bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-P11-8: GESTATIONAL DIABETES MELLITUS AS A PREDICTOR OF TYPE 2 DIABETES MELLITUS: CARDIOVASCULAR RISK FACTORS AND BIOLOGICAL MARKERS IN KAZAKH WOMEN
Authors: Danyarova Laura , Kuanyshbekova Roza , Svyatova Gulnara , Berezina Galina , Sultanova Balnur 
Published: January 2023

Aim:
To study the prevalence of gestational diabetes mellitus in the regions of the Republic of Kazakhstan, cardiovascular risk factors and biological markers in women of the Kazakh population

Design and method:
Analysis of the prevalence of gestational diabetes mellitus was carried out according to the data of the medical information systems “Diabetes mellitus” and “Register of pregnant women and women of childbearing age”.

Results:
Analysis of the primary incidence of DM2 among adults, within 5 years there has been a steady increase, while women with type 2 diabetes are much more - 65.5%. The increase in cases of type 2 diabetes was 140 thousand cases (46%), and among women over this period - 85 thousand cases (41%). At the same time, an analysis of the prevalence of type 1 diabetes indicates that there is no gender difference in this type of diabetes mellitus, the number of women left 47.3%. The increase since 2016 was 34.2%, among women 29.5%.
The increase DM2 among women of childbearing age is 58.3%, which is significantly higher than in women of all age groups (41%). DM1 increase was 37.4%.
Analysis of the prevalence of GDM according to the statistical data of the “Register of pregnant women and women of childbearing age” showed differences in frequency across the regions of Kazakhstan (from 4.0% to 11.0%). At the same time, in 2021 alone, the growth in GDM amounted to about 50% compared to 2020.
Abdominal obesity was found in more than 50% of patients with GDM (the highest rate in the Almaty region, the lowest in Aktobe). The prevalence of hypertension among women with GDM is also lower in Aktobe region. An analysis of the prevalence of behavioral risk factors for CVD showed that the largest number of smokers was in Almaty and Almaty region.
To study gene polymorphism, GWAS-associated SNPs polymorphisms with the development of GDM were selected: genes for impaired insulin synthesis and those associated with insulin signal transmission; genes for impaired insulin secretion; genes that regulate carbohydrate and lipid metabolism.

Conclusion:

The results of the analysis demonstrate high prevalence rates of GDM and DM 2. among women in the studied regions, including women of childbearing age, and high variability between regions.There is a need to standardize approaches to screening for GDM. Abdominal obesity and hypertension are the leading risk factors for the development of GDM.
PS-P12-12: ASSOCIATION OF PSYCHOLOGICAL STRESS WITH FEMALE HYPERTENSION: EVIDENCE FROM OVER 10 MILLION CHINESE MARRIED FEMALE POPULATION
Authors: Lyu Xinyi , Zhao Zhenyan , Jia Jiajing , Yang Ying , Zhang Lihua , Wang Yuanyuan , He Yuan , Peng Zuoqi , Zhang Ya , Zhang Hongguang , Wang Qiaomei , Shen Haiping , Zhang Yiping , Yan Donghai , Ma Xu 
Published: January 2023

Objective:
Psychological stress was a potential risk factor for hypertension, but the association between specific chronic stressors and female hypertension remains unclear. We examined the potential associations between the psychological stress within the family and female hypertension.

Design and method:
Reproductive-aged females along with their husbands from the National Free Pre-pregnancy Checkup Projects in 2016 and 2017 were recruited. The stress of wives and husbands was collected by a 5-point Likert-type scale, assessed by two domains: work/life-related stress and economic-related stress. Overall stress was defined as the higher stress level of work/life stress and economic stress. To include categories in the analysis with sufficient numbers of persons, this variable was recoded into four categories as follows: 1 = not stressed at all, 2 = slightly stressed, 3 = moderately stressed and 4 = a lot or extremely stressed. Hypertension was defined as systolic BP/diastolic BP > = 140/90 mm Hg or self-reported history of hypertension. Age-adjusted and multiple-covariates-adjusted logistic regression models were used to assess the associations between multiple types of stress statuses and hypertension.

