bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional status, body image satisfaction, and self-esteem in adolescents from the SI program for secondary school trial
Authors: Bodega P , Fernandez-Alvira J M , De Cos-Gandoy A , Moreno L A , De Miguel M , Rodriguez C , Tresserra-Rimbau A , Martinez-Gomez J , Ramirez-Garza S , Laveriano-Santos E , Estruch R , Lamuela-Raventos R M , Fernandez-Jimenez R , Santos-Beneit G 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Other. Main funding source(s): 1. SHE Foundation and "la Caixa" 2. Fondo de Investigación Sanitaria - Instituto de Salud Carlos III.

Background/Introduction
Adolescence is a sensitive period regarding self-esteem and body image. In particular, nutritional status could affect self-esteem levels and body image satisfaction.

Purpose
To evaluate the distribution of body image satisfaction by nutritional status, and to assess the relationship between body image satisfaction and self-esteem over adolescence.

Methods
1315 adolescents from the SI! Program for Secondary Schools trial were assessed at baseline (12.5 (0.4) years, 48.2% girls), first follow-up (1-FU) (13.9 (0.4) years, 47.6% girls) and second follow-up (2-FU) (15.8 (0.4) years, 48.4% girls). Adolescents were classified as having underweight, normal weight or overweight/obesity according to Center for Disease Control (CDC) standards for body mass index (BMI). Body image satisfaction and self-esteem were assessed with Stunkard's figure rating scale and self-esteem domain of the Child Health and Illness Profile-Adolescent Edition (CHIP-AE) questionnaire, respectively. The association between both variables was estimated using linear and logistic mixed models.

Results
Overall, only 14.6% of adolescents were systematically satisfied with their body image. Most adolescents with overweight/obesity desired to lose weight (89.7% at baseline, 84.9% at 1-FU, and 83.9% at 2-FU), while most adolescents with underweight desired to gain weight (76.3% baseline, 80.0% 1-FU, 84.0% 2-FU). The percentage of girls with normal weight desiring to lose weight increased from 33.4% at ~12 years of age to 45.9% at ~16 years of age, while the desire to gain weight increased in boys with normal weight (32.3% at baseline vs 38.2% at 2-FU) (Figure 1). Satisfied adolescents consistently presented higher self-esteem over time compared to unsatisfied adolescents, especially girls (Table 1).

Conclusion(s)
Body image satisfaction was consistently related to nutritional status over adolescence. The desire to lose weight in girls with normal weight increased over time, while the desire to gain weight increased in boys with normal weight. Data suggests that body image satisfaction could determine self-esteem levels. These results show how gender stereotypes may affect body image and self-esteem, and therefore eating and exercise behaviors, highlighting the importance to reinforce body acceptance through school-based health promotion interventions.
Persistent hypovitaminosis D among Italian patients with myocardial infarction
Authors: Aleksova A , Zandona' L , Beltrami A P , Pierri A , Stenner E , D'errico S , Sinagra G 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Previously we have demonstrated that hypovitaminosis D is common in the Italian population and it has a comparable deleterious effect to diabetes mellitus on survival after an acute myocardial infarction (AMI).

Aim
Here, we sough to evaluate if the prevalence of hypovitaminosis D changed over time, considering also frequent lockdowns in the last years due to COVID-19 pandemic.

Methods
Our large population of 1042 patients hospitalized for AMI, were divided into three groups, according to the year of enrollment: group 1 included 368 patients enrolled between 2014-2016, group 2 with 470 patients enrolled between 2017- 2019, and group 3 from 204 patients enrolled in the last three years, 2020-2022). We determined Vitamin D level at hospital admission and we evaluated whether the concentration of vitamin D changed in the last decade.

Results
The median concentration of vitamin D in our cohort of patients with AMI was 18.2 (11.48-25.73) ng/ml). Throughout the three groups (2014-2016, 2017-2019, 2020-2022), the median plasma vitamin D showed a trend toward an increase (17.3 (10.33 – 24.2) ng/ml, 18.95 (11.6 – 26.73) ng/ml, and 19.05 (12.5 – 27.3) ng/ml respectively), which was significant between the group 1 vs 2 and 3 (p = 0.033 and p = 0.004, respectively), while between the group 2 and 3 did not. Despite the trend of increase, the percentage of patients with hypovitaminosis D in each group remained high (61.4%, 53.8% and 52.0% respectively). As expected, samples taken between May and September have significantly higher vitamin D values compared to ones taken from October to April for each group (the group 1: 21.80 (15.55 – 31.23) ng/ml vs 15.8 (9.22 – 23.98) ng/ml, p &lt; 0.0001; the group 2: 22.05 (14.10 – 30.98) ng/ml vs 16.50 (11.03 – 23.90) ng/ml, p &lt; 0.0001); the group 3: 20.00 (11.90 – 26.90) ng/ml vs 16.30 (9.75 – 22.30) ng/ml, p = 0.001). In all three groups, low levels of Vitamin D were associated with worse outcome as previously we have shown.

