bluuebunny/crossref_metadata_2025_split huggingface dataset:
C91. “Successful management of ventricular septal rupture after myocardial infarction in elderly: the role of intra-aortic balloon pump and timing for surgery”: A Case Report
Authors: Pradityawati A , Pradana S Y , Habibi F N , Sidiek A , Safir S 
Published: March 2023

Abstract

Background
Ventricular septal rupture (VSR) after myocardial infarction (MI) is a case with a high mortality rate, early diagnosis and appropriate treatment are essential. Surgical VSR closure though challenging and associated with high mortality, remains one of the main therapy in VSR closure.

Case Presentation
A 70-year-old woman had a complaint about the shortness of breath (SoB). From anamnesis, 17 days before admission, she complained of chest pain. 15 days before admission, she was taken to a local hospital and got hospitalized for 7 days in the intensive care unit. ECG showed anterior MI. During admission, patient developed SoB. From echocardiography, it showed VSR at apical. She was referred to dr. Kariadi hospital for further management.
Coronary angiography showed total occlusion in mid LAD. An intra-aortic balloon pump (IABP) was inserted for stabilized hemodynamic and as bridging. Inotropic support was given and afterload reduction was also administered. Surgical VSR closure and coronary artery bypass grafting (CABG) was successfully performed on the 22nd day after the onset of MI. The patient was discharged 10 days after surgery in a good condition.

Discussion
The mortality of VSR varied significantly depending on the timing of surgery. Patients who underwent surgery within 7 days of presentation had a 54.1% mortality compared with 10 % mortality if the repair was delayed until after 21 days. The cornerstone of preoperative management of VSR is afterload reduction. IABP provides mechanical afterload reduction and augmentation of cardiac output.
C92. Successful Percutaneous Coronary Intervention (PCI) in Rare Case of Anomalous Aortic Origin of the Right Coronary Artery from the Opposite Sinus (AAORCA) Presenting as Inferior ST Elevation Myocardial Infarction (STEMI)
Authors: GK Ahimsa , N Taufiq , BY Setianto 
Published: March 2023

Abstract

Background
AAORCA from opposite sinus is a rare congenital anomaly that can present with symptoms similar to coronary artery disease, even sudden cardiac death. AAORCA with Inferior STEMI is a rare combination situation. Management of acute myocardial infarction with AAORCA is not well established and still debatable.

Case Summary
We presented a case 61 years old aged male with STEMI and AAORCA. He admitted to our hospital with complaint of retrosternal chest pain with ST segment elevation in inferior lead thus we diagnosed as Inferior STEMI. He underwent an emergency coronary angiography (CAG) that showed anomalous of right coronary artery (RCA) and total occlusion of the proximal RCA with atherosclerotic lesion. Stent then implanted at proximal of RCA. Further work-up by Computed Tomography Angiography (CTA) revealed an AAORCA with interarterial course.

Discussion
AAORCA with interarterial course that presents as inferior STEMI is a rare case. Diagnosis requires CAG and coronary CTA to identify anatomy and physiology so revascularization can be carried out appropriately. It is still arguable whether atherosclerosis or the interarterial course of AAORCA that caused acute MI. There is evidence that anomalous coronary arteries doesn’t increase atherosclerosis risk than normal. Total occlusion located at the distal to interarterial course reinforce that atherosclerosis may be the possible cause of acute MI. PCI could be the preferred choice in patients with inferior STEMI accompanied by AAORCA with evidence of atherosclerotic lesion, because may result in complete reperfusion and good clinical outcome.
C93. Temporary Pacemaker Lead Insertion with Echocardiography Guided Technique in Emergency Setting: a Case Report
Authors: Kristanto H , Rizal A 
Published: March 2023

Abstract

Background
The implantation of the temporary pacemaker (TPM) must be done in symptomatic bradycardia to provide adequate heart rate and stabilize hemodynamic. Transvenous TPM is inserted under the fluoroscopy guidance. However, in an extraordinary situation, such as the unavailability of the catheterization laboratory, transvenous TPM insertion can be performed with echocardiography guiding.

Case Summary
A 27 years old male came to our ER with symtomatic bradicardia. Emergency procedure like medical treatment and transcutaneous pacing were done, but failed to increase heart rate. We planned transvenous pacing with fluoroscopy but the catheterization laboratory was not immediately available. Echocardiography guided temporary pacemaker were done in ER successfully and the patient was strabilized.