Results:
Of 10 027 644 couples, 261 098 (2.60%) females were hypertension. The median age of wives was 27 (24–32) years and husbands 29 (26–34) years.1 574 191 (15.7%) wives feel stressed and 1 807 480(18.0%) husbands feel stressed. The stressor of 734 095 (7.32%) wives and 878 887 (8.76%) husbands was work/life, and 1 400 973 (14.0%) wives and 1722 007(17.2%) husbands economic. The results showed that the higher stress level wives or husbands had, the higher prevalence of female hypertension was found (Pfor trend < 0.001). Compared with the unstressed participants, wives or husbands with the highest stress level had the highest risk of female hypertension, with adjusted ORs of 1.28(95%CI:1.23 to 1.34) and 1.23(95%CI:1.18 to 1.27), respectively. After further adjustment for female stress, slightly stressed husbands decreased the risk of female hypertension [OR:0.96(95%CI: 0.94 to 0.97)]. Consistent trends were also observed in economic-stressed groups and life/work-stressed groups.

Conclusions:
Not only stress of wives but also moderate or severe stress of husbands within the family indicates a higher risk of female hypertension. A family-based stress-relieving program may help improve hypertension control in females.
PS-P13-1: DIFFERENTIAL MANAGEMENT OF HYPERTENSION AND DYSLIPIDAEMIA IN URBAN SOUTH AFRICANS BY GLYCAEMIC STATUS
Authors: Peer Nasheeta , Horstmann Liske Kotze , Hill Jillian , Kengne Andre Pascal 
Published: January 2023

Objective:
Considering the sub-optimal care of hypertension and other cardiovascular disease risk factors (CVDRF), this study aimed to describe the management and associations of hypertension and dyslipidaemia in adults with known diabetes (KD), newly diagnosed diabetes (NDD) and normoglycaemia.

Design and Method:
In this population-based cross-sectional study, participants with KD, and those identified as high-risk for diabetes who subsequently underwent oral glucose tolerance tests, and were classified as NDD or normoglycaemia, were included. Data collection comprised administered interviews, clinical measurements, and biochemical analyses. Multiple logistic regressions determined the associations of sociodemographic and CVDRF with hypertension and dyslipidaemia detection, treatment and control in separate models.

Results:
Among 618 participants (82% women), aged 49–63 years, there were 339 participants with KD, 70 with NDD and 212 with normoglycaemia. KD participants were older, but had lower rates of obesity, smoking and alcohol use than their counterparts. Prevalence of hypertension (BP > 140/90mmHg or on treatment) and dyslipidaemia (raised low-density lipoprotein cholesterol > 3mmol/l or on treatment) was highest in known diabetes (89% and 83%) compared with NDD (64% and 74%) and normoglycaemia (66% for both) (p < 0.001). Hypertension detection, treatment and control among participants with hypertension (n = 485) was higher in KD (97%, 88%, 74%) compared with NDD (89%, 69%, 44%) and normoglycaemia (80%, 60%, 46%) (all p < 0.005). Dyslipidaemia detection, treatment and control among participants with dyslipidaemia (n = 471) was higher in KD (85%, 73%, 49%) compared with NDD (37%, 23%, 10%) and normoglycaemia (36%, 22%, 14%) (all p < 0.001). Diabetes control was poor; only 20% of KD had HbA1c < 7%. In the regression models, KD compared with normoglycaemia was associated with hypertension detection (OR:6.91, 95%CI:2.25–21.22) and control (OR:2.05, 95%CI:1.04–4.02,). KD compared with normoglycaemia was associated with dyslipidaemia detection (OR:10.29, 95%CI:5.21–20.32) and treatment (OR:3.94, 95%CI:1.68–9.27). Sociodemographic (age, gender, education, income, employment) and CVDRF (smoking, alcohol use, physical inactivity, obesity) were generally not associated with hypertension or dyslipidaemia management.

Conclusions:
Albeit that diabetes control was poor and requires better management, hypertension and dyslipidaemia prevalence were higher and better managed in KD than their counterparts, likely because of their regular contact with healthcare services for their diabetes management. Improved screening and management of cardiometabolic diseases are required for individuals at high-risk for diabetes, who may not be in regular contact with healthcare services.
PS-P14-8: BRINGING SALT REDUCTION TO THE ACTIVITIES OF COMMUNITY SERVICE ORGANIZATION KURE ROTARY CLUBS. SMALL EFFORTS TO REDUCE SALT
Authors: Kusaka Miho 
Published: January 2023

