bluuebunny/crossref_metadata_2025_split huggingface dataset:
57. VISIT-TO-VISIT SYSTOLIC BLOOD PRESSURE VARIABILITY IS ASSOCIATED WITH MAJOR ADVERSE CARDIAC EVENTS (MACE) IN CARDIOLOGY CLINIC DR. M. DJAMIL HOSPITAL PADANG
Authors: Metasari Sisca , Fernando Harben , Ferdian Vicky , Yanni Mefri , Syafri Masrul , Syukri Muhammad 
Published: May 2021

Background:
Elevated blood pressure variability has been associated with a major risk factor for cardiovascular events and mortality. Long-term BPV has also been described, including seasonal BP variation changes between clinic visits over months or years (visit-to-visit BPV).

Objective:
This study aims to investigate the association of visit-to-visit variability of systolic blood pressure with major adverse cardiac events.

Methods:
This was a retrospective study based on medical records in Dr. M. Djamil Hospital, Padang. Hypertensive patients (N = 187) without a history of major adverse cardiac events before were follow-up duration from June-December 2019. Visit-to-visit variability was measured by standard deviation and correlation of the two variable using the ANOVA test (p-value <0.05)

Results:
Female was the dominant characteristic observed in our study (n = 53.5%), followed by elderly (n = 87.7%), smoker (n = 39.6%), ACEI/ARB therapy (n = 34.8%) and pre-hypertension condition (n = 59.9%). The mean age of the study population was 59.13. The mean systolic blood pressure variability at the first visit was 132.9 dan no statistically significant difference afterward. The visit-to-visit variability of systolic blood pressure was significantly associated with the occurrence of major adverse cardiac events (rehospitalization due to MI, heart failure, arrhythmia, and death) p-value = 0.001 (p < 0.05).

Conclusion:
Female gender, elderly, pre-hypertension condition, smoker, and ACE/ARB therapy were the dominant patterns in our study. Increased visit-to-visit variability blood pressure was significantly associated with increasing the occurrence of major adverse cardiac events among hypertensive patients in clinical treatment
60. LEFT VENTRICULAR GEOMETRY AND CLINICAL OUTCOMES IN HYPERTENSIVE PATIENTS WITH NORMAL EJECTION FRACTION
Authors: Maulana Giovanno Rachmanda , Widyastuti Wenny , Azzuhdi Muhammad Zakiy , Yanni Mefri 
Published: May 2021

Background:
In hypertensive populations, left ventricular (LV) geometry, which is characterized by different types of hypertrophy, predicts cardiovascular outcome.

Objective:
To evaluate the prevalence and clinical outcomes of various LV geometric patterns in hypertensive patients admitted with normal EF (>55%) who were referred for echocardiography examination.

Methods:
We obtained relevant clinical and echocardiographic data from our clinical echocardiographic database of 176 hypertensive patients admitted with various cause during 2018 - 2019 who met the inclusion criteria and absence condition of valvular heart disease. Clinical outcome obtained from medical record and direct contact to the patients. Subjects were arbitrarily categorized according to the LV geometric pattern into LV concentric remodelling (CR), concentric hypertrophy (CH) and eccentric hypertrophy (EH), and normal groups. Statistical analysis was performed using SPSS 26.

Results:
LV concentric hypertrophy was the most common abnormal LV geometric pattern observed in our study (n = 103), followed by concentric remodelling (n = 53). Diastolic dysfunction was more frequent found in CH group compared to CR and EH group, and no statistically significant relationship was found (p value = 0.247). Diabetes mellitus was statistically significant in all four groups (p < 0.001). The most frequent medication being prescribed was Ca channel blocker. There was no statistically significant relationship between the four groups and the incidence of rehospitalization (p = 0.573). However, the CH group accounted for the highest rehospitalization rates among the four groups (n = 13). The most frequent cause of rehospitalization in this study was non-cardiac causes (n = 14), while the most common cardiac cause for rehospitalization was acute coronary syndrome (n = 10).

