bluuebunny/crossref_metadata_2025_split huggingface dataset:
ELECTROLYTE IMBALANCES IN THE CONTEXT OF SARS-COV-2 INFECTION IN HYPERTENSIVE PATIENTS
Authors: Grigore Cristiana , Balaceanu Beatrice , Gurau Cristian Dorin , Giuglea Carmen , Dina Ion , Balaceanu Alice 
Published: June 2023

Objective:
The purpose of this study is to compare the clinical features and laboratory examinations in hypertensive patients diagnosed with Sars Cov 2 infection and electrolyte imbalance detected during hospitalization.

Design and method:
We conducted a retrospective study on 43 patients diagnosed with Sars Cov 2 infection admitted to an Internal Medicine department of an Emergency Hospital between January 2022 and October 2022.
43 patients diagnosed with Sars Cov 2 infection by RT-PCR test were admitted to the internal medicine department, most of them with a severe form of the disease (24 patients, 55%), of which only 8 patients (18.6%) were vaccinated anti Sars Cov 2. The average age of the patients was 78.7 years, with a minimum age of 62 years old and a maximum of 98 years old. The sex ration shows: females 26 patients (60.4%) and 17 men (39.6%).
Patient comorbidities: 5 patients (11.62%) had neoplasms before hospitalization and 2 patients (4.65%) were diagnosed during hospitalization. Cognitive dysfunctions and dementia are found in 18 patients (41.86%) and all patients had a history of hypertension at admission. Heart failure in different stages is found in 15 patients (34.88%). 41.86% (18) of the patients had type 2 diabetes upon admission and 3 patients (6.97%) were diagnosed during hospitalization through specific tests. Atrial fibrillation is in a small percentage (31.23%-13 patients) and the frequently followed treatments are beta blockers (53.48%-23 patients) and thiazide and loop diuretics (17 patients-39.53%). 44.18% of patients died during hospitalization.

Results:
During the hospitalization, the patients presented various electrolytes disorders. An approximately equal number of patients, 22 and 23 respectively, had normal serum levels of sodium and potassium. Mild electrolytie disorders were prevalent: mild hyponatremia (7 pac, 16.27%) and hypokalemia followed the rule (20.93% - 9 patients).

Conclusions:
The electrolytic disorders occurring in the case of patients with multiple cardiovascular comorbidities and diagnosed with Sars Cov 2 infection can worsen their prognosis, ranging from psychiatric effects to death.
PROGNOSTIC ROLE OF INTERLEUKIN-10 AND GLYCOSYLATED HEMOGLOBIN IN THE DEVELOPMENT OF CARBOHYDRATE DISORDERS IN PATIENTS WITH ARTERIAL HYPERTENSION
Authors: Zhuravlyova Larysa , Kulikova Maryna 
Published: June 2023

Objective:
Arterial hypertension (AH) is one of the most pressing problems in medicine due to its prevalence and central role in the development of vascular accidents. Among the causes that increase the risk of developing the disease and its complications, consider hyperglycemia, insulin resistance, hyperinsulinemia. The aim of our study is to develop a diagnostic algorithm for predicting type 2 diabetes mellitus (T2DM) based on a comprehensive study of carbohydrate metabolism and serum interleukin-10 (IL-10) activity in patients with AH.

Design and method:
The study involved 54 patients with AH. The levels of glucose, insulin, HbA1c were determined by biochemical method, HOMA index was calculated. In order to determine the level of anti-inflammatory IL -10 was used ELISA method. A discriminant analysis was used to identify the dependencies that explain the mechanisms of T2DM development in patients with AH.

Results:
As the result of evaluation of carbohydrate metabolism, 24 patients were diagnosed with type 2 DM (fasting glucose> 7.0 mmol / L; 2-hour oral glucose tolerance test (OGGT) >11.1 mmol / L, HbA1c >6.5%)), 30 - prediabetes (fasting glucose from 5.6 to 6.9 mmol / L or 2-hour OGGT - from 7.8 to 11.0 mmol / L, HbA1c from 5.7 to 6.4%). The level of IL-10 was increased in patients with AH and prediabetes (90.8 (90.6-91.1) pg / ml, p <0.05). At the same time, patients with AH combined with T2DM were characterized by the decrease of IL-10 level (77.4 (75.5-79.3) pg / ml, p <0.05). According to the results of discriminant analysis, directed to search of signs that allow to differentiate prediabetes and T2DM, it was found that IL-10 and HbA1c are exactly the required signs:
Type 2 DM = 5,216xIL-10 + 2,643xHbA1c-211,174;
Prediabetes = 6,114xIL-10 + 3,059xHbA1c-290,53.