Discussion
Emergency transvenous pacemaker implantation with echocardiography guiding can be accomplished successfully in our case without complication. There are several techical aspect that we should consider in temporary pacemaker insertion without fluoroscopy. We use femoral access and with echocardiography guided in our case. The confirmation of the lead placement using fluoroscopy was needed to ensure that the tip of the electrode was in the proper position. Future research that focuses on the safety and effectiveness of the technique across the range of operator skill levels is needed.
C94. The characteristics and outcome of pediatric patients with congenital heart disease (CHD) infected by coronavirus disease 2019 (COVID-19) between march 2020 to february 2021 at sanglah hospital: a case series of 12 patients
Authors: Ambara G S , Gunawijaya E , Yantie N P V K 
Published: March 2023

Abstract

Background
Coronavirus disease 2019 (COVID-19) has a complex connection to cardiovascular system. COVID-19 infection has been proven to cause significant dysfunction in lung, heart, and endothelial cells. Therefore, patients with complex congenital heart lesions have a high risk of developing severe complications and worse outcomes. This paper aims to determine the characteristics and outcome of pediatric congenital heart disease (CHD) patients infected by COVID-19 at Sanglah hospital.

Case Summary
Within the period of March 2020 to February 2021, there were 12 cases of pediatric CHD accompanied by COVID-19 infection, which consists of 8 females and 4 males within the age of 6 days to 18 years. Based upon symptomatic CHD classification, there were 4 cyanotic CHD cases and 1 acyanotic case, respiratory problems were reported in all 5 cases. These are pneumonia in 4 cases and respiratory distress caused by hyaline membrane disease (HMD) in 1 case. 2 cases require mechanical ventilation. The outcome of all inpatient cases were favorable.

Discussion
To date, there are only few scientific evidence detailing how COVID-19 affects CHD. We were unable to calculate the correlation analysis since the population sample was too small. The most severe cases that requires mechanical ventilation had comorbidities in the form of malnutrition and down syndrome. From the perspective of pathophysiology, one of the most important factor determining outcome was the severity of CHD itself. Other contributing factors were COVID-19’s destructive effect on heart tissue and co-infection by other microorganism.
C95. The electrocardiographic changes in a hypertensive COVID-19 patient who received beta-blocker and favipiravir: a case report
Authors: Fatimah V A N , Istiqomah N S , Fadjri M 
Published: March 2023

Abstract

Background
Various electrocardiographic manifestations have been reported in COVID-19 which either result from myocarditis or insult-induced re-emerging of pre-existing condition. Some antiviruses used off-labelly for COVID-19, including favipiravir, are considered to be proarrhythmic. Meanwhile, anti-hypertensive drugs such as beta-blocker may induce bradyarrhythmia.

Case Summary
A 69-year-old male with confirmed COVID-19 and a history of uncontrolled hypertension presented with blood pressure of 216/111mmHg at admission. No sign and symptom of acute target organ damage had been reported. His electrocardiography showed normal sinus rhythm (heart rate [HR] 60bpm). The echocardiographic finding revealed normal heart function. He received favipiravir for 5 days, intravenous nicardipine (0.5mcg/kgBW/hour), and peroral amlodipine (1x10mg), candesartan (1x16mg), and bisoprolol (1x2.5mg). During hospitalization, the HR fluctuated between 52-109. On the sixth day, a total atrioventricular (AV) block with junctional escape rhythm (HR 66bpm) was present. Both favipiravir and bisoprolol were ceased simultaneously. The AV block persisted for 4 days then transformed into a junctional rhythm for the next 3 days and sinus bradycardia (HR 48bpm) thereafter. No pacing was performed.