Conclusion:
Diabetes mellitus was statistically significant in all four groups. But, there was no statistically significant relationship between the four groups and the incidence of rehospitalization.
66. ASSOCIATION HYPERTENSION AND RISK FACTORS OF COGNITIVE IMPAIRMENT IN THE ELDERLY WITHOUT DIABETES: ATMA JAYA ACTIVE AGING RESEARCH STUDY
Authors: Turana Yuda , Suryakusuma Linda , Barus Jimmy F , Andre  , Suswanti Ika , Handajani Yvonne S 
Published: May 2021

Introduction:
Cognitive impairment is often associated with aging and a history of cardiovascular disease. This study aims to determine the relationship between hypertension and other risk factors for cognitive disorders in the elderly without diabetes.

Methods:
This study uses secondary data in Atma Jaya Cognitive and Aging studies, 2013–2017 on 711 elderly. Subjects with fasting blood sugar ≥126 mg/dl (n = 94) and incomplete data (n = 127) were excluded in this study. Subjects that can be analyzed are as many as 490 elderly.
The variables studied were demographic characteristics, lipid profile, hypertension status, smoking and depression. Subjects are categorized as experiencing cognitive impairment if they have an MMSE score <24. The bivariate statistical test was performed using the chi-square analysis and the mean Whitney test, while the multivariate analysis used multiple logistic regression.

Result:
Most of the subjects were female (68%), with a mean age of 66.8 ± 7.8 years, and having education <9 years (62.7%), and as many as 204 (41.5%) subjects experienced cognitive impairment. The bivariate analysis results showed that female gender, low education, and hypertension were independently associated with poorer cognitive function (p < 0.05). Multivariate analysis showed that education <9 years was found to be the dominant factor in cognitive impairment (p-value <0.05; OR = 10.855), after being controlled by gender and hypertension variables.

Conclusion:
Female gender, low education and hypertension are associated with impaired cognitive function. Low education was found to be the dominant factor in cognitive impairment in non-diabetic elderly.
68. ASSOCIATION OF RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM BLOCKER DRUGS AND OUTCOMES IN COVID-19 PATIENTS WITH HYPERTENSION
Authors: Yanni Mefri 
Published: May 2021

Background:
The role of renin-angiotensin-aldosterone system (RAAS) blockers during the coronavirus disease 2019 (COVID-19) pandemic is a matter of controversies. Studies based on in-hospital exposure have suggested a beneficial effect of these drugs, unlike those based on chronic exposure.

Objective:
To analyse RAAS blocker prescription before and during hospital stay and clinical outcomes in patients with COVID-19. The primary outcome was in-hospital mortality within 30 days of admission. The secondary outcome was a severe disease defined as the need for high flow nasal cannula (HFNC), ICU admission, or death, within 30 days of admission.

Methods:
A retrospective cohort study was conducted in 112 hypertensive patients hospitalized for COVID-19 during March until December 2020. The association between exposure and outcomes within hospitalization was analysed using logistic regression analysis.

Results:
Of 112 patients, mean age was 56.33 ± 12.9 years, 61 (54.5%) were male, with mean Systolic BP was 147 ± 25.4 and mean Diastolic BP was 86.6 ± 14.2 mmHg in all groups. There were 86 (76.7%) patients had prior use of RAAS blocker at admission. Baseline characteristics showed significant difference on peripheral SpO2 saturation at admission between prior use and without prior use of RAAS blockers groups, 96.8 ± 3.5% vs 94 ± 9.13%, p = 0.046, and use of Ca channel blocker drugs 65 (75.6%) vs 14 (53.8%), p = 0.03, respectively. Overall mortality was 22 (19.6%) in both groups. Among patients with prior exposure to RAAS blockers, 20.9% died within 30 days of admission versus 15.4% in patients without prior exposure to RAAS blockers [OR 1.28 (95% CI, 0.39–4.23), p = 0.67] and 25.6% patients suffered severe disease vs 26.9% in patients without prior exposure to RAAS blockers [OR 0.12 (95% CI, 0.01–0.74), p = 0.02].