Conclusions:
These studies demonstrate that an increase in the level of anti-inflammatory IL-10 in patients with AH and prediabetes can serve as a protective reaction and an early marker of carbohydrate metabolism disorders. Changes in the levels of IL-10 and HbA1c are the most important prognostic factors that affect the development of carbohydrate metabolism disorders in hypertensive patients.
THE EFFICACY OF COMBITATION OF EMPAGLIFLOZIN AND METFORMIN IN PATIENTS WITH ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS
Authors: Zhuravlyova Larysa , Filonenko Maryna , Rogachova Tetyana , Sokolnikova Nelly 
Published: June 2023

Objective:
To determine the efficacy of combination of empagliflozin and metformin in patients with arterial hypertension (AH) and type 2 diabetes mellitus (T2DM).

Design and method:
A total of 52 patients with AH, stage II; obesity, stage I and concomitant T2DM were examined (28 women and 24 men, mean age 58.4 ± 2.9, fasting plasma glucose < 9 mmol/L, glycosylated hemoglobin (HbA1c) - 7.54 ± 1.2%, mean blood pressure (BP) 167/104 ± 15.5/3.6 mm Hg, BMI 32.2 ± 2.1 kg/m2, disease duration 5.4 ± 1.6 years,). Two groups of patients were formed: the comparison group included 25 patients who received metformin 1000 mg 2/day, amlodipine 10 mg 1/day and lisinopril 10 mg 1/day. Patients of the main group (n = 27) received empagliflozin 10 mg in addition to standard therapy. The follow-up period lasted 6 months.

Results:
The following results were obtained by the end of the study period: HbA1C in the main group was 6.23±0.7%, while in the comparison group – 6.58±0.5% (p < 0.05). 46.6% of patients in the main group had achieved the target HgA1c<7.0% compared to 24.5% in the control group (p<0.01). There was no significant increase in the frequency and severity of hypoglycemic episodes. The patients of the main group were characterized by greater weight loss (3.4±0.4 kg) than those of comparison group (0.9±0.3 kg), p<0.01. The mean systolic BP in the main group was 133 ± 6.12 mm Hg., while in the comparison group - 147.2 ± 8.13 mm Hg., p < 0.05. The diastolic blood pressure (DBP) was 84.6 ± 3.7 mm Hg and 89,8 ± 5.1 mm Hg, respectively.

Conclusions:
The obtained data suggest that inclusion of empagliflozin into a standard therapy of hypertension and type 2 diabetes provides multiple benefits, namely: improves glycemic control, ensures better regulation of blood pressure and promotes weight loss.
ROSUVASTATINE TREAMENT IN A BIG UKRAINIAN COHORT OF PATIENTS WITH TYPE 2 DIABETES
Authors: Torbas Olena , Kushnir Svitlana , Sirenko Yuriy 
Published: June 2023

Objective:
Diabetes mellitus (DM) remains one of the most important cardiovascular risk factors significantly worsening the prognosis in patients with hypertension and dyslipidemia. The leading role among drugs for the treatment of such patients is played by statins with their powerful influence on the development and progression of atherosclerosis and its complications. We used the OZIRKA study database and performed additional subanalysis to study the effects of rosuvastatin in patients with diabetes and dyslipidemia. To study the effect of Ozalex (rosuvastatin) on lipid and cholesterol levels in patients with lipid metabolism disorders and hypercholesterolemia and DM.

Design and method:
A prospective open population study on a primary care level. Recruitment of patients was conducted from March to December 2019. The analysis of the study data was conducted from June to November 2020. All patients attended in total 3 visits.

Results:
A total of 20,000 patients from all over Ukraine were included in the study. The full follow-up period was completed by 18,100 patients, of whom 17,530 had all the necessary data, and they were included in the final analysis. The mean follow-up period was 2.2 months. Approximately 13% of patients included in the study had DM type 2. We observed a significant reduction in total cholesterol, LDL and triglyceride levels in patients with diabetes. In addition, there was a tendency to increase the level of HDL in this group of patients. In general, it can be noted that there was a significant improvement in lipid profile in patients with diabetes - the level of total cholesterol decreased by 28%, LDL cholesterol by 34%, and triglycerides by 24%. Administration of rosuvastatin did not impair glucose control in any way in the group of patients with DM, moreover, even in the group of people without DM there was no negative effect of rosuvastatin on fasting glucose level.