Discussion
The possible differential diagnoses in this case include sick sinus syndrome (SSS), COVID-19-induced myocarditis, and drug-induced. The SSS might explain the wide variability of the HR. There were some reports presenting the sinus node dysfunction as a manifestation of SARS-CoV-2 infection. Further evaluation using Holter and/or electrophysiological study is warranted. Drug-induced cause may be excluded because the bradyarrhythmia remained after the cessation of both beta-blocker and favipiravir.
C97. The Important Role of Manual Aspiration through Guiding Catheter after Percutaneous Mechanical Thrombectomy (Angiojet) in Patient with Subacute Limb Ischemia due to Essential Thrombocytosis
Authors: A Ramadhani , H Hariawan , MT Ismail , VY Anggraeni 
Published: March 2023

Abstract

Background
Essential thrombocytosis (ET) is a myeloproliferative neoplasm characterized by increased platelet counts and excessive large and morphologically mature megakaryocytes in the bone marrow. ET may be complicated by thrombotic events, mostly in small and medium vessel. However there are limited evidence to guide management, particularly in cases with acute tissue ischemia. Understanding the basic pathophysiology concept of thrombosis in patient with ET is vital in choosing the right modality for revascularization.

Case Summary
A 73-year-old female with history of essential thrombocytosis presenting with severe debilitating pain on her right lower extremity. Physical examination showed decreased peripheral oxygen saturation. Dupplex Ultrasound revealed total thrombus at femoral artery dextra and no flow at popliteal artery, anterior and posterior tibial artery. We decided to perform revascularization with percutaneous mechanical thrombectomy (Angiojet). Arteriography evaluation still showing abundant number of thrombus. We continued with manual aspiration using guiding catheter and showing a remarkable result with normal blood flow down to the distal part with minimal residual thrombus.

Discussion
Histopatbological evaluations of arterial thrombi in ET revealed platelet-rich clots with abundant von Willebrand factor (VWF) and very little fibrin. Hence tllrombolysis agent used in CDT will not effective. Large thrombus which can not be lysed by fibrinolytic should be evacuated by a larger hole catheter aspiration
C98. The Role of Echocardiography as a Diagnostic Modality in Pulmonary Embolism in Intensive Care
Authors: Alaydrus S Q , Munirwan H 
Published: March 2023

Abstract

Background
Pulmonary embolism (PE) is the third most frequent cause of death in the world. In epidemiological studies, annual incidence rates for PE range from 39-115 per 100 000 population. Acute PE interferes with both circulation and gas exchange. Right ventricular (RV) failure due to acute pressure overload is considered the primary cause of death in severe PE.

Case Summary
A 70-year-old female patient presents to the emergency room of RSUDZA with complaints of typical chest pain that has been experienced since 3.5 hours before admission. In the emergency department, patients with obesity status with a general condition are weak and agitated. Physical examination found within normal limits. From laboratory test, there were leukocytosis and increasing of D-Dimer. From ECG we found McGinn White Sign. Based on echocardiography, we found RV/LV basal ratio &gt; 1 accompanied by Mc Connel sign and decreased right ventricular systolic function.

Discussion
Echocardiography is one of diagnostic modalities that is very useful for making a diagnosis, where the use of echocardiography is more accessible than computer tomography (CT) as the gold standard. In this case, by using echocardiography especially in intensive rooms, the diagnosis of pulmonary embolism can be established faster in high risk patients. The prognosis of pulmonary embolism is very dependent on the speed at which the diagnosis is made.
C99. Torsade de pointes in coronavirus disease 2019 patient: hypopotassemia, cardiac injury, and drug-induced arrhythmia
Authors: Shandy C A , Jayantika I G A B K 
Published: March 2023

Abstract

Background
Coronavirus disease 2019 (COVID-19) is a viral disease with wide spectrum of clinical manifestation. Malignant arrhythmia had been reported, however the exact mechanism remains unclear. We present a case of Torsade de Pointes (TdP) in COVID-19 patient.

Case Description
A 28 years old female, post caesarean section, confirmed COVID-19, was consulted to cardiology department due to acute lung oedema and premature ventricular complex (PVC) bigeminy. Oxygen saturation dropped to 78% with non-rebreathing mask, so she was intubated. She got furosemide and amiodarone drip. Later on, she developed pulseless ventricular tachycardia, TdP. Defibrillation 200 J was done and MgSO4 2 gram intravenous bolus was delivered. The rhythm converted to normal sinus rhythm, with prolonged QT Interval (503 ms). Potassium level was 2.7, hs-troponin I level was 510.6, and IL-6 level was 33.95. Echocardiogram showed global normokinetic with EF 64% on dobutamin. Amiodarone was stopped. She got MgSO4 drip and potassium chloride drip.