Conclusions:
Mortality was found higher in patients with prior exposure to RAAS blockers than in patients without prior exposure to RAAS blockers. There was no significant association between RAAS drugs exposure and mortality in COVID-19 patients, but patients with no prior RAAS blockers prescription tend to suffer severe disease (need for ICU admission, use of HFNC) than other group.
70. ASSOCIATION BETWEEN HYPERTENSION AND IN-HOSPITAL MORTALITY IN COVID-19 PATIENTS
Authors: Allo Iswandy Janetputra Turu’ , Tiksnadi Badai Bhatara , Prakoso Pranata Priyo , Najiyah Hana Hadianty , Rahmawati Mira , Hasmirani Mira , Wibowo Robin Hendra , Utomo Priyanto , Yudisman Ade 
Published: May 2021

Background:
Indonesia reported ≥1 million cases of Coronavirus Disease (COVID-19) with remarkable number of deaths. Notably, hypertension's status as predictor for poorer outcome remains debatable.

Objective:
We aim to investigate the association between in-hospital mortality and hypertension in COVID-19 patients.

Methods:
A retrospective study using adult (≥18 years old), confirmed COVID-19 patients’ medical record at Cibabat General Hospital, Cimahi, West Java, Indonesia between September to December 2020 was conducted. Patient's gender, age, hospital-stay length, comorbidities (type 2 diabetes mellitus, coronary artery diseases, arrythmia, kidney diseases, respiratory diseases, and stroke), and outcomes were collected. Hypertension was defined as hypertension history before the infection. Chi-square and logistic regression analysis were conducted to understand the association between hypertension and mortality.

Results:
A total of 205 patients were included, 117 (57.1%) were males, of whom 40 (19.5%) died and 165 (80.5%) were discharged. The mean value of the patients’ age was 53.7 ± 13.8 years old, and the median hospitalization-day was 11 (range: 1–45) days. Hypertension was the most common comorbidity (n = 72; 35.1% patients); 13 (18.1%) were dead and 59 (81.9%) survived. A chi-square test showed no statistically significant difference between mortality and hypertension, X
2 (1, N = 205) = 0.15, p = 0.70; OR: 0.87, 95% confidence interval (CI) 0.42–1.80. Logistic regression analysis reveals that patient's age is the only statistically significant factor for death in this study (p < 0.05; OR: 1.05, 95% CI 1.02–1.08).

Conclusion:
Hypertension is not associated with mortality in COVID-19 patients. Further investigations including larger sample size and more possible variables are warranted to understand this relationship further.
73. OMECAMTIV MECARBIL, A NOVEL THERAPEUTIC AGENT FOR HEART FAILURE WITH REDUCED EJECTION FRACTION: A SYSTEMATIC REVIEW
Authors: Trifitriana Monica , Mulawarman Rido , Felani Muhammad Rizky , Tondas Alexander Edo 
Published: May 2021

Background:
At least half of the millions of heart failure patients have heart failure with reduced ejection fraction (HFrEF). There have been many drugs used to treat heart failure, but these drugs don’t directly work on the target pathogenesis of HFrEF. Improving systolic function will prevent neurohormonal activation and ventricular remodeling, which clinically will provide better results from hospitalization and causes of death. Omecamtive mecarbil (OM) is a novel selective cardiac myosin activator, it will improve cardiac function in patients with HFrEF.

Objective:
We aim to assess the latest evidence on the outcome of OM in heart failure patients.

Method:
We performed a comprehensive search on topics that assesses OM outcomes in heart failure patients from inception up until January 2021.

Results:
There were 17.712 HFrEF patients from six studies. Three studies showed the decrease of heart rate, two studies prove that OM increase the stroke volume and systolic ejection time, while each of one study showed increase of left ventricular ejection fraction and decrease left ventricular end systolic volume, left ventricular end diastolic volume, left ventricular fraction shortening, left ventricular end systolic dimension and left ventricular end diastolic dimension from the baseline. The route via intravena maximum tolerated by dose 0,5 mg/kg per h, while via orally start with dose 25 mg twice daily. No significant side effects were found. One randomized controlled trial study also showed a lower risk of a composite heart failure events and cardiovascular death than those who received placebo.

