bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of kids save lives program on Knowledge, skills and attitude of Greek students. Final results from 2 years of implementation
Authors: Parisis C , Bouletis A , Chatzidimitriou K , Palla DD , Makri P , Ntaliani M , Economou K , Aggelosopoulou M , Papa E , Triantafyllou TH 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Sudden cardiac death is one of the main issues worldwide, with more than 700.000 deaths annually. It is strongly believed that the implementation of "Kids Save Lives" project in schools can change this situation. The Kids Save Lives initiative, endorsed by the World Health Organization in 2015, is teaching school children worldwide about the importance of CPR and how to perform it. In Greece this project is a suggestion of Ministry of Education to schools.

Purpose
Τo evaluate the level of theoretical knowledge, willingness to perform Cardiopulmonary resuscitation (CPR) and active skills of Greek secondary school students on the subject of Basic life Support before and after a "Kids Save Lives" program.
Material – Method: Data collection took place on the academic periods of 2017-2018 and 2018-2019 and was performed in secondary schools of Thessaly’s region. A total of 5092 students (51,9% female, mean age 14.2 years) participated on the "Kids save Lives" program according to the European Resuscitation Council (ERC) and World Health Organization (WHO) statement. A 12 point questionnaire was answered by the students before and after completing the "kid saves lives" program, while practical skills were evaluated on manikins by experienced ERC Basic Life Support (BLS) Instructors.

Results
The training improves significantly the theoretical knowledge regarding Cardiopulmonary resuscitation (CPR), with the percentage of correct answers being 48,4% and 82,8%,before and after the course respectively (p &lt; 0.001). The participants willingness to perform bystander CPR significantly increased after the completion of the course (93,7% before to 97,4% after, p &lt; 0.001). Almost all of the participants (98.9%) could recognize the correct position near the victim and 91% performed chin lift maneuver and recognized cardiac arrest. More than 90% of the students performed chest compressions with the correct rate and placing their hands on the center of the chest (90,1% and 93.4%, respectively), whereas only 76.1% of the participants achieved the desired compression depth of 5 to 6 cm.

Conclusions
The overall results strongly recommend that the "Kids Save Lives" program can boost prospects for bystander CPR and indicate the necessity of implementation in a greater scale nationwide.
The impact of kids save lives program on knowledge of students after the first and second year of implementation in Thessaly region of greece
Authors: Parisis C , Bouletis A , Chatzidimitriou K , Palla D-D , Papa E , Makri P , Aggelosopoulou M , Economou K , Ntaliani M , Triantafyllou TH 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Sudden cardiac death is one of the main issues worldwide, with more than 700.000 deaths annually. It is strongly believed that the implementation of "Kids Save Lives" project in schools can change this situation. The World Health Organization endorsed the ‘Kids Save Lives’ project in 2015 in order to reduce mortality, while in countries, where children were taught cardiopulmonary resuscitation (CPR) in schools, have higher rates of bystander CPR and higher survival rates. In Greece, this project is a suggestion from Ministry of Education to schools.

Purpose
Τo evaluate the level of theoretical knowledge of secondary school students on the subject of Basic life Support before and after a "Kids Save Lives" program and to compare the results after the first and second year of implementation.
Material – Method: Data collection took place on the academic periods of 2017-2018 and 2018-2019 and was performed in secondary schools. A total of 691 students participated on the "Kids save Lives" program in both academic periods according to the European Resuscitation Council (ERC) and World Health Organization (WHO) statement. A 12-point questionnaire was answered by the students before and after the "kids saves lives" program. The same program was performed one year later and the same questionnaire was given to students in order to fill it again before and just after the course

Results
The training improves significantly the theoretical knowledge regarding Cardiopulmonary resuscitation (CPR), with the percentage of correct answers being 48,4% and 82,8%,before and after the first year course respectively (p &lt; 0.001). One year later, students retain a big part of their knowledge before the course (64,1% correct answers), and also improve their performance (87,5% correct answers, p &lt; 0,001) after the course.