Discussion
Cardiac involvement in COVID-19 are common. Possible mechanisms are systemic inflammation and cytokine storm, as shown by increased IL-6. Cardiac injury, marked by increased hs-troponin I, causes abnormal conduction and prolonged repolarization due to interstitial edema and cardiac fibrosis, with abnormal Ca2+ handling and down regulation of K+ channels. These, together with QT-prolonging effect of amiodarone and hypokalemia, hypoxia, or neurohormonal stress, can induce TdP. Early treatment, ECG monitoring, and correcting electrolyte imbalance are very crucial in COVID-19. Once lethal arrhythmia ensues, proper anti-arrhythmia administration and withdrawal of contributing medications can prevent mortality.
C101. Toxoplasmic Myocarditis in Immunocompetent Patient: A Rare Case Report
Authors: Suryawan Willy , Siswanto Bambang Budi , Kurniawan Agnes 
Published: March 2023

Abstract

Background
Toxoplasmosis is the most frequent protozoan infection among human. Primary acquired infections in immuno-competent hosts are usually asymptomatic or may cause only slight, self-resolving and not pathognomonic symptoms. Although often considered as benign, acute infections in young healthy adults can lead to heart inﬂammation, including acute myocarditis.

Case Illustration
A 28-year-old man was admitted to the hospital with a chief complaint of flu-like illness with intermittent fever and sharp chest pain. His physical examination was unremarkable. The electrocardiography showed no significant ST-T changes. His laboratory investigations gave the following results: elevated level of HsTrop T (571 ng/L; reference: &lt;4 ng/dL), SGOT (112 U/L; reference: &lt;41 U/L), SGOT (114 U/L; reference: &lt;41 U/L). The echocardiography showed lateral pericardial thickening with preserved left ventricular function. He underwent cardiac MRI (cMRI). The cMRI showed myocardial edema without ischemic scar. The serological test is positive for recent Toxoplasma infection. Therefore, the patient was diagnosed with acute toxoplasmic myocarditis and subsequently treated with corticosteroid, ACE-I, beta blocker, and a combination of pyrimethamine and clindamycin. His symptoms was improved.

Discussion
We reported a case of an acute toxoplasmic myocarditis in an immunocompetent young man. This case demonstrates the importance of determining the etiology of myocarditis in order to start an appropriate therapy and prevent possible sequeale.
Continuity of primary care among homeless adults with mental illness who received a housing and mental health intervention
Authors: To Matthew J , Mejia-Lancheros Cilia , Lachaud James , Hwang Stephen W 
Published: March 2023

Abstract

Background
Continuity of primary care (CPC) is associated with reduced mortality and improved health status. This study assessed the level of CPC and changes in CPC over 6 years among adults with experience of homelessness and mental illness who received a Housing First intervention.

Methods
Participants were adults (≥18 years old) with a serious mental disorder and experiencing chronic homelessness enrolled between October 2009 and June 2011 in the Toronto site of the Canadian At Home/Chez Soi study and followed until March 2017. Participants were randomized to Housing First with intensive case management (HF-ICM), Housing First with assertive community treatment (HF-ACT), or treatment as usual. For this report, 280 intervention group participants (HF-ICM, n = 193 and HF-ACT, n = 87) were analysed using data from health records. The main outcome was CPC measured by the Continuity of Care Index as a continuous and categorical variable among participants during 3 consecutive 2-year periods.

Results
Most HF-ICM participants had low levels of CPC, with 68%–74% of this group having low CPC across all time periods. Similarly, most HF-ACT participants had low levels of CPC, with 63%–78% of this group having low CPC across all time periods.