Conclusions:
In general, we can recommend rosuvastatin in a dose of 10 to 20 mg as an optimal start of statin therapy at the stage of primary care for patients with DM.
TOTAL CARDIOVASCULAR RISK ASSESSMENT AND CAROTID DAMAGE IN HYPERTENSIVE INDIVIDUALS WITH TYPE-2 DIABETES/PRE-DIABETES: A PILOT STUDY
Authors: Menti Ariadni , Kollias Anastasios , Kyriakoulis Konstantinos , Ntousopoulos Vasileios , Stathopoulou Panagiota , Theodosiadi Aikaterini , Ntineri Angeliki , Bountzona Ioanna , Asimakopoulou Athina , Stergiou George S. 
Published: June 2023

Objective:
This study compared the performance of cardiovascular disease (CVD) risk prediction scores in terms of their association with preclinical carotid damage in patients with type-2 diabetes/pre-diabetes and hypertension without established CVD.

Design and method:
Adults (> = 18 years) with type-2 diabetes/pre-diabetes and hypertension, without pre-existing CVD were assessed through anthropometric parameters and blood tests. Preclinical carotid damage was assessed by echocardiographic estimation of Carotid Plaque Score (CPS). Carotid damage was defined as CPS higher than the value of the 75th percentile and/or carotid stenosis >50%. Five CVD risk scores were considered (SCORE2/OP2; FRAMINGHAM; UKPDS STR; UKPDS CHD; ASCVD).

Results:
Fifty-one individuals with complete data on age, sex, smoking, lipid profile and HbA1c were analyzed [mean age (years) 63.7±8.0 (SD), 63% males, body mass index (BMI) (kg/m2) 31.4±5.0 (SD), 44 diabetes, LDL-cholesterol 99.3±32.1 mg/dl, HbA1c 6.4±0.8%]. The C-statistic (ROC curve) in identifying patients with carotid damage was 0.642 [95% CI 0.487, 0.797] for SCORE2/OP2, 0.576 [95% CI 0.408, 0.745] for FRAMINGHAM, 0.696 [95% CI 0.553, 0.839] for UKPDS STR, 0.644 [95% CI 0.491, 0.796] for UKPDS CHD and 0.563 [95% CI 0.396, 0.730] for ASCVD. The UKPDS STR had a significant higher C-statistic value compared to ASCVD (p<0.05), whereas no other score discriminated better than the others in identifying individuals with preclinical carotid damage (p = NS).

Conclusions:
This pilot analysis suggests that the available CVD risk prediction scores show moderate ability in identifying which patients with type-2 diabetes/pre-diabetes and hypertension have preclinical carotid damage. Although there seems to be no superiority of any of them, the UKPDS STR performed somewhat better.
ASSOCIATION OF SERUM VITAMIN E WITH DIABETES IN THE US NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES) 2001-2006
Authors: Liang Xiaopeng , Chou Oscar Hou In , Cheung Bernard Man Yung 
Published: June 2023

Objective:
Although there has long been interested in how vitamin E affects human health, the effect of vitamin E on diabetes is controversial. This study aimed to investigate the relationship between serum alpha-tocopherol (the main form of vitamin E) and diabetes.

Design and method:
The National Health and Nutrition Examination Survey (NHANES) 2001-2006 included 8240 non-pregnant adults aged over 20 in this cross-sectional study. Participants with invalid data on fasting glucose or glycated haemoglobin, serum vitamin E and covariates, including demographics, socioeconomic status, smoking, alcohol, medical history, and vitamin E supplements, were excluded. Restricted cubic spline and logistic regression were used to examine the association between serum vitamin E with diabetes.

Results:
7.3% (95% CI, 6.6-8.0) of participants had diabetes. The mean (± standard error) serum vitamin E was (28.62 ± 0.34) μmol/L. Serum vitamin E greater than 45.8 μmol/L was highly associated with diabetes [OR = 1.56, 95% CI (1.24-1.80), P < 0.01]. Stratified by gender, the cut-off serum vitamin E concentration with an odds ratio less than 1.0 was 41.6 μmol/L for men and 48.5μmol/L for women. The odds ratio for high serum vitamin E (> 41.6μmol/L for men or > 48.5μmol/L for women) associated with diabetes was 1.77 [95% CI (1.35-2.13)] in men and 1.49, [95% CI (1.30-1.72)] in women.