Conclusions
The overall results strongly depict the benefits of "Kids Save Lives" program by improving the theoretical knowledge. The course should performed for at least 2 years in order to attain optimal results of theoretical knowledge. Further research is needed to identify the times a student must follow the program to maximize its effectiveness
Tocilizumab reduces cardiac injury after out-of-hospital cardiac arrest primarily in patients without acute revascularization - Results from a randomized trial, The IMICA trial
Authors: Meyer M , Wiberg S , Grand J , Meyer ASP , Obling L , Kjaergaard J , Hassager C 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): The Danish Heart Foundation (Reference no. 19-R135-A9302-22125) Lundbeck Foundation (Reference no. R186-2015-2132)

BACKGROUND
Patients remaining comatose after the initial resuscitation from out-of-hospital cardiac arrest (OHCA) have a high risk of morbidity and mortality as part of the ensuing post cardiac arrest syndrome (PCAS). Systemic inflammation and myocardial dysfunction are constituents of PCAS. The cytokine Interleukin-6 (IL-6) is associated with PCAS severity and poor outcome. Also, the extend of cardiac injury is a prognostic marker. We have recently shown that the IL-6 receptor antagonist tocilizumab dampens systemic inflammation and cardiac injury after cardiac arrest.

PURPOSE
To investigate if the reduction in cardiac injury by tocilizumab is differentiated in patients undergoing acute coronary revascularization compared to those who do not.

METHODS
Eighty comatose OHCA patients were randomized 1:1 in a double-blinded placebo-controlled trial to a single infusion of tocilizumab or placebo in addition to standard of care including targeted temperature management. Trial registration: Clinicaltrials.gov NCT03863015. Blood samples were sequentially drawn for biomarker analysis. Endpoints were markers of cardiac injury and inflammation: Troponin T (TnT), N-terminal pro B-type natriuretic peptide (NT-proBNP), and C-reactive protein (CRP). Continuous variables were log2 transformed and analyzed using mixed models; values shown as geometric mean with 95%-confidence limits [95%CL] after back-transformation.

RESULTS
Thirty-nine patients were randomized to treatment with tocilizumab and 41 to placebo. In the tocilizumab group 15 (39%) patients underwent acute revascularization (all PCI), and this was 22 (54%) for placebo. Patients not undergoing acute revascularization had a marked reduction by treatment with tocilizumab in TnT at 6h, as well as NT-proBNP at 48h (Figure). For patients treated with acute revascularization there was no significant group difference in TnT at 6h, whereas there was a marked reduction in NT-proBNP at 48h. There was a substantial reduction in CRP by treatment with tocilizumab irrespective of whether acute revascularization was performed.

CONCLUSION
Treatment with tocilizumab resulted in a significant reduction in myocardial injury as measured by TnT primarily in patients not undergoing acute revascularization, whereas the reduction in NT-proBNP, as well as CRP, was seen irrespective of whether acute revascularization was performed. Abstract Figure. Acute vs. NO acute revascularization
The impact of kids save lives program on knowledge and skills of Greek students, subgroup analysis on recognition of cardiac arrest
Authors: Parisis C , Bouletis A , Chatzidimitriou K , Palla D-D , Makri P , Economou K , Ntaliani M , Aggelosopoulou M , Triantafyllou TH 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Sudden cardiac death is one of the main issues worldwide, with more than 700.000 deaths annually. It is strongly believed that the implementation of "Kids Save Lives" project in schools can change this situation. The World Health Organization endorsed the ‘Kids Save Lives’ project in 2015 in order to reduce mortality. The first chain of survival concerns the recognition of cardiac arrest with chin lift and head tilt manoeuvre of the victim and the feel- look- listen approach.

Purpose
Τo evaluate the level of theoretical knowledge, as far the recognition of cardiac arrest is concerned in Greek secondary school students before and after the "Kids Save Lives" program.
Material – Method: Data collection took place on the academic periods of 2017-2018 and 2018-2019 and was performed in secondary schools of Thessaly’s region. A total of 4922 students (51,9% female, mean age 14.2 years) participated on the "Kids save Lives" program according to the European Resuscitation Council (ERC) and World Health Organization (WHO) statement. A 12-point questionnaire was answered by the students before and after the "kid saves lives" program, while practical skills were evaluated on manikins by experienced ERC Basic Life Support (BLS) Instructors. The knowledge of the recognition of cardiac arrest is investigated in this subgroup analysis

Results
The training improves significantly the theoretical knowledge regarding the recognition of cardiac arrest, with the percentage of correct answers being 58,3% and 96,1%,before and after the course respectively (p &lt; 0.001). In the practical part of the program, almost all of the participants (98.9%) could recognize the correct position near the victim and 91% perform chin lift manoeuvre and recognize cardiac arrest.