Conclusions
There has been a trend of increasing vitamin D values over the years, but insufficient vitamin D levels persists. We did not observed a decrease of Vitamin D levels, over the pandemic, possibly due to media awareness that emphasized the significance of vitamin D administration against viral infection.
Exercise systolic blood pressure indexed to work rate predicts future risk of incident stroke
Authors: Carlen A , Lindow T , Cauwenberghs N , Elmberg V , Brudin L , Ekstrom M , Hedman K 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): 1) The CircM network, Linköping University 2) The Swedish Stroke Association.

Background
Hypertension is a major risk factor for stroke. Exaggerated peak systolic blood pressure (SBP) during exercise is associated with increased risk of hypertension in normotensive subjects, whereas low, rather than high, peak exercise SBP predicts cardiovascular and all-cause mortality.

Purpose
We aimed to study the risk of incident fatal and non-fatal stroke in relation to absolute and work rate indexed exercise SBP, in patients referred for exercise testing.

Methods
We cross-linked clinical data from 14,428 bicycle ergometer exercise tests with data from the National Patient Registry and the Registry of Prescribed Medications up until December 2019. Subjects with a history of cerebrovascular disease were excluded, as well as subjects with submaximal tests, a drop in SBP during exercise, or with missing SBP data at the end of exercise. Baseline comorbidity was defined as diagnosis of, or treatment for, hypertension, diabetes, hyperlipidemia, and coronary artery disease (CAD). Work rate indexed SBP response (SBP/Watt-slope) was calculated as the increase in SBP during exercise divided by the increase in work rate. We applied Cox regression to calculate hazard ratios (HR) with 95% confidence intervals (95% CI) for the risk of incident stroke in association to peak SBP and the SBP/Watt-slope. We used absolute values as well the upper limit of normal (≥2 Z scores) of a recently published reference population, with reference equation including age, sex, SBP at rest, Wmax (for SBP peak only) and height (for SBP/W-slope only). Analyses were adjusted for age, sex, and baseline comorbidity.

Results
In total, 7,946 subjects (54% male, age 55±13 years) were included, with baseline comorbidity of hypertension (28%), diabetes (7%), hyperlipidemia (16%), and CAD (13%). During a median follow-up of 8.4 years (inter quartile range 5.8-11.5), 3.1% developed ischemic (2.2%) or hemorrhagic (1.0%) stroke. There were positive associations to future stroke with absolute peak exercise SBP (HR: 1.08 [1.03 – 1.13] per 10 mmHg increase) and with SBP/Watt-slope (HR: 1.09 [1.05 – 1.14] per 1 mmHg/10 Watt increase), but not after adjustment for sex, age and baseline comorbidity. However, having a SBP/Watt-slope ≥2 Z scores was associated with an increased risk for stroke (HR: 1.56 [1.08 – 2.25)] after adjustment for baseline comorbidity, whereas an adjusted SBP peak ≥2 Z scores was not (HR: 0.62 [0.32 – 1.21]).

Conclusion
A workload-indexed SBP response (SBP/Watt-slope) above the upper limit of normal may help to identify subjects with no history of cerebrovascular disease at risk of future stroke. In contrast, the absolute exercise SBP response to exercise does not add substantial information to the risk estimation above age, sex, and baseline comorbidity.
Psychological well-being and illness perception in hypertrophic cardiomyopathy patients undergoing hybrid cardiac rehabilitation
Authors: Mierzynska A , Sadowski K , Piotrowicz R , Klopotowski M , Wolszakiewicz J , Lech A , Witkowski A , Smolis-Bak E , Kowalik I , Piotrowska D , Dobrowolski P , Dabrowski M , Sadowy E , Piotrowicz E 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute of Cardiology.

Background
Hypertrophic cardiomyopathy (HCM) is a congenital heart disease influencing patients' physical capacity and quality of life and increasing the risk of sudden cardiac death. For many years patients with HCM were advised to avoid physical activity and intense psychological stress. Current studies suggest that cardiac rehabilitation (CR) could be safe and beneficial for somatic and psychological status in HCM patients.

Method
In the RCT study assessing the efficacy of hybrid CR patients with HCM from rehabilitation (R) and control (C) groups were asked to fill the questionnaires regarding their psychosocial well-being (GHQ-28) and illness perception (Brief IPQ) at every stage of the study (baseline, 3, 6, 9, and 15 months).

Results
There was a significant improvement in the overall distress level in the R group (p=0,003), but not in the C group (p=0.559). There were no significant differences in the illness perception (p=0.200 for the R group and p=0.090 for the C group), although the R group showed significant short-term improvement after three months (p=0.032).

Conclusions
Cardiac rehabilitation can enhance the psychological well-being of HCM patients and their adjustment to illness. However, significant improvement is observed only in the first months after the rehabilitation.
Apolipoprotein B and cardiovascular risk in asymptomatic patients: need for systematic evaluation?
Authors: Halatiu V B , Rodean I P , Benedek I , Benedek T 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The involvement of apolipoprotein B (apoB) in atherogeneis is well known because of its role in the metabolism of lipids. Elevated levels of apoB have been found not only to be correlated with clinical atherosclerosis, but also with sub-clinical forms. Cardiovascular risk can be estimated based on clinical risk scores. However, the main limitation of these risk score models is to estimate only traditional risk factors and not other important factors such as apoB.

Purpose
To assess the interactive effects of apoB in asymptomatic patients, and its link to cardiovascular risk.

Methods
This prospective observational study included 811 asymptomatic participants. According to the median apoB value (set at 130 mg/ dl) the study population was divided into two groups as follows: group 1 – 713 patients with low apoB values and group 2 – 98 patients with high apoB. Also, for each patient personal data, such as family history of premature cardiovascular disease, smoker status, personal history of heart failure or atherosclerotis were obtained. Regarding the subclinical atherosclerosis the carotid thickness of intima-media was measured.

Results
Patients with high apoB are more frequent males (p=0.008) with a mean age of 57.6 ± 11.9 years old (p&lt;0.0001) and smokers (p=0.01). The apoB level was not higher in patients with known atherosclerosis or with traditional risk factors such as diabetes melitus, history of stroke, myocardial infarction, or hypertension. Although, subclinical atherosclerosis, expressed by the presence of carotid plaques is more frequent found in patients with elevated apoB levels (p=0.0001). A higher total cholesterol (p&lt;0.0001), triglycerides (p&lt;0.0001) and LDL-cholesterol levels (p&lt;0.0001) were identified in patients from group 2 compared with those form group 1. Moreover, the uric acid was observed to be correlated with the apoB serum level (5.2 ±1.5 vs. 6.2 ±1.7, p=0.001). The risk of diabetes melitus was also found to be higher in group 2 compared with group 1, expressed by the glycosylate haemoglobin (5.6 ± 0.7 vs 5.9 ± 1.1, p&lt;0.0001).

Conclusions
Apolipoprotein B level is correlated with subclinical atherosclerosis and worse outcomes expressed by a higher lipid profile and risk of diabetes melitus development. These findings highlighted that the determination of the apoB is therefore mandatory for a better stratification of cardiovascular risks in primary prevention of atherosclerosis.
Clinical outcomes after a home cardiac rehabilitation program
Authors: Parada Barcia J , Maria Sol Bravo Amaro M B A , Iria Sanchez I S , Maria Concepcion Abreu Pazo M C A , Antonio Chamorro Comesana A C C , Cristina Prieto Fernandez C P F , Cristina Fernandez Caamano C F C , Maria Jesus Garrido Ferrero M J G , Marisol Samartin Ucha M S U , Isabel Caride Gonzalez I C G , Inmaculada Gonzalez Bermudez I G B , Noa Pineiro Fernandez N P F , Eduardo Pena E P , Enrique Cespon Outeda E C , Andres Iniguez Romo A I N 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiac rehabilitation programs (CRP) still do not reach all patients with this indication. In the context of COVID-19 pandemic, the new home CRP model has been introduced.

Purpose
To evaluate the results in terms of control of cardiovascular risk factors (CVRF) and changes in functional capacity with home CRP.