I am just a practicing physician. Although I cannot move society or influence medical policies, I have nevertheless been steadily building up small salt reduction activities with people in the community since 2008.
Since there is a limit to individual efforts to reduce salt, the ultimate goal is to make society as a whole a low-salt society where people can automatically reduce salt in their normal lives. To achieve this, it is important to work to deepen understanding not only among medical professionals, but also across the board, including companies, government, mass media, and education.
This time I introduce a community service organization (Kure Rotary Club) that I am a member of, which has started a salt reduction activity that takes advantage of the characteristics of the organization.
This organization is composed of managers and executives from many professions in the community, and the members have a great deal of influence, so we thought it would be effective in spreading the word about salt reduction. We have weekly meetings over lunch and learn about community service and other topics. The first thing we did at this meeting was to have a low-sodium and potassium-enriched lunch once a month for all 70 members, with the standard for one serving being less than 2.5 g of salt and more than 1,000 mg of potassium. The day is named “Natokari Lunch Day” and is well known.
In addition, to encourage citizens to reduce salt intake, a video supporting salt reduction has been created and distributed on YouTube. Many members, including a director of a major local hospital, a nutritionist, a researcher, a financier, a shipping businessman, a restaurant owner, a miso manufacturer, a Shinto priest, a lawyer and others appear in the videos and relay short speeches of one minute or less about how they are reducing salt and their recommendations for salt reduction. I believe that many doctors in the world are members of Rotary clubs. I hope this will inspire your activities.
We have been conducting a series of small activities. For example, we held the “Low-Sodium Summit in Kure 2012,” which led to the start of low-sodium school lunches at elementary schools in Kure City. We have also had many restaurants serve low-sodium dishes, bakeries make low-sodium bread, and we have produced a book of low-sodium recipes. These are just a few examples of activities that medical practitioners can do
PS-P14-10: CHALLENGES TO HYPERTENSION AND DIABETES DETECTION AND MANAGEMENT IN URBAN AREA OF DUBREKA, GUINEA
Authors: Bah Fatoumata , Balde Alpha Oumar , Traore Mohamed Sahar , Dioubate Djessona , Keita Tenin Oulen , Sylla Ibrahima Kalil , Diane Sere , Barry Rayhanatou , Balde Elhadj Saidou , Balde Aliou Mamadou 
Published: January 2023

Background:
Hypertension (HTN) and Diabetes mellitus (DT2) are frequently underdiagnosed in Africa. The present study was carried out to assess the situation in the urban commune of Dubreka.

Methods:
Prospective and transversal, the study was focused on 287 participants (174 females; 113 males). HTN and DT2 were defined according to the blood pressure standards of at least 140/90 mm Hg and glycemia at least 1.26 g /l, respectively [1,2].

Results:
Overall rate was 74% (211/287) for HTN and 37% (105/287) for DT2. Both sex were concerned: 75% HTN and 36% DT2 in females vs 71% HTN and 38% DT2 in males. Salty diet and sedentary lifestyle were common. In females, 39% were overweight and 34% were obese. The association HTN and DT2 have been noted in 46% (96/211) among the hypertensive and 91% (96/105) among the diabetics. Of the 96 diabetic hypertensives, 45% were overweight (43/96), and 27% (26/96) were obese. In hypertensive, 85% (179/211) were aware of their status and 7% (13/179) were undergoing treatment without any control. In diabetics, 22% (23/105) were aware of their diagnosis with 30% (7/23) on treatment without any control. Conventional treatment of the few patients has generally focused on generic metformin and glibenclamide for diabetes and nifedipine for hypertension which in health centers cost from 15,000 GNF to 25,000 GNF (3,45$ to 5,75$). Such financial inaccessibility to conventional medicine partly justifies the frequent use of medicinal plants either alone or in association with conventional medicines.

Conclusion:
Hypertension and diabetes remain a concern in Dubréka where low rates of awareness, treatment and control were noticed.

REFERENCES
1. 2018 ESC/ESH Guidelines for the management of arterial hypertension: J Hypertens. 2018 Oct;36(10):1953–2041.2. [2019] ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD. European Heart Journal (2020) 41, 255–323.
PS-R06-4: POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME TRIGGERED BY FLUID RETENTION AND HYPERTENSION AFTER STEROID INITIATION IN PATIENTS WITH ANCA-ASSOCIATED VASCULITIS
Authors: Mimura Ayumi , Fujii Kentaro , Sugi Wataru , Kato Ai , Yoshifuji Ayumi , Komatsu Motoaki , Ryuzaki Munekazu 
Published: January 2023

Objectives:
Central nervous system (CNS) involvement in antineutrophil cytoplasmic antibody (ANCA) -associated vasculitis is common, with hypertrophic pachymeninges, cerebrovascular events, hypophysitis, or posterior reversible encephalopathy syndrome (PRES) being the most common CNS presentations.

Design and Methods:
Case report.

