bluuebunny/crossref_metadata_2025_split huggingface dataset:
Waning Effectiveness of the BNT162b2 Vaccine Against Infection in Adolescents in Israel
Authors: Prunas Ottavia , Weinberger Daniel M , Pitzer Virginia E , Gazit Sivan , Patalon Tal 
Published: April 2022

Abstract

Background
The short-term effectiveness of a 2-dose regimen of the BioNTech/Pfizer BNT162b2 vaccine for adolescents has been demonstrated. However, little is known about the long-term effectiveness in this age group. It is known, however, that waning of vaccine-induced immunity against infection in adult populations is evident within a few months.

Methods
Leveraging the database of Maccabi Healthcare Services (MHS), we conducted a matched case-control design for evaluating the association between time since vaccination and the incidence of infections, where 2 outcomes were evaluated: documented SARS-CoV-2 infection (regardless of symptoms) and symptomatic infection (COVID-19). Cases were defined as individuals aged 12–16 with a positive polymerase chain reaction (PCR) test occurring between 15 June and 8 December 2021, when the Delta variant was dominant in Israel. Controls were adolescents who had not tested positive previously.

Results
We estimated a peak vaccine effectiveness between 2 weeks and 3 months following receipt of the second dose, with 85% (95% confidence interval [CI]: 84–86%) and 90% (95% CI: 89–91%) effectiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and coronavirus disease 2019 (COVID-19), respectively. However, in line with findings for adults, waning effectiveness was evident. Long-term protection was reduced to 73% (95% CI: 68–77%) against infection and 79% (95% CI: 73–83%) against COVID-19 3–5 months after the second dose and waned to 53% (95% CI: 46–60%) against infection and 66% (95% CI: 59–72%) against COVID-19 after 5 months.

Conclusions
Although vaccine-induced protection against both infection and COVID-19 continues over time in adolescents, the protection wanes with time since vaccination, starting 3 months after inoculation and continuing for more than 5 months.
The Effect of Macrolides on Mortality in Bacteremic Pneumococcal Pneumonia: A Retrospective, Nationwide Cohort Study, Israel, 2009–2017
Authors: Chowers Michal , Gerassy-Vainberg Shiran , Cohen-Poradosu Ronit , Wiener-Well Yonit , Bishara Jihad , Maor Yasmin , Zimhony Oren , Chazan Bibiana , Gottesman Bat-sheva , Dagan Ron , Regev-Yochay Gili ,   IAIPD research group, Cohen-Poradosu Ronit , Brosh Tal , Weinberger Miriam , Rogozin Evgeny , Bishara Jihad , Hershman Mirit , Tziba Yevgenia , Strahilevitz Jacob , Istomin Valery , Chazan Bibiana , Stein Michal , Maor Yasmin , Weber Gabriel , Cohen Regev , Katzir Michal , Chowers Michal , Schindler Yehudit , Glikman Daniel , Reisenberg Klaris , Oren Ilana , Ghanem-Zoubi Nasrin , Rahav Galia , Weider Anat , Wiener-Well Yonit , Dagan Ron , Regev-Yochay Gili 
Published: April 2022

Abstract

Background
Previous cohort studies of pneumonia patients reported lower mortality with advanced macrolides. Our aim was to characterize antibiotic treatment patterns and assess the role of quinolones or macrolides in empirical therapy.

Materials
An historical cohort, 1 July 2009 to 30 June 2017, included, through active surveillance, all culture-confirmed bacteremic pneumococcal pneumonia (BPP) among adults in Israel. Cases without information on antibiotic treatment were excluded. Logistic regression analysis was used to assess independent predictors of in-hospital mortality.