Conclusions
Among this group of individuals with mental illness who were experiencing homelessness, CPC remained low over 6 years of follow-up. This study highlights that housing and mental health interventions may need to place greater emphasis on improving CPC using effective strategies that are specifically geared towards this important goal among their clients.
Comprehensive mutation profiling from wastewater in southern Germany extends evidence of circulating SARS-CoV-2 diversity beyond mutations characteristic for Omicron
Authors: Agrawal Shelesh , Orschler Laura , Zachmann Kira , Lackner Susanne 
Published: March 2023

AbstractTracking SARS-CoV-2 variants in wastewater is primarily performed by detecting characteristic mutations of the variants. Unlike the Delta variant, the emergence of the Omicron variant and its sublineages as variants of concern has posed a challenge in using characteristic mutations for wastewater surveillance. In this study, we monitored the temporal and spatial variation of SARS-CoV-2 variants by including all the detected mutations and compared whether limiting the analyses to characteristic mutations for variants like Omicron impact the outcomes. We collected 24-hour composite samples from 15 wastewater treatment plants (WWTP) in Hesse and sequenced 164 wastewater samples with a targeted sequencing approach from September 2021 to March 2022. Our results show that comparing the number of all the mutations against the number of the characteristic mutations reveals a different outcome. A different temporal variation was observed for the ORF1a and S gene. As Omicron became dominant, we observed an increase in the overall number of mutations. Based on the characteristic mutations of the SARS-CoV-2 variants, a decreasing trend for the number of ORF1a and S gene mutations was noticed, though the number of known characteristic mutations in both genes is higher in Omicron than Delta.
Multimodal deep learning methods enhance genomic prediction of wheat breeding
Authors: Montesinos-López Abelardo , Rivera Carolina , Pinto Francisco , Piñera Francisco , Gonzalez David , Reynolds Mathew , Pérez-Rodríguez Paulino , Li Huihui , Montesinos-López Osval A , Crossa Jose 
Published: March 2023

Abstract
While several statistical machine learning methods have been developed and studied for assessing the genomic prediction (GP) accuracy of unobserved phenotypes in plant breeding research, few methods have linked genomics and phenomics (imaging). Deep learning (DL) neural networks have been developed to increase the GP accuracy of unobserved phenotypes while simultaneously accounting for the complexity of genotype–environment interaction (GE); however, unlike conventional GP models, DL has not been investigated for when genomics is linked with phenomics. In this study we used 2 wheat data sets (DS1 and DS2) to compare a novel DL method with conventional GP models. Models fitted for DS1 were GBLUP, gradient boosting machine (GBM), support vector regression (SVR) and the DL method. Results indicated that for 1 year, DL provided better GP accuracy than results obtained by the other models. However, GP accuracy obtained for other years indicated that the GBLUP model was slightly superior to the DL. DS2 is comprised only of genomic data from wheat lines tested for 3 years, 2 environments (drought and irrigated) and 2–4 traits. DS2 results showed that when predicting the irrigated environment with the drought environment, DL had higher accuracy than the GBLUP model in all analyzed traits and years. When predicting drought environment with information on the irrigated environment, the DL model and GBLUP model had similar accuracy. The DL method used in this study is novel and presents a strong degree of generalization as several modules can potentially be incorporated and concatenated to produce an output for a multi-input data structure.
Transcriptome profile in Drosophila Kc and S2 embryonic cell lines
Authors: Klonaros Daniel , Dresch Jacqueline M , Drewell Robert A 
Published: March 2023

Abstract
Drosophila melanogaster cell lines are an important resource for a range of studies spanning genomics, molecular genetics, and cell biology. Amongst these valuable lines are Kc167 (Kc) and Schneider 2 (S2) cells, which were originally isolated in the late 1960s from embryonic sources and have been used extensively to investigate a broad spectrum of biological activities including cell–cell signaling and immune system function. Whole-genome tiling microarray analysis of total RNA from these two cell types was performed as part of the modENCODE project over a decade ago and revealed that they share a number of gene expression features. Here, we expand on these earlier studies by using deep-coverage RNA-sequencing approaches to investigate the transcriptional profile in Kc and S2 cells in detail. Comparison of the transcriptomes reveals that ∼75% of the 13,919 annotated genes are expressed at a detectable level in at least one of the cell lines, with the majority of these genes expressed at high levels in both cell lines. Despite the overall similarity of the transcriptional landscape in the two cell types, 2,588 differentially expressed genes are identified. Many of the genes with the largest fold change are known only by their “CG” designations, indicating that the molecular control of Kc and S2 cell identity may be regulated in part by a cohort of relatively uncharacterized genes. Our data also indicate that both cell lines have distinct hemocyte-like identities, but share active signaling pathways and express a number of genes in the network responsible for dorsal–ventral patterning of the early embryo.