Conclusion:
Omecamtiv mecarbil improved cardiac function in heart failure and could be the first in class of a new therapeutic agent. Further controlled studies are warranted for definite conclusion.
Acupuncture treatment for nausea and vomiting after chemotherapy
Authors: Hou Xian-Bing , Chen Dan-Dan , Cheng Tong-Fei , Wang Dan , Dai Xiao-Jun , Wang Yao , Cui Bi-Xian , Wang Yuan-Yuan , Xu Hui , Chen Hong-Zhou 
Published: May 2021

Abstract

Background:
Chemotherapy-induced nausea and vomiting (CINV) are 1 of the main obstacles to continuous treatment. External treatment of Chinese medicine has been widely used in the treatment of CINV, especially acupuncture therapy, but studies about overall safety and effectiveness of acupuncture treatment have not been scientifically and methodically evaluated in recent years. Evaluating the overall safety and effectiveness of acupuncture treatment in patients with CINV is the purpose of this review.

Methods and analysis:
Relevant randomized controlled trials are being searched in the following electronic databases: PubMed, Cochrane Library, Web of Science, EMBASE, China National Knowledge Infrastructure, Chinese Scientifific Journal Database, Wanfang Data Knowledge Service Platform, and Chinese Biomedical Literature Database. We will also attempt to obtain the unpublished academic data by contacting the colleague, professor, or Institute of Traditional Chinese Medicine. The RCTs of the acupoint therapies for CINV patients will be searched in the databases from inception to December 2020. The primary outcomes are defined as severity, duration and frequency of nausea or vomiting, or both. The secondary outcomes are defined as any adverse events and quality of life. Performing the meta-analysis by using RevMan version 5 software. Mean difference or standardized mean difference will express the continuous variables, while relative risk (RR) will express the categorical variables.

Results:
The results of this review will provide a high-quality synthesis to evaluate the effectiveness and safety of acupuncture treatment for CINV.

Conclusion:
This review will provide evidence to estimate whether acupuncture treatment is effective interventions for CINV.

Dissemination:
This systematic review will provide evidence for the effectiveness of acupuncture treatment in the intervention of CINV. The purpose is to provide new ideas and methods for the treatment of CINV. The results of this systematic review will be disseminated through various forms of presentation and publication of data in journals or electronic databases.

PROSPERO registration number:
CRD42021225872
Celiac plexus neurolysis for abdominal cancers: going beyond pancreatic cancer pain
Authors: Ambai Vats T. , Singh Vinita , Boorman David W. , Neufeld Nathan J. 
Published: May 2021

Introduction:
Celiac plexus neurolysis (CPN) has been verified for mitigating pancreatic cancer pain. However, information regarding CPN's use beyond this remains limited.

Objectives:
Identify which cancers benefit from CPN, which symptoms improve, and when symptoms improve.

Methods:
Retrospective analysis was conducted on 173 patients who received CPN for pain caused by various malignancies. Mean symptom changes on the MD Anderson Symptom Inventory (MDASI) from baseline to 2 weeks, 1 month, and 2 months after CPN were analyzed overall and then by cancer type: pancreatic (all stages and stages III–IV), hepatobiliary, and nonpancreatic, nonhepatobiliary gastrointestinal (NPNH-gastrointestinal).

Results:
Eighty-two pancreatic, 43 NPNH-gastrointestinal, 14 hepatobiliary, and 34 patients with other cancers met inclusion criteria. Statistically significant changes included decrease in the pain score at 1 month by 1.01 points for all cancers, 1.65 points for all pancreatic cancers, and 1.88 points for late-stage pancreatic cancers. At 2 months, pain decreased by 1.50 points for all cancers, 1.68 points for all pancreatic cancers, 2.37 points for late-stage pancreatic cancers, and 1.50 points in NPNH-gastrointestinal cancers. At 2 months, quality of life improved by 1.07 points for all cancers and 1.53 points for all pancreatic cancers. Sleep improved at 2 months for all cancers by 0.73 points and 1.60 points in late-stage pancreatic cancers. At 2 months, pancreatic cancer patients improved in general activity by 0.93 points, walking by 1.00 points, and working by 1.12 points.

Conclusion:
Celiac plexus neurolysis can decrease cancer symptom burden beyond pain including quality of life and sleep for pancreatic and nonpancreatic cancers, as well as general activity for pancreatic cancers.
Dual-Energy Computed Tomography for the Diagnosis of Mediastinal Lymph Node Metastasis in Lung Cancer Patients: A Preliminary Study
Authors: Hu Xiaoli , Gu Qianbiao , Zhang Kun , Deng Dong , Li Lei , Li Ping , Shen Hongrong 
Published: May 2021

Objective
This study explored the feasibility of dual-energy computed tomography (DECT) for the diagnosis of mediastinal lymph node (LN) metastasis in patients with lung cancer.

