (15%) and apixaban (18.5%) were the most frequently prescribed with an inappropriate dose. Patients treated with an inappropriate dose were elderly people, with low-creatinine clearance value, who had experienced previous bleeding and with a high CHADS2 VASc score. In 2 years, a trend for higher numbers of thromboembolic events (5.2 vs. 3.3%, P = 0.348) and less major bleeding (2.1 vs. 4.2%, P = 0.316) has been observed in patients with inappropriate NOACs prescriptions.

Conclusion
Nearly 13% of patients were treated with an inappropriate dose of NOACs, in this single-center study. A trend for higher numbers of thromboembolic events was observed in these patients. The results should be considered as hypothesis generating.
Paradoxical effect of fat diet in matrix metalloproteinases induced mitochondrial dysfunction in diabetic cardiomyopathy
Authors: Gliozzi Micaela , Scarano Federica , Musolino Vincenzo , Carresi Cristina , Scarcella Antonino , Nucera Saverio , Scicchitano Miriam , Ruga Stefano , Bosco Francesca , Maiuolo Jessica , Macrì Roberta , Zito Maria Caterina , Oppedisano Francesca , Guarnieri Lorenza , Mollace Rocco , Palma Ernesto , Muscoli Carolina , Mollace Vincenzo 
Published: August 2020

Aims
Diabetic cardiomyopathy represents the main cause of death among diabetic people. Despite this evidence, the molecular mechanisms triggered by impaired glucose and lipid metabolism inducing heart damage remain unclear. The aim of our study was to investigate the effect of altered metabolism on the early stages of cardiac injury in experimental diabetes.

Methods
For this purpose, rats were fed a normocaloric diet (NPD) or a high fat diet (HFD) for up to 12 weeks. After the fourth week, streptozocin (35 mg/kg) was administered in a subgroup of both NPD and HFD rats to induce diabetes. Cardiac function was analysed by echocardiography. Matrix metalloproteinases (MMPs) activity and intracellular localization were assessed through zymography and immunofluorescence, whereas apoptotic and oxidative markers by immunohistochemistry and western blot.

Results
Hyperglycaemia or hyperlipidaemia reduced ejection fraction and fractional shortening as compared with control. Unexpectedly, cardiac dysfunction was less marked in diabetic rats fed a hyperlipidaemic diet, suggesting an adaptive response of the myocardium to hyperglycaemia-induced injury. This response was characterized by the inhibition of N-terminal truncated-MMP-2 translocation from endoplasmic reticulum into mitochondria and by superoxide anion overproduction observed in cardiomyocytes under hyperglycaemia.

Conclusion
Overall, these findings suggest novel therapeutic targets aimed to counteract mitochondrial dysfunction in the onset of diabetic cardiomyopathy.
Rationale and design of the EPLURIBUS Study (Evidence for a comPrehensive evaLUation of left ventRicle dysfnctIon By a whole-heart coverage cardiac compUted tomography Scanner)
Authors: Andreini Daniele , Conte Edoardo , Mushtaq Saima , Pontone Gianluca , Guglielmo Marco , Baggiano Andrea , Annoni Andrea , Mancini Maria E. , Formenti Alberto , Nicoli Flavia , Tanzilli Alessandra , Muscogiuri Giuseppe , Magini Alessandra , Agostoni Piergiuseppe , Bartorelli Antonio L. , Fiorentini Cesare , Pepi Mauro 
Published: August 2020

Background
Cardiac magnetic resonance (CMR) is the standard of reference for myocardial fibrosis detection by late gadolinium enhancement. Cardiac computed tomography (CCT) is emerging as a promising alternative. The Evidence for a comPrehensive evaLUation of left ventRicle dysfnctIon By a whole-heart coverage cardiac compUted tomography Scanner study will assess the feasibility and diagnostic accuracy of a comprehensive functional and anatomical cardiac evaluation with CCT as compared with CMR and invasive coronary angiography as standard of reference.

Methods
Consecutive patients with a newly diagnosed left ventricle (LV) dysfunction (left ventricular ejection fraction <50%) and a clinical indication to CMR will be screened. Exclusion criteria will be contraindications to contrast agents and impaired renal function. CCT will be performed per protocol within 10 days from CMR. A total of 100 patients will be enrolled within 24 months. We will evaluate with CCT volume and ejection fraction of the LV and right ventricle, presence, extent and pattern of delayed enhancement and cardiac venous system. Moreover, presence and degree of coronary stenoses will be evaluated among patients undergoing invasive coronary angiography in the 6 months following CCT.