Conclusions:
High serum vitamin E is associated with diabetes; this association is stronger among men. Prospective research is needed to investigate whether there is a causal relationship.
LINKING ULTRASOUND ASSESSMENT OF RENAL ARTERIES TO THE CARDIOVASCULAR AND RENAL EVENTS AT HYPERTENSIVE PATIENTS WITH OR WITHOUT DIABETES MELLITUS
Authors: Gavrila Adrian Ion , Mehedintu Anca 
Published: June 2023

Objective:
The objective of the study was to estimate how the ultrasound parameters of the renal arteries correlate with cardiovascular and renal events at hypertensive patients (pts), with or without diabetes mellitus (DM).

Design and method:
50 hypertensive pts (mean age 59.5±9.4 years, 52% males) = group 1 and 50 hypertensive pts with DM, matched for age and sex (mean age 61.4±10.5 years, 54% males) = group 2. Vascular ultrasound parameters performed in renal arteries were: peak systolic velocity (PSV), resistance index (RI), end-diastolic velocity (EDV), systolic acceleration time (SAT), renal versus aortic systolic velocity ratio (RAR). All pts were evaluated during one year, in order to detect the following complications: unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), ischemic stroke (IS), renal dysfunction (RD): microalbuminuria, proteinuria, chronic kidney disease.

Results:
In group 1, UA was significantly associated with higher RI (0.79±0.07 vs 0.61±0.08, p = 0.04). In the same group, RD was found in a significant higher proportion at pts with longer SAT (74±1.1 ms vs 47±1.3 ms, p = 0.01).
In group 2, UA was also significantly associated with greater RI (0.76±0.04 vs 0.58±0.05, p = 0.02). NSTEMI was significantly more frequent at pts with greater RI (0.80±0.08 vs 0.59±0.07, p = 0.01) and with higher RAR (3.5±0.2 vs 2.2±0.3, p = 0.04). In the same group, RD was found in a significantly higher proportion at pts with longer SAT (71±1.3 ms vs 43±1.2 ms, p = 0.02) and with higher RAR (3.8±0.2 vs 2.3±0.1, p = 0.04).

Conclusions:
Higher RI and greater RAR seem to predict a worse midterm outcome (one year) concerning cardiovascular events at hypertensive pts, especially with DM.
Moreover, greater RAR appears to have more powerful midterm prognostic value for incidence of acute coronary syndromes without ST-segment elevation at hypertensive pts with DM.
Longer SAT may have a relatively good correlation with the development of RD in both groups of pts.
BASELINE REMNANT CHOLESTEROL MODIFIES THE EFFECT OF INTENSIVE BLOOD PRESSURE CONTROL ON CARDIOVASCULAR OUTCOMES IN PATIENTS WITH TYPE 2 DIABETES: THE ACCORD-BP TRIAL
Authors: Chen Chao-Lei , Nie Zhi-Qiang , Feng Yingqing 
Published: June 2023

Objective:
The equivocal benefit of intensive blood pressure lowering in patients with diabetes may be partially due to the neglected residual cardiovascular risk. However, it remains uncertain whether residual cholesterol (RC) level affect the benefit of intensive blood pressure lowering in patients with diabetes. We aimed to determine whether the treatment difference of intensive versus standard blood pressure therapy on risk of cardiovascular events (CVD) in the ACCORD-BP trial depended on baseline RC level.

Design and method:
Participants in the ACCORD-BP trail were divided into two groups based on baseline RC levels (low RC: < 31 mg/dL and high RC: 31mg/dL and higher). We report the primary outcomes identical to those used in the original ACCORD trial, which included nonfatal myocardial infarction, nonfatal stroke, and/or incident cardiovascular death. Adjusted hazard ratios (aHR) with 95% confidence intervals (CI) estimated from stratified Cox regression models were used to quantify the association between intensive therapy and incident CVD for the 2 different baseline RC groups.

Results:
The incident rate was significantly lower in the intensive-therapy group as compared with standard-therapy group in the low RC group (log-rank P = 0.029) but not in the high RC group (log-rank P = 0.74). Compared with standard therapy, intensive therapy was associated with a lower risk of incident CVD among participants with low RC (aHR: 0.71; 95% CI: 0.53 to 0.94), but not among participants with high RC (aHR: 1.04; 95% CI: 0.80 to 1.35). The same pattern was observed for nonfatal stroke (aHR [95% CI] in participants with low RC: 0.48 [0.25-0.93]; aHR [95% CI] in participants with high RC: 0.76 [0.41-1.41]). Subgroup analyses revealed that the protective effect of intensive therapy against CVD events among the low RC group was not influenced by sex, previous CVD at baseline, assignment to intensive glycemic control, systolic or diastolic blood pressure at baseline, and baseline low-density lipoprotein cholesterol levels.