Results
A total of 2016 patients with BPP were identified. The median age was 67.2 years (interquartile range [IQR] 53.2–80.6); 55.1% were men. Lobar pneumonia was present in 1440 (71.4%), multi-lobar in 576 (28.6%). Median length of stay was 6 days (IQR 4–11). A total of 1921 cases (95.3%) received empiric antibiotics with anti-pneumococcal coverage: ceftriaxone, in 1267 (62.8%). Coverage for atypical bacteria was given to 1159 (57.5%), 64% of these, with macrolides. A total of 372 (18.5%) required mechanical ventilation, and 397 (19.7%) died. Independent predictors of mortality were age (odds ratio [OR] 1.051, 95% confidence interval [CI] 1.039, 1.063), being at high-risk for pneumococcal disease (OR 2.040, 95% CI 1.351, 3.083), multi-lobar pneumonia (OR 2.356, 95% CI 1.741, 3.189). Female sex and macrolide therapy were predictors of survival: (OR 0.702, 95% CI .516, .955; and OR 0.554, 95% CI .394, .779, respectively). Either azithromycin or roxithromycin treatment for as short as two days was predictor of survival. Quinolone therapy had no effect.

Conclusions
Empirical therapy with macrolides reduced odds for mortality by 45%. This effect was evident with azithromycin and with roxithromycin. The effect did not require a full course of therapy.
Impact of Vaccination and Early Monoclonal Antibody Therapy on Coronavirus Disease 2019 Outcomes in Organ Transplant Recipients During the Omicron Wave
Authors: Solera Javier T , Árbol Berta G , Alshahrani Abdullah , Bahinskaya Ilona , Marks Nikki , Humar Atul , Kumar Deepali 
Published: April 2022

Abstract

Background
Solid organ transplant (SOT) recipients are at high risk for complications from coronavirus disease 2019 (COVID-19) and vaccine breakthrough infections are common. We determined the effectiveness of ≥3 doses of mRNA vaccine and early monoclonal antibody therapy in reducing disease severity against the Omicron (B.1.1.529) variant.

Methods
Prospective cohort study of consecutive SOT recipients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection referred to our transplant center who were followed for at least 30 days. The primary outcome was supplemental oxygen requirement. Effectiveness of sotrovimab and ≥3 vaccine doses was estimated using adjusted risk ratios (RR).

Results
Three hundred adult organ transplant recipients were included. Seventy-one patients (24.1%) were hospitalized, 44 (14.9%) required supplemental oxygen, 19 (6.5%) were admitted to the intensive care unit (ICU), 15 (5.1%) required mechanical ventilation (MV), and 13 (4.4%) died. On multivariate analysis, age and multiple comorbidities were risk factors for oxygen requirement. Both receipt of ≥3 vaccine doses prior to SARS-CoV-2 infection and receipt of sotrovimab in the first 7 days of symptom onset was associated with a reduction in the need for supplemental oxygen (RR 0.30 [95% confidence interval {CI}: .17 to .54] and RR 0.24 (95% CI: .1 to .59), respectively]. For sotrovimab, the number needed to treat (NNT) to prevent one patient requiring oxygen was 6.64 (95% CI: 4.56–13.66). Both sotrovimab use and having received ≥3 vaccine doses were also associated with a shorter hospitalization length of stay.

Conclusions
In a cohort of SOT recipients with Omicron variant COVID-19 infection, prior receipt of ≥3 mRNA vaccine doses and early monoclonal antibody therapy were independently associated with significantly reduced disease severity.
OR12. Augmentation of endothelial progenitor cell proliferation in stable coronary artery disease subjects using human umbilical cord blood-mesenchymal stem cell-derived secretome in hyperglycemia condition
Authors: Hidayat D F O , Oktaviono Y H , Lefi A 
Published: April 2022

Abstract

Background and Aims
The number of endothelial progenitor cells (EPC) was decreased in stable coronary artery disease (SCAD) and diabetic patients. Human umbilical cord blood-mesenchymal stem cell-derived secretome (secretome) has the potential to improve the proliferation of EPC. This study aims to figure out the effect of the secretome on EPC proliferation of SCAD patients and hyperglycemia conditions.