Results
The primary study endpoints will be: first, to assess the diagnostic performance of CCT vs. CMR to detect the delayed enhancement in a territory-based and patient-based analysis; second, to assess the agreement between CCT and CMR in the discrimination between ischemic vs. nonischemic delayed enhancement patters in a territory-based analysis; third, to assess the correlation between CCT and CMR for LV and right ventricle end-diastolic and end-systolic volumes and ejection fraction measurements.

Conclusion
The Evidence for a comPrehensive evaLUation of left ventRicle dysfnctIon By a whole-heart coverage cardiac compUted tomography Scanner study will assess the diagnostic performance of CCT using the latest scanner generation for a comprehensive evaluation of patients with new-onset LV dysfunction.
A very long-term observation of a family with dilated cardiomyopathy and overlapping phenotype from lamin A/C mutation
Authors: Porcu Maurizio , Corda Marco , Pasqualucci Daniele , Binaghi Giulio , Sanna Nadia , Matta Gildo , Cossa Stefano , Scalone Antonio , Tola Gianfranco 
Published: August 2020

Aims
We aim to describe one of the longest longitudinal follow-ups reported so far (>22 years), concerning a whole family affected by a missense lamin A/C mutation (Arg60Gly), which manifested as an overlapping phenotype with cardiac and extracardiac involvement over time.

Methods
Starting from the family history, two generations of that family were prospectively observed, from 1997 until 2020. At baseline, four individuals with dilated cardiomyopathy and cardiac conduction defects showed the same mutation. This was also found in three young individuals, phenotypically unaffected at baseline assessment.

Results
The prolonged clinical and laboratory evaluation has shown the evolution of an overlapping phenotype in which cardiac alterations have been associated with lipodystrophy and neurological manifestations. In the first observed generation, the prognosis was negatively affected by the progression of heart failure and lipodystrophy, whereas in the second generation the first phenotypic manifestations became evident after the 2nd decade. Cardiac magnetic resonance played a relevant role in the early detection of cardiac alteration. Right bundle branch block was another sign of initial phenotypical expression.

Conclusion
In lamin A/C gene mutation carriers, a strict, multidisciplinary follow-up allows the opportunity to monitor the progress of the disease and to intervene precociously with the best available treatments.
Incidence and mortality risk in coronavirus disease 2019 patients complicated by acute cardiac injury: systematic review and meta-analysis
Authors: Zuin Marco , Rigatelli Gianluca , Zuliani Giovanni , Bilato Claudio , Zonzin Pietro , Roncon Loris 
Published: August 2020

Background
The prevalence and prognostic implications of acute cardiac injury (ACI), as a complication of coronavirus disease 2019 (COVID-19), remain unclear.

Objectives
We conducted a systematic review and meta-analysis to investigate the relationship between ACI and mortality risk in COVID-19 patients.

Methods
Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed in abstracting data and assessing validity. We searched MEDLINE, Scopus and Web of Science to locate all articles published up to 10 April 2020 reporting data of COVID-19 survivors and nonsurvivors developing ACI as a complication of the infection. Quality assessment was performed using the Newcastle–Ottawa quality assessment scale. Data were pooled using the Mantel–Haenszel random effects models with odds ratio as the effect measure with the related 95% confidence interval. Statistical heterogeneity between groups was measured using the Higgins I
2 statistic.

Results
Eight studies, enrolling 1686 patients (mean age 59.5 years), met the inclusion criteria and were included in the final analysis. Data regarding the outcome of patients complicated with ACI were available for 1615 patients. Of these, 387 (23.9%) experienced ACIs as COVID-19 complications during the hospitalization. The incidence of ACI was significantly higher among non survivors when compared with survivors (61.6 vs. 6.7%, P < 0.0001). The pooled analysis confirmed a significantly increased risk of death in COVID-19 patients complicated with ACI during the disease (odds ratio: 21.6, 95% confidence interval: 8.6–54.4, P < 0.0001, I
2 = 82%).