Conclusions
The overall results reveal that the "Kids Save Lives" program can play a important role in improving the theoretical knowledge and the practical skills of Greek students towards towards the recognition of cardiac arrest and indicate the necessity of implementation in a greater scale nationwide.
Acute myocarditis in COVID19 patients. Clinical features, severity and outcomes. Results from Spanish multicenter registry Car-COVID19
Authors: Abellas Sequeiros M , Sanmartin Fernandez M , Cosin Sales J , Corbi Pascual M , Escudier Villa JM , Ortiz Cortes C , Baron Esquivas G , Gomez Doblas JJ , Barge Caballero E , Garcia Del Egido A , Barrios Alonso V , Gonzalez Juanatey C , Anguita Sanchez M , Zamorano JL 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Fundacion del Corazon

Introduction
COVID19 has emerged as a new disease, spreading around the world, leading to a complete lockdown. It is known that other infectious diseases can affect the heart inducing myocarditis. As a new entity, it was unknown if SARS-COV2 could provoke that cardiovascular manifestation. This national registry was created to describe COVID19 cardiac affection and its severity.

Methods and results
A multicenter registry was conducted, including 28 centers in Spain. Patients with COVID19 diagnosis presenting an acute cardiovascular event between March 1st and May 30th were included. Eighty-two patients were included. Of them, 9 (14,1%, excluding missing data) presented with acute myocarditis; the rest were diagnosed of acute myocardial infarction or stress cardiomyopathy. Baseline characteristics of these patients are summarised in Table 1. The 83,3% of patients with myocarditis presented with heart failure and 25% simulating an acute coronary syndrome.
According to severity, 5 patients (62,5%) were admitted in the Intensive Care Unit, requiring orotracheal intubation 4 patients (57,1%). Left ventricle was affected in 66,7% of patients, whereas the remaining 33,3% presented biventricular failure. Mean left ventricle ejection fraction was 46% [30,0%-52%]. One patient developed refractory cardiogenic shock requiring implantation of both intra-aortic balloon pump and VA- ECMO. Three patients died during hospitalization.
Cardiac magnetic resonance was conducted in 2 patients (28,6%), showing oedema and subepicardial enhacement in postero-lateral segments. Cardiac biopsy was performed in one patient showing significant lymphoid infiltration and intersticial oedema.

Conclusions
Patients with COVID 19 who develop acute myocarditis usually present with heart failure secondary to ventricular failure. This entity has a bad prognosis with high in-hospital mortality rate. Table 1. Baseline characteristics.n (%)Age65,0[47,0-77,0]Sex (female)3 (42,9%)Hypertension3 (42,9%)Dyslipidemia3 (42,9%)Diabetes mellitus2 (28,6%)Chronic coronary disease1 (14,3%)Previous stroke1 (14,3%)Cancer1 (14,3%)
Catheter-directed low-dose fibrinolysis infusion for treat acute intermediate-high risk pulmonary embolism
Authors: Martin Cabeza MM , Garcia Gonzalez MJ , Jorge Perez P , Sanchez-Grande Flecha A , Munoz Rodriguez R , Igareta Herraiz AT , Leiva Gordillo M , Mendez Vargas C , Yanes Bowden G , Bosa Ojeda F 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
BACKGROUND
Intermediate-high risk (IHR) Pulmonary Embolism (PE) are a common disease witch could have a high mortality. Anticoagulation remains the first therapeutic option, but Catheter-directed therapies are being investigated as a safe and effective treatment option.

PURPOSE
To evaluate the safety and efficacy of Catheter-directed low-dose fibrinolysis infusion to treat IHR-PE.

METHODS
Retrospective analysis of 16 patients IHR-PE treated. After performing Right catheterization (RC) and angiogram, Pigtail catheters were located for intrapulmonary infusion of Alteplase 1mg/h/catheter for 24 h (25-30mg/day). Baseline and clinical characteristics, inicial and evolutive echocardiography, also clinical evaluation and echocardiography 6 months after discharge were evaluated.