Methods
Cross-sectional observational study that included 173 patients, ≥ 18 years, after acute coronary syndrome or after coronary revascularization, included in home PRHC. Electronic medical records were analyzed to collect data on baseline clinical variables at the entrance and exit after 2 months of the home CRP: smoking habit, weight, abdominal perimeter, total cholesterol, LDLc, HDLc, triglycerides, HBA1c, METS in stress test and employment status.

Results
A total of 173 patients has been studied. Mean age was 51.6 (SD: 7.94), 15.6% women. Indication for home CRP was non-ST-elevation myocardial infarction (NSTEMI) in 45.7% of patients, 31.8% had STEMI, 17.9% after elective coronary interventions, 3.5% after cardiac arrest, and 1.2% corresponded to other causes. Patients were at low risk in 50%, 48% moderate and 2% high risk. With 1, 2, or 3 vessels disease in 38.1%, 28.3%, and 33.5% respectively. Coronary revascularization was obtained by percutaneous interventions in 80.9% while 14.5% by surgery. Baseline 45.7% of patients were hypertensive, 71.7% dyslipidemic, 33.5% obese, 15.7% diabetic, and 14 % smoked at index admission. After two months of home CRP we obtained a reduction of 85.5% in smoking (p&lt;0.001), improvement in lipid control (p&lt;0.001), with a mean LDLc of 54.5 mg/dl, a loss of 4.6 kg of weight in obese people and improvement in 1.50 METS (p&lt;0.0001).

Conclusions
The present study indicates that home cardiac rehabilitation programs are a valid alternative in low- and moderate-risk patients after acute coronary syndrome.
Cardiac rehabilitation can change the destiny of the patient with ST-elevation acute coronary syndrome
Authors: Padilla Rodriguez G , Gomez Gonzalez A , Lucas Garcia M , Lopez Flores M C , Martinez Quesada M M , Garcia Rubira J C 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiac rehabilitation (CR) has become a basic element in the recovery of patients with acute coronary syndrome, since it achieves greater therapeutic adherence and better control of cardiovascular risk factors.

Purpose
We aim to describe the characteristics of patients with ST-elevation acute coronary syndrome (STEACS) included in a Cardiac rehabilitation program, as well as the achievement of prevention objectives and the occurrence of mayor adverse cardiovascular events (MACE).

Methods
Observational prospective study where a total of 664 STEMI patients admitted to a Coronary Unit during the years 2017-2020 were included. They were classified according to their participation in a CR program. We compared medical history, lipid-lowering treatment (prior, at discharge and titration), lipid levels at discharge and at 1-year follow-up, and degree of achievement of lipid targets. MACE (mortality, reinfarction, coronary revascularisation and restenosis) were observed at 2-year follow-up.

Results
From 664 patients, 351 were excluded due to lack of follow-up or early mortality. From a total of 313 patients (mean age 59.9±11.2 years; 81% male), 55.3% were included in the CR program. This group had a lower mean age (55.46±8.7 vs 65.39±11.5, P&lt;0.001), as well as a higher frequency of early ischaemic heart disease history and smoking, with a lower frequency of hypertension and diabetes (Table). Lipid-lowering treatment at discharge was similar in both groups. In patients undergoing CR, there was a lower level of total cholesterol and low-density lipoprotein cholesterol (LDLc) at one year follow-up (126.2±27 vs 137.2±34, P=0.002; 57.8±23 vs 67.5±26, P&lt;0.001) and a greater reduction in LDLc (41.4% vs 20.86%, P&lt;0.001) was achieved even from higher initial LDLc values. Titration of lipid-lowering treatment was also greater, with the old target of LDLc&lt;70 being achieved in a greater number of cases (81.5% vs 59.3%, P&lt;0.001). At 1-year follow-up, the new lipid reduction target (LDLc&lt;55 + 50% reduction) was achieved in only 26.8% of patients, with a greater reduction in the CR group (34.1% vs 17.9%; P=0.02). Although differences were observed in the follow-up in terms of mortality and new events, in favor of the CR group, these did not reach statistical significance.