Method and Results
EPC’s were isolated from peripheral blood samples and cultured for three days in the Stemline II medium. Cultured EPC’s were incubated with various concentrations of secretome (2%, 10%, and 20%). The other groups were treated with high glucose (25 mmol/L), a combination of secretome and high glucose, vascular endothelial growth factors-only (positive group), and the basal medium only (negative group). MTT cell proliferation assay kit was used to evaluate the EPC’s proliferation at 72 hours after reagent addition. The absorbance of MTT was measured in optical density (OD). The 20% secretome group was significantly higher than the positive control group (1.59 vs. 1.43; p &lt; 0.001). EPC proliferation in the secretome group is dose-dependent manner. EPC’s proliferation of the high glucose group was significantly lower than the negative control group (0.65 vs. 0.89; p &lt; 0.001). EPCs proliferation OD was significantly higher between a combination of 20% secretome and high glucose than the secretome-only group (1.78 vs. 1.59; p &lt; 0.001).

Conclusion
The secretome enhances the EPC proliferation of SCAD patients, even in a high glucose condition. The secretome is a new potential substance to modulate the EPC proliferation of SCAD patients.
OR20. Correlation between diabetes mellitus and significant in-stent restenosis in patient underwent coronary angiography evaluation
Authors: Putera N M , Pintaningrum Y , Habib P 
Published: April 2022

Abstract

Aims
Percutaneous Coronary Intervention (PCI) is a non-surgical invasive intervention with or without stenting performed on coronary heart disease (CHD) patient to improve blood flow of narrowed coronary arteries. One of the complication after PCI is in-stent restenosis (ISR), which is the narrowing of stented segment of coronary artery. Diabetes Mellitus (DM), is characterized by hyperglycemia, has long been known to increase the risk of CHD by 2-4 fold. Condition of hyperglycemia in diabetes has affects on the progression of neointimal hyperplasia (NIH) that progress to ISR. As the number of CHD patients with diabetes mellitus (DM) is expected to increase, so is the risk of ISR incidence in CHD patients with diabetes mellitus (DM) who undergo PCI.

Method and Results
A retrospective cross-sectional study was conducted using medical records of CHD patients who underwent coronary angiography evaluation between January 2018 and March 2020 at Catheterization Laboratory, Regional General Hospital of West Nusa Tenggara. Significant ISR was defined as diameter of stenosis ≥50% at coronary angiography evaluation. Total subjects were 66 subjects, with 33 DM subjects and 33 non-DM subjects, and ISR was found in 12 and 10 subjects respectively. There was no significant difference on the incidence of ISR between the DM and non-DM groups.

Conclusion
There was no correlation between DM and ISR, and there was no significant difference in the incidence of ISR between the DM and non-DM group in CHD subjects underwent coronary angiography evaluation.
OR21. Correlation between monocyte count and severity of coronary artery in patient with coronary arterial disease quantification using syntax score system hospitalized in nusa tenggara barat hospital
Authors: Humaera N N , Pintaningrum Y , Irawati D 
Published: April 2022

Abstract

Aims
Currently cardiovascular disease has become the first cause of non-communicable diseases death globally. It is predicted that the mortality rate will increase reaching up to 23.3 million in 2030. This study aims to investigate the correlation between monocyte count and severity of CAD quantification using Syntax Score.

Methods and Result
An observational cross-sectional study was conducted among CAD patients admitted in Nusa Tenggara Barat Hospital. The research data was documented from the medical and cathlab records of patients diagnosed with CAD during the period of December 2018 - October 2019 hospitalized in Nusa Tenggara Barat Hospital. Syntax score was calculated by Syntax Score 1 calculator. Statistical analysis were performed using SPSS 26.0 with Pearson correlation test. Sixty-five patients data was analysed. Majority of the subjects were men (80%) and 73.8% aged less than 65 years old. Approximately 69.2% exhibited low category syntax score and 76.9% had high monocyte level. Statistical analysis using Pearson correlation test finds p value 0.081 and r value is 0.218.