RESULTS
The majority were women (11) and obese (93.8%), aged 22-74 years with cardiovascular risk factors: 5 hypertension, 3 Dyslipidemia, 2 smokers and 3 severe CKD . At admission 11 patients consulted for dyspnea and 5 for syncope; all were hemodynamic stable. 68.8% presented respiratory failure. All had bilateral PE (angiography) and elevation of Nt-proBNP and troponins. The echocardiographic at admission, and its evolution are shown in Table 1. The invasive measurement of pulmonary hypertension (PH) reflected greater severity than the estimated by echo: 5 (31.3%) Severe PH, 5 (31.3%) Moderate PH and 2 (12.5%) mild PH.
At discharge all presented a decrease in PH and 15 (93.8%) improved RV function. 2 patients suffered bleeding complications (relation with femoral access): 1 not severe, 1 severe without mortality; none suffered intracranial hemorrhage.
In the evaluation at 6-months: 13 patients (81.3%) where on functional Class I and without PH, 3 patients (18.8%) where in Class II and with mild-PH.

CONCLUSION
In short-term follow-up, intrapulmonary low-dose fibrinolysis reduces PA pressures and improves RV function, without an increased bleeding complications, especially if femoral access is avoided. However impact on long-term remains unclear. Table 1: Echocardiography evolution.RV function admissionNormal Function1 (6.3%)Mild Dysfunction9 (56.3%)Moderate Dysfunction6 (37.5%)RV Dilatation admissionDilatation 16 (100%)Not dilatation 0 (0%)PH Degree admissionMild PH6 (37.5%)Moderate PH5 (31.3%)Severe PH5 (31.3%)PH Degree 24h-postNot PH1 (6.3%)Mild PH10 (62.5%)Moderate/severe PH5 (31.3%)Improvement RV 24h-postYes14 (87.5%)Not2 (12.5%)RV function dischargeNormal Function16 (100%)Mild Dysfunction0 (0%)Moderate Dysfunction0 (0%)RV Dilatation dischargeDilatation 5 (31.3%)Not dilatation 11 (68.8%)PH Degree dischargeNot PH 9 (56.3%)Mild PH7 (43.8%)Moderate/severe PH0 (0%)RV Right Ventricular; PH: Pulmonary Hypertension,
Impact of ESC-endorsed high ischemic risk features and ARC-high bleeding risk criteria on clinical outcomes in all-comer patients undergoing PCI
Authors: Wang HY , Yin D , Yang YJ , Xu B , Dou KF 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: Foundation. Main funding source(s): Beijing Municipal Health Commission (Grant number: 2020-1-4032).

Background
Whether the underlying risk of high bleeding risk (HBR) influences the relationship of high ischemic risk (HIR) features with adverse events after drug-eluting stent implantation remains unclear. The purpose of this study was to evaluate (1) the prognostic effect of ESC guideline-endorsed HIR features on long-term clinical outcomes and (2) whether the outcomes of HIR versus non-HIR features vary by HBR status.

Methods
Ten thousand one hundred sixty-seven consecutive patients who underwent percutaneous coronary intervention between January 2013 and December 2013 were prospectively enrolled in Fuwai PCI Registry. Patients who are at HIR were defined as: diffuse multivessel disease in diabetic patients, chronic kidney disease, at least three stents implanted, at least three stents lesions treated, bifurcation with two stents implanted, total stent length &gt; 60 mm, or treatment of chronic total occlusion. The definition of HBR was based on the Academic Research Consortium (ARC) for HBR criteria. The primary ischemic outcome was major adverse cardiac event (MACE), a composite of cardiac death, myocardial infarction, target vessel revascularization and stent thrombosis. The primary bleeding outcome was clinically relevant bleeding, defined according to Bleeding Academic Research Consortium (BARC) type 2, 3 or 5 bleeding.

Results
With a 2.4-year median follow-up, 4430 patients (43.6%) having HIR experienced a significantly higher risk of MACE (hazard ratio [HR] adjust : 1.56, 95% confidence interval [CI]: 1.34–1.82; P &lt; 0.001) and device-oriented composite endpoint (composite of cardiac death, target-vessel MI, and target lesion revascularization) (HRadjust : 1.52 [1.27–1.83]; P &lt; 0.001), compared to those having non-HIR. The risk of clinically relevant bleeding did not differ between groups (HRadjust : 0.85 [0.66–1.08]; P = 0.174). Associations between HIR and adverse events were similar in HBR and non-HBR groups, without evidence of interaction (all P interaction &gt; 0.05); however, adverse event rates were highest among subjects with both HIR and HBR.