Results:
A 73-year-old Japanese woman presented with a fever and cough. The patient had no relevant medical history. Her c-reactive protein (CRP) level increased to 22.38 mg/dl, and meropenem was initiated; however, her fever and CRP levels did not improve. Furthermore, creatinine level increased from 0.83 to 3.44 mg/dl during hospitalization. She was transferred to our hospital for evaluation of renal function deterioration. Her consciousness level was alert, and her blood pressure was 140/80 mm Hg. A renal biopsy was performed, and histological examination of the kidneys revealed diffuse pauci-immune necrotizing and crescentic glomerulonephritis. Myeloperoxidase (MPO) -ANCA was 2.9 IU/mL and proteinase 3 (PR3) -ANCA was negative. On the basis of these findings, the patient was diagnosed with ANCA-associated vasculitis. On the fourth hospital day, she was treated with 500 mg intravenous methylprednisolone, once daily, for 3 days, followed by oral prednisolone (40 mg; 0.8 mg/kg). Although her fever and CRP levels improved after the initiation of immunosuppressive therapy, she required renal replacement therapy on the eighth hospital day. Rituximab (500 mg) was administered on the ninth hospital day. Her blood pressure subsequently increased, with the systolic blood pressure being 190 mmHg, and consciousness suddenly deteriorated on the 11th hospital day. Head fluid-attenuated inversion-recovery (FLAIR) MRI showed multiple lesions with high signal intensity, and she was diagnosed with PRES. After intravenous administration of nicardipine and fluid removal by hemodialysis, her blood pressure decreased and her consciousness dramatically improved.

Conclusion:
In addition to the vascular endothelial damage associated with vasculitis itself, steroid therapy, renal failure, elevated blood pressure, and administration of rituximab are related to an increased susceptibility of PRES. In particular, steroid administration increases blood pressure due to fluid retention and can be a risk factor for the development of PRES, suggesting the need for adequate fluid management during steroid administration.
PS-R07-5: A CASE OF PRIMARY ALDOSTERONISM WITH DECLINED GLOMERULAR FILTRATION RATE AFTER ADRENALECTOMY
Authors: Kohmoto Hikari , Kobayashi Sakiko , Miyashita Kazutoshi , Kinouchi Kenichiro , Nakamura Toshifumi , Mizutani Yosuke , Takeda Toshikazu , Oya Mototsugu , Tamura Masashi , Nakatsuka Seishi , Itoh Hiroshi 
Published: January 2023

Background:
Primary aldosteronism (PA) has been known to cause organ damage, such as renal and cardiovascular disorders more frequently than essential hypertension (EH), independently of blood pressure. Among renal disorders, albuminuria is more prevalent in patients with PA than EH, while GFR tends to be higher in PA due to glomerular hyperfiltration. Surgical and medical treatments for PA correct these effects of excess aldosterone, which sometimes uncover preexisting chronic kidney disease (CKD). Here we present a case of PA with CKD who manifested decline of glomerular filtration rate (GFR) and overt renal failure following resection of aldosterone-producing adenoma.

Case report:
A 53-year-old woman was diagnosed with hypertension at the age of 40. Her primary care physician started treatment with a calcium channel blocker (CCB). At the age of 49, she was diagnosed with Sjogren's syndrome (SS). Blood tests revealed severe hypokalemia and eGFR of 50 mL/min/1.73m2, while 24-hr urine collection showed urinary protein of 0.5 g per day. SS was suspected to underlie her renal disease. A renal biopsy was performed, and suggested nephrosclerosis and IgA nephropathy. On the other hand, a 11mm-sized tumor in the left adrenal gland was discovered during the investigation of secondary hypertension. PA was confirmed based on active renin concentration (ARC) of 4.3 pg/mL, plasma aldosterone concentration (PAC) of 342 pg/mL, an aldosterone-to-renin ratio of 79.5 (> 40), and 24-hr urinary aldosterone levels of 15.9 μg per day under the adequate salt-loaded condition. Adrenal venous sampling yielded aldosterone hypersecretion from the left adrenal vein, which indicated aldosterone-producing adenoma. Laparoscopic partial left adrenalectomy was performed and fully normalized ARC, PAC, and urinary aldosterone levels, which indicated biochemical cure of PA. Consequently, blood pressure had been well controlled with a single CCB. However, while her preoperative serum creatine level ranged from 0.9 to 1.1 mg/dL and eGFR was around 40–50 mL/min/1.73m2, her postoperative serum creatine level increased to 1.4 to 1.9 mg/dL and eGFR decreased to 25 to 35 mL/min/1.73m2 on average. In contrast, urinary protein level improved to less than 0.1 g/day, suggesting that post-treatment increase in creatine level indicated unveiling CKD rather than deterioration of renal function.