Methods
Forty-two consecutive patients with lung cancer, who underwent DECT, were included in this retrospective study. The attenuation value (Hounsfield unit) in virtual monochromatic images and the iodine concentration in the iodine map were measured at mediastinal LNs. The slope of the spectral attenuation curve (K) and normalized iodine concentration (in thoracic aorta) were calculated. The measurement results were statistically compared using 2 independent samples t test. Receiver operating characteristic curve analysis, net reclassification improvement, and integrated discrimination improvement were used to evaluate the diagnostic performance of DECT for mediastinal LN metastasis.

Results
A total of 74 mediastinal LNs were obtained, including 33 metastatic LNs and 41 nonmetastatic LNs. The attenuation value at the lower energy levels of virtual monochromatic images (40–90 keV), K, and normalized iodine concentration demonstrated a significant difference between metastatic LNs and nonmetastatic LNs. The attenuation value at 40 keV was the most favorable biomarker for the diagnosis of mediastinal LN metastasis (area under curve, 0.91; sensitivity, 0.94; specificity, 0.81), which showed a much better performance than the LN diameter-based evaluation method (area under curve, 0.72; sensitivity, 0.66; specificity, 0.82; net reclassification improvement, 0.359; integrated discrimination improvement, 0.330).

Conclusions
Dual-energy computed tomography is a promising diagnostic approach for the diagnosis of mediastinal LN metastasis in patients with lung cancer, which may help clinicians implement personalized treatment strategies.
Examining the Effects of Postmastectomy Radiation Therapy in Prepectoral Versus Subpectoral Autologous Breast Reconstruction
Authors: Patel Ashraf A. , Arquette Connor P. , Yesantharao Pooja S. , Borrelli Mimi R. , Broderick Kristen P. , Cheesborough Jennifer E. , Lee Gordon K. , Nazerali Rahim S. 
Published: May 2021

Background
Postmastectomy radiation therapy (PMRT) is known to increase the risk of multiple adverse outcomes after breast reconstruction. In the context of delayed-immediate autologous breast reconstruction, PMRT is typically conducted after placement of subpectoral (SP) tissue expanders. With the re-emergence of prepectoral (PP) reconstruction, there are little data assessing the outcomes of PP reconstruction in breasts receiving PMRT. We compared postoperative outcomes of PMRT patients undergoing delayed-immediate, autologous breast reconstruction with placement of tissue expanders in either the PP or SP plane.

Methods
A retrospective chart review was conducted on all consecutive patients who underwent delayed-immediate autologous breast reconstruction and received PMRT at either the Stanford University or the Johns Hopkins University Hospitals between January 2009 and December 2018. Demographics, comorbidities, perioperative information, and oncologic data were collected for all patients. Complications were collected and analyzed after stage 1 surgery, between 30 days of stage 1 and up to stage 2 surgery, and after stage 2 surgery. Multivariable regressions were used to determine predictors of 1 or more complications.

Results
A total of 71 patients (73 breasts) were included. Prepectoral reconstruction comprised of 52.2% of the cohort, and the remaining 47.8% were SP reconstructions. Demographics and comorbidities were similar between groups, except for premastectomy radiation, which was more prevalent in the PP cohort (P = 0.010). Complications were similar between cohorts after stage 1 surgery (P = 0.420), between stages 1 and 2 (P = 0.100), and after stage 2 (P = 0.570). There were higher rates of skin necrosis in the SP cohort between stages 1 and 2 (PP: 2.6%, SP: 20%, P = 0.004). Multivariable analysis revealed body mass index to be the only predictor of complication (P = 0.041). The mean number of revisionary surgeries was higher in the SP cohort (PP: 0.8 vs SP: 1.9, P = 0.002). The mean follow-up was 385.5 days and similar between groups (P = 0.870).

Conclusions
Rates of overall complication were similar between PP and SP expander placement. However, in SP reconstructions, skin necrosis was significantly higher between stages 1 and 2. The patients in the SP cohort also underwent a greater number of revisionary surgeries, although overall rates of pursuing any revisionary surgery were similar between groups.