Conclusions
Participation in a CR program is associated with better lipid control in patients admitted for STEACS. These programmes represent a basic tool for achieving lipid and cardiovascular risk factor targets and improved long-term clinical outcomes.
Arterial hypertension management in patients with confirmed coronary heart disease: how far are we from meeting prevention goals?
Authors: Gabulova R , Marza-Florensa A , Isayeva M , Rahimov U , Gahramanova S , Alaskarova S H , Ibrahimov F , Aliyev F , Imanov G , Musayeva A , Rasulova R , Zarbaliyeva N , Abasov R , Graham I , Grobbee D E 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
International registry studies offer useful information on the state of the cardiovascular risk factor management. The SURF CHD (Survey of Risk Factors in Coronary Heart Disease) II study is a clinical audit of the recording and management of major cardiovascular (CV) risk factors in patients with established coronary heart disease (CHD). CV risk factors’ control varies by countries and is typically insufficient, according to the prior studies.

Purpose
This study aimed to assess adherence to European Society of Cardiology (ESC) recommendations for secondary prevention of cardiovascular diseases based on the measurement of blood pressure (BP) control and its therapeutic management in patients with confirmed CHD at different hospitals in one of the regions at high risk for cardiovascular disease.

Methods
Eight public and private health care centres of Azerbaijan participated in the SURF CHD II study between November 2019 and April 2022. A one-page standard questionnaire of the study was used to collect information electronically on demographics, diagnostic category, risk factors, physical and laboratory data, and prescribed medications from consecutive patients aged ≥18 years with established CHD during outpatient visits. Uncontrolled arterial hypertension (AH) is identified as follows: systolic blood pressure (SBP) ≥140 mmHg or diastolic blood pressure (DBP) ≥90 mmHg.

Results
Data from 949 patients with CHD (the mean age 59.6±9.58 years; 27.3% female) were included in the study. Only 11.7% of participants were involved in a cardiac rehabilitation program. Previous history of AH was registered in 73,1% of participants, while uncontrolled SBP was detected in 59.6% of them. Regarding medications, 82.4% of patients were taking antihypertensive drugs: 52.2% were taking beta-blockers, 51.2% ACE inhibitors, 7.9% ARBs, and 31.7% calcium antagonists. Only 11.7% of participants were involved in a cardiac rehabilitation program.

Conclusion
The study results have shown that the implementation of the current ESC recommendations for CHD secondary prevention and in particular the control rate of BP is insufficient. Given the fact that patients are at very high risk with different comorbid pathologies, this is of great importance in the management of such patients. This should be taken into account by healthcare organizers when planning secondary prevention activities and public health protection measures, especially in the regions at high risk for cardiovascular disease.
Impact of physician's perception about LDL cholesterol control in clinical practice when treating patients in Spain
Authors: Cosin Sales J , Campuzano R , Diaz-Diaz J L , Escobar Cervantes C , Fernandez Olmo M R , Gomez-Doblas J J , Mostaza J M , Pedro-Botet J , Plana Gil N , Valdivieso P 
Published: May 2023

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): This work is a study of the Spanish Society of Cardiology and Spanish Society of Atherosclerosis, sponsored by Daiichi Sankyo Spain.

Objective
To understand the impact of physicians` perception about LDL-cholesterol (LDLc) control on the management of patients with dyslipidemia in Spain.

Methods
Cross-sectional and multicenter study, in which 435 healthcare professionals from 145 healthcare areas in Spain participated in face-to-face meetings, collecting qualitative and quantitative information related to hypercholesterolemia patients’ management. Additionally, aggregated anonymized data of the last 10 patients with hypercholesterolemia attended by each physician were collected and analyzed with descriptive statistics.

Results
A total of 4,010 patients (8%, 13%, 16% and 61% with low, moderate, high, and very high cardiovascular [CV] risk) were included. Physicians` perception was that 62% of their patients attained LDLc goals (66%, 63%, 61% and 56%, for low, moderate, high and very high CV risk, respectively). However, when looking into the data only 31% (vs 62% P&lt;0.01) of patients attained the risk-based LDL-C goals (47%, 36%, 22% and 25%, respectively). Overall, 33% of patients were taking high intensity statins, 32% statin/ezetimibe, 21% low/moderate intensity statins and 4% PCSK9 inhibitors. These numbers were 38%, 45%, 8% and 6% for very high CV risk patients and 44%, 21%, 21% and 4% for high CV risk patients, respectively. In only 32% of patients a change in lipid lowering therapy was performed after the visit, mainly combining statins with ezetimibe (55%). The proportion of patients achieving LDL-C goals improved as higher potency lipid-lowering therapy was used (Figure 2).

Conclusions
In Spain most patients with dyslipidemia do not achieve the recommended LDL-C goals because of an insufficient intensification of lipid lowering therapy, regardless of CV risk, at least in part due to the misperception of physicians about LDL-C control.