Conclusion:
PA treatment may unmask CKD through improving glomerular hyperfiltration from aldosterone excess.
ABC score is an effective predictor of outcomes in peptic ulcer bleeding
Authors: Sakong Heon , Moon Hee Seok , Choi Seong Woo , Kang Sun Hyung , Sung Jae Kyu , Jeong Hyun Yong 
Published: January 2023

Background:
Risk stratification is recommended for patients with gastrointestinal (GI) bleeding. The ABC score is a new scoring tool with high accuracy for upper and lower GI bleeding. We aimed to evaluate the effectiveness of the ABC score in predicting the outcomes of patients with peptic ulcer bleeding.

Methods:
This single-center retrospective study included 809 patients, each with symptoms of upper GI bleeding, and who were diagnosed with ulcerative lesions between October 2011 and March 2021. The association between the ABC score’s variables and the patients’ outcome was analyzed. The score’s performance in predicting the patients’ outcome was validated using receiver-operating characteristic curve analysis and compared with that of other scores.

Results:
The study analyzed 772 patients with peptic ulcer bleeding. The primary outcome measure was all-cause 30-day mortality. Secondary outcome measures included rebleeding within 30 days and the need for radiologic/surgical intervention. Age (P = .013), serum albumin levels (P < .001), serum creatinine levels (P = .004), mental status (P < .001), and American Society of Anesthesiologists score (P < .001) were associated with the primary outcome. The ABC score predicted the 30-day mortality (area under the receiver-operating characteristic curve [AUROC] 0.927; 95% confidence interval [CI] 0.899–0.956) better than other scores. However, it was less accurate in predicting rebleeding (AUROC 0.630; 95% CI 0.563–0.697) and need for radiologic/surgical intervention (AUROC 0.641; 95% CI 0.550–0.732).

Conclusions:
The ABC score accurately predicts the 30-day mortality in patients with peptic ulcer bleeding. However, it may not be suitable for predicting rebleeding or the need for radiologic/surgical interventions.
Emerging Treatment Options for Chronic Tendinopathy of the Foot
Authors: Chowdhary Kuntal , Sherrier Matthew , Onishi Kentaro 
Published: January 2023

Abstract
The patient is a 65-year-old female recreational skier and avid walker who presented with a several-month history of right ankle and foot pain. The patient’s pain began without inciting event and was described as a constant aching pain aggravated by downhill walking and alleviated with rest. She was diagnosed with right distal tibialis anterior tendinopathy with partial thickness tear noted on magnetic resonance imaging and musculoskeletal ultrasound. Given symptoms recalcitrant to conservative measures, the patient opted to pursue an ultrasound-guided prolotherapy injection and a course of physical therapy; unfortunately, she did not have any improvement in symptoms. The patient subsequently underwent ultrasound-guided percutaneous ultrasonic tenotomy and debridement of the distal tibialis anterior tendon, followed by a postprocedure rehabilitation protocol of physical therapy with transition to home exercise program with complete resolution of her pain. Prolotherapy, and percutaneous ultrasonic tenotomy and debridement are two treatment modalities that show promise in the treatment of painful, chronic tendinopathy.
Baseline Function and Rehabilitation Are as Important as Stroke Severity as Long-term Predictors of Cognitive Performance Post-stroke
Authors: Girgenti Sophia G. , Brunson Autumn O. , Marsh Elisabeth B. 
Published: January 2023

Objective
Although individuals with low stroke severity tend to recover well, cognitive impairment is common independent of stroke size or location. In this study, the patterns of recovery for individual cognitive domains and factors associated with outcome were examined.

Design
A prospectively enrolled cohort of patients with minor stroke was administered cognitive testing at 1, 6, and 12 mos postinfarct. Composite T scores were generated for global cognition and well as independent cognitive domains at each time point. Paired t tests compared changes in scores over time. Regression models identified factors associated with improvement.

Results
A total of 46 patients, with an average NIH Stroke Scale score of 2.7, were enrolled. Average age was 61.3 yrs. Patients improved overall between 1 and 6 mos; however, distinct patterns of recovery were seen for different cognitive domains. The most significant improvement was in spatial memory. Verbal memory scores remained low longitudinally. Motor speed and executive function increased, then plateaued. Despite a mean education of 13.6 yrs, only 36% of global cognition scores were higher than or equal to the normative mean at 12 mos, and only 57% of patients improved their global scores from 6 to 12 mos. Late recovery was associated with lower NIH Stroke Scale scores, higher 1-mo Montreal Cognitive Assessment scores, and rehabilitation. Baseline function predicted overall long-term recovery.

Conclusion
Patterns of recovery are distinct for individual cognitive domains for patients with minor stroke. Stroke severity and rehabilitation influence trajectory. Premorbid baseline predicts long-term outcome.