Conclusion
Development of ACI during COVID-19 significantly increases the risk of death during the infection.
Clinical characteristics and treatment of Spontaneous Coronary Artery Dissection in Young Women Undergoing Percutaneous Coronary Intervention
Authors: Inoue Yosuke , Tanaka Akihito , Asano Hiroshi , Uemura Yusuke , Takagi Kensuke , Ohashi Taiki , Tanaka Miho , Umemoto Norio , Ajioka Masayoshi , Tashiro Hiroshi , Watarai Masato , Morishima Itsuro , Tatami Yosuke , Takada Yasunobu , Shimizu Kiyokazu , Ishii Hideki , Murohara Toyoaki 
Published: August 2020

Background
Spontaneous coronary artery dissection (SCAD) has recently been recognized as a cause of acute coronary syndrome (ACS), especially in young women. However, the characteristics, optimal treatment, and prognosis of patients who experience SCAD have not been fully described.

Methods
Data were retrospectively collected from a multicenter registry. Among 187 young women less than 60 years of age who underwent percutaneous coronary intervention, 19 (10.2%) with SCAD were identified through coronary angiography. Clinical characteristics and outcomes were investigated.

Results
Those with SCAD less frequently exhibited coronary risk factors, such as diabetes, dyslipidemia, and smoking, than those without SCAD. Intense emotional and/or physical stress was more frequently observed as a prominent precipitating factor in cases of SCAD. All 19 SCAD patients presented with ACS, 7 of whom were treated using stents, and the other 12 treated without stents. During a median follow-up of 960 days (interquartile range, 686–1504 days), two recurrent coronary artery dissections occurred within 7 days, both of which occurred in a vessel other than that in which primary dissection occurred. There were no deaths or recurrent dissection after 1 week.

Conclusion
SCAD was not uncommon among young Japanese women requiring percutaneous coronary intervention. Patients with SCAD exhibited fewer coronary risk factors and more precipitating factors than those without SCAD, and long-term clinical outcomes after an early period appeared to be favorable.
Clinical performance of a novel sirolimus-coated balloon in coronary artery disease: EASTBOURNE registry
Authors: Cortese Bernardo , Testa Luca , Di Palma Gaetano , Heang Tay M. , Bossi Irene , Nuruddin Amin A. , Ielasi Alfonso , Tespili Maurizio , Perez Ignacio S. , Milazzo Diego , Benincasa Susanna , Latib Azeem , Cacucci Michele , Caiazzo Gianluca , Seresini Giuseppe , Tomai Fabrizio , Ocaranza Raymundo , Torres Alfonso , Perotto Anna , Bedogni Francesco , Colombo Antonio 
Published: August 2020

Aims
The purpose of the EASTBOURNE registry is to evaluate the immediate and long-term clinical performance of a novel sirolimus-coated balloon (SCB) in a real-world population of patients with coronary artery disease. We here present the prespecified interim analysis after the enrollment of the first 642 patients who obtained 1-year clinical follow-up.

Methods
EASTBOURNE is a prospective, international, multicenter, all-comer investigator-driven clinical registry, which is enrolling consecutive patients treated with SCB at 42 European and Asiatic centers. Primary study endpoint is target-lesion revascularization (TLR) at 12 months. Secondary endpoints are procedural success and major adverse cardiac events through 36 months.

Results
Diabetes mellitus was present in 41% of patients. Acute coronary syndrome was present in 45% of patients and de novo lesions were 55%; 83% of the in-stent restenosis (ISR) patients had drug-eluting stents restenosis. Lesion predilatation was performed in 95% of the cases and bailout stenting occurred in 7.5%. So far, 642 patients have a complete 12-month follow-up. TLR occurred in 2.5%, myocardial infarction in 2.3%, total death in 1% and major adverse cardiac events in 5.8% of patients. A prespecified analysis of comparison between ISR and de-novo lesions showed a significantly higher occurrence of TLR in the ISR population (5.4 vs. 0.2%, P = 0.0008).

Conclusion
The current interim analysis of 12-month follow-up of the EASTBOURNE registry shows good immediate performance and an adequate and encouraging safety profile through 12 months for this novel SCB.
Good Literacy to Enhance Response in Diabetes Mellitus (GLITTER-DM)
Authors: Dang Yen , Patel-Shori Nima , Barros Michael , Yu Daohai 
Published: August 2020