Conclusions
ESC guideline-endorsed HIR was associated with significantly increased risk of MACE without any significant differences in clinically relevant bleeding. The presence of ARC-HBR does not emerge as a modifier of cardiovascular risk for patients at HIR, suggesting more potent and longer antiplatelet therapy may be beneficial for this patient population.
The radioprotective effect of the cathpax air cabin during interventional cardiology procedures
Authors: Noval Morillas I , Gutierrez Barrios A , Angulo Pain E , Gheorghe L , Alarcon De La Lastra I , Canadas Pruano D 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Hospital Puerta del Mar

BACKGROUND
The use of ionizing radiation during cardiac catheterization interventions adversely impacts both the patients and the medical staff. Traditional radiation protection equipment is only partially effective. The Cathpax® radiation protection cabin (RPC) has demonstrated to significantly reduce radiation exposure in electrophysiological and neuroradiology interventions. Our objective was to analyze whether the Cathpax® RPC reduces radiation dose in coronary and cardiac structural interventions in unselected real-world procedures.

METHODS AND RESULTS
In this non-randomized all-comers prospective study, 119 consecutive cardiac interventional procedures were alternatively divided into two groups: the RPC group (n = 59) and the non-RPC group (n = 60). No significant changes in patients and procedures characteristics, average contrast volume, air kerma (AK), dose area-product (PDA) and fluoroscopy time between both groups were apparent.
In RPC group, the first operator relative radiation exposure was reduced by 78% at the chest and by 70% at the wrist. This effect was consistent during different types of procedures including complex percutaneous interventions and structural procedures.

CONCLUSIONS
Our study demonstrates, for the first time, that the Cathpax® cabin significantly and efficiently reduces relative operator radiation exposure during different types of interventional procedures, confirming its feasibility in a real-world setting. Table 3.Comparison of radiation exposureStructural (n = 12)Coronary (n = 107)pPrimary outcomesFirst operator relative exposure at chest*6.8 ± 33 ± 0.60.06First operator relative exposure at left wrist*19.3 ± 104 ± 1.50.01Secondary outcomesSecond operator relative exposure at chest*2.5 ± 1.21.2 ± 0.20.06First operator dose at chest (E in µSv)59.2 ± 4317.2 ± 50.08First operator dose at left wrist (E in µSv)134.1 ± 9623.4 ± 90.04Second operator dose at chest (E in µSv)19 ± 165.7 ± 20.1Patient exposure (DAP in mGy·cm2)62651 ± 2618059682 ± 142860.8Fluoroscopy time, min (±SD)24.2 ± 715.7 ± 40.2Abstract Figures 1 and 2
Vital exhaustion and risk of myocardial infarction in male population aged 25- 64 years in Russia/Siberia. Epidemiological program WHO Monica-psychosocial
Authors: Gafarov V , Gromova E , Panov D , Gagulin I , Gafarova A 
Published: April 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Purpose
To determine the effect of vital exhaustions (VE) on risk of myocardial infarction (MI) in male population aged 25-64 years in Russia/Siberia.

Methods
Within the framework of WHO program MONICA-psychosocial a representative sample of men 25-64 years was examined in 1994 year in Novosibirsk. Total sample of 657 males were measured for VE symptoms at baseline with the use of the MONICA - psychosocial Interview - Vital Exhaustion scale. The incidence of new-onset MI cases was revealed over 14-years of follow-up in frame budgetary issue # AAAA-A17-117112850280-2. Cox - proportional regression model was used for an estimation of hazard ratio (HR).

Results
Prevalence of VE in cohort of men with AH was 73.7%. 58% men had high level of VE and 15.7% - an average level of VE. The risk MI incidence over the first 5 years of follow-up in a group with VE was 2.7-fold higher compare o those without VE. Within 10 years HR = 2.25, within 14 years HR = 2,1 for males with VE (p for all &lt;0.05). In the multivariate Cox regression model after controlling for social factors (education, occupation, marital status) and age, the influence of vital exhaustion on MI risk decreased but remained statistically significant HR = 1.16 (p &lt;0.05). Marital status as divorced and primary degree (elementary school) increased risk of MI more significantly in men with VE.

Conclusions
Vital exhaustion is a predictor of higher risk of MI in middle-age men. Level of MI risk influenced by social gradient.