Conclusions:
Intensive blood pressure lowering therapy was effective at preventing incident CVD events in the ACCORD-BP trial participants with low baseline RC level but not in those with high RC level.
THE GREAT PRETENDER: COULD A PHEOCHROMOCYTOMA MANIFEST ITSELF AS A SEIZURE?
Authors: Miletic Marija , Stojanovic Milos , Tancic-Gajic Milina , Vujovic Svetlana 
Published: June 2023

Objective:
Seizures are defined as transient occurrence of signs or symptoms due to the abnormally excessive or synchronous neuronal activity in the cerebral cortex. Pheochromocytomas and paragangliomas (PPGL) are chromaffin cell tumors arising from the adrenal medulla in 80–85% of patients and from extra-adrenal sympathetic tissue in 10–20% of patients. PPGL has been referred to as ‘‘the great mimic’’ disease. We present a patient with pheochromocytoma possibly disguised as seizures.

Design and method:
A 44 years old woman was referred to University Clinic of Endocrinology by radiologist. Two years earlier she had syncopal crises . She complained of headache, heart palpitation and malaise, heart palpitations and fatigue during exertion and sense of panic. The maximal self-measured blood pressure was 160/100 mmHg, the pulse is 90-100 beats per min. Abdominal US: a hyperechoic change, 76x65mm was seen, then described in the right lobe of the liver. The following year she had two commotional crises of consciousness and spasms of the extremities . She had a non-specific slowing of FC on EEG on the right for 1-2 seconds. MSCT abdomenal : in the right adrenal gland, a mass 144 x 90mm, with clear borders, pressing into the liver and pushing the right kidney,. The 24h urine was collected, which confirmed a norepinephrine secreting pheochromocytoma. We administered long acting alpha blocking agent preoperatively. The complete surgical excision of the right adrenal mass was done, pathohistological diagnosis: Pheochromocytoma. The last EEG after sleep deprivation performed 2 months postoperatively was described as normal. The patient had no headache or seizure.

Results:
PPGLs have a notable ability of boosting NE levels systemically and hypertension, the most common sign of PPGL could facilitate the permeability of blood brain barrier to NE. Studies showed NE could play its anticonvulsant property at an appropriate concentration but has a proconvulsant effect in either too high or too low concentrations .

Conclusions:
The definite pathogenetic mechanisms explaining how PPGL can cause seizures are far from being clearly understood, though “the great pretender” should be considered as a possible etiological factor of seizures.
PARAGANGLIOMA AS CAUSE OF RESISTANT ARTERIAL HYPERTENSION: A CASE REPORT
Authors: Gulkevych Oksana , Mishchenko Larysa , Bezrodna Larysa , Bozhenko Galyna , Logvynenko Alla , Bezrodnyj Volodymyr 
Published: June 2023

Objective:
Approximately 3%of patients with resistant arterial hypertension are diagnosed with pheochromocytoma. On other hand, paragangliomas of the head and neck are rare, representing <0,5% of all head and neck tumors. They arise in a number of locations along the carotid sheath.

Design and method:
Herein, we present the case of a 66-year-old Caucasian woman (BMI 29,3 kg/m2) with resistant arterial hypertension (BP 160-170/100-110 mmHg while taking antihypertensive drugs: valsartan 320 mg/day, hydrochlorothiazide 25 mg/day, amlodipin 10 mg/day) and episodic headaches. Over the last 5 years prior to presentation, she had resistant hypertension and each year normal urinary metanephrine level and CT scan of the abdomen.

Results:
At the presentation a tumor (4,6x3,6x2,9 cm) was detected by ultrasound in the left submandibular region and laboratory tests detected a normal plasma metanephrine level - 0,16 nmol/l (reference values <0,36 nmol/l) and normal plasma 3-methoxytyramine level -<0,06 nmol/l (reference values<0,15 nmol/l) and increased plasma normetanephrine level - 3,25 nmol/l (reference values<1,05 nmol/l.
The tumor was surgically removed and a carotid paraganglioma was confirmed histologically.
After surgery, patient's blood pressure is controlled (130/80 mmHg) by taking a fixed combination valsartan 80/hydrochlorothiazide 6,25 mg /day).

Conclusions:
Patients with resistant arterial hypertension should be screened for secondary hypertension, even if such screening has already been done in previous years.