Objective: The purpose of this study is to determine the effectiveness of individualized communication strategies and self-management action plans to improve A1c control at 3 months in patients with low health literacy.
Methods: A prospective, open-labeled, pilot study was conducted on 23 patients with diabetes mellitus in a pharmacist-led ambulatory care clinic. Patients who had a Rapid Estimate of Adult Literacy in Medicine- Revised (REALM-R) score of 6 or less and an A1c greater than 7% upon study entry were included. The first group received the teach-back method, personalized actions, and follow-up phone calls to assess comprehension (N = 12). The second group was assigned to usual care (N = 11).
Results: Patients receiving literacy-appropriate interventions had greater A1c percent reduction (A1c difference of -2.0 ± 1.3 vs -1.0 ± 2.2; P = 0.02) and less hyperglycemic events per week (0.1 vs. 2.1; P = 0.04). There were no differences in the number of hypoglycemic events, testing frequency, medication-adherence rates, or hospitalizations and emergency room visits related to diabetes.
Conclusion: Literacy-appropriate methods such as the teach-back method, personalized action plans, and telephone follow-ups may improve glycemic control in low health literate patients with diabetes.
Practice Implications and Innovations: The findings from this study suggest that pharmacists may improve diabetes outcomes when managing patients who possess low health literacy using simplified teaching methods.

Original Research
Evaluation of Oxidative Stress and LeptinLevel in Samples of Iraqi Obese Women
Authors: Ali Israa M. Mubarak , Yenzeel Jabbar H. , Al-ansari Hani M. Saleh 
Published: August 2020

The aim of this study is to investigate oxidative stress and leptinlevel in obese women. Fifty obese women with BMI value of â‰¥ 30.0 kg/m2 and thirty healthy women with BMI<24.9 kg/m2 were involved in the study during their attendance at Gastroenterology and Liver Hospital/ Medical city in Baghdad province from October 2018 to February 2019. The age range for all women was 30-50 years. Blood samples were collected from each participant for the evaluation of the levels of leptin hormone, Super Oxide Dismutase (SOD), and Malondialdehyde (MDA). The results of BMI, leptin hormone, MDA and SOD showed highly significant increase (P<0.01) in obese women in comparison with the control group.
Results: The results show that BMI value were significantly higher (P<0.01) in obese women (41.90 Â± 0.87kg/m2) in comparison with the control (23.58 Â± 0.28kg/m2). The level of leptin hormone was significantly higher(P<0.01) in obese women (1444.00 Â± 10.67pg/ml) in comparison with the control (932.26 Â± 25.92pg/ml). Also, MDA level was significantly higher(P<0.01) in obese women (6.81 Â± 0.29mg/dl) in comparison with the control (4.53 Â± 0.44) mg/dl. The level of SOD was significantly higher(P<0.01) in obese women (15.67 Â± 1.42mg/dl) in comparison with the control group (3.75 Â± 0.60mg/dl).
Conclusions: Obesity is detected by the level of leptin Hormone; leptin is regarded as a good parameter for monitoring obesity,showing a high increasewith increasing BMI.Theincrease in obesity causes oxidant stress and formation of MDA that is considered as a major risk factor in obesity,where adecrease in antioxidants was also recorded.
Bacteremia Associated with Pressure Ulcers at Alyarmuk Teaching Hospital in Baghdad
Authors: Jassim Nuha S. , Alash Sameer Abdul ameer 
Published: August 2020

Fifty patients(24 female and 26 male)with pressure ulcersassociated with different diseasesand attending AL-yarmouk Teaching Hospital in Baghdad were selected in this study. The duration of sample collection was from March to December 2018. All blood samples collected from patients were submitted to a blood culturing technique to examine bacteremia. The results showed that12 blood bacterial isolates were obtained. The isolated bacteria were subjected to Vitek-2, which is an accurate identification technique. The results of the blood culturing technique revealed that 33.3% were Gram negative bacteria, while 66.6% were Gram positive. Diagnosis by Vitek-2 showed that 33.3% wereStaphylococcus spp. , 33.3% were Enterococcus spp. , 25.1% wereSerratiamarcescens and 8.3% comprised Acinetobacterbaumannii. The results of minimum inhibitory concentration (MIC)by Vitek-2showed that Trimethoprime â€“Sulfamethazole concentration at 320 Âµg\ml was the MIC for Acinetobacterbaumanni, while piperacilin, Ticarcillin, and Ticarcillin-Clavulanic acidat 128 Âµg\ml were the MIC for Serratia marcescens . Acinetobacterbaumanniishowed 100% resistance to all antimicrobial agents, while for the Serratiamarescenceresistancevalues were 54.55%, 54.55%, and 45.45% for isolate numbers 1, 2, and 3, respectively. Gram positive bacteria recorded NitrofurantionMIC of 256 Âµg\ml against Staphylococcus epidermidisand Enterococcus spp., withboth species showinghigh resistance compared with the others which had a value of87.50%.