Conclusion
No correlation between Syntax Score with monocyte count was observed.
OR24. Creation and validation of 3D-printing based fluoroscopic coronary angiography simulator’s prototype as a learning media
Authors: Mawaris K , Gharini P P R , Anggrahini D W 
Published: April 2022

Abstract

Background and Aims
Obtaining a good projections of coronary angiogram (CA) and interpreting them is a complex ability for cardiology residents to learn. We aimed to create and validate a simple learning media protoype which can simulate fluoroscopic coronary angiography (FCA) phenomenon in a concrete way as well as being realistic, radiation-free, portable, and cost-effective.

Methods and Results
We used “Research & Development” steps. FCA simulator consisted of CT-scan derived transparent heart and opaque coronary mannequin, visible light and white screen in a minimized “C-arm” system, and video circuits. After interviewing anatomist (n = 1) and instrumentational engineer (n = 1), we obtained validation from FCA practitioners: cardiology interventionists (n = 3), cardiology interventional fellows (n = 2), and interventional radiographers (n = 3) by using a rating scale questionaire. Prototype was rated as very eligible (90%). Each aspect: relevance to curriculum (94%); educational value (92%); efficiency (88%); accuracy (90%); aesthetic (80%); durability (83%); safety (95%); portability (91%); cost (97%) were also rated as very eligible. Simulated images of right coronary artery were rated as very similar by all FCA practitioners, while left coronary artery’s (LCA) were rated as quite to very similar.

Conclusion
We successfully created a prototype of 3D-printing based FCA simulator. The simulator was able to demonstrate a concrete and visible phenomenon of CA, as well as radiation-free, portable, and cost-effective. The simulated images were realistic, however, improvement was needed for LCA. The protoype is very eligible for diagnostic CA learning media and ready to be field tested.
OR30. Effect of hyponatremia in heart failure patients at discharge on 30-day readmission rate: a single-centre study
Authors: Wibowo P G , Nathania M , Hasanah D Y , Soerarso R 
Published: April 2022

Abstract

Background and Aims
Hyponatremia is often observed in patients with heart failure. The proposed pathophysiology of hyponatremia in heart failure is due to increase of arginine vasopressin activity that elevates renal water reabsorption, thereby diluting sodium content in plasma. Hyponatremia has been identified as a factor that worsens heart failure patients' prognosis, including cardiovascular morbidity and mortality. Thus, this study was conducted to investigate the impact of hyponatremia in heart failure patients on rehospitalisation within thirty days.

Methods and Results
This is a single-centre prospective cohort study. A total of 205 acute decompensated heart failure patients admitted to National Cardiovascular Center Harapan Kita from July 2018 to March 2019 were included into the study. The study population was then divided into two groups based on predischarge sodium level. In this study, hyponatremia was defined as serum sodium level less than 135 mEq/l. Among the study population, 58 patients (28.3%) had hyponatremia at discharge. The data was analyzed using chi-square test. There were 19 patients who were readmitted within 30 days and 52.9% of them had hyponatremia at discharge. The effect of hyponatremic status at discharge to 30-day readmission rate was statistically significant (p = 0.03, OR = 3.19 95%CI 1.22-8.33).

Conclusion
Hyponatremia in heart failure patients at discharge is associated with increased risk of 30-day readmission.
OR32. Efficacy and Safety of Therapeutic Versus Prophylactic Dose of Anticoagulation in Hospitalized Patients with Severe COVID-19 Pneumonia and Coagulopathy: An Open-Label, Randomized Controlled Trial
Authors: Adrian L H , Hutomo S A , Negari A D S 
Published: April 2022

Abstract

Background and Aims
The use of therapeutic anticoagulation to improve outcomes in COVID-19-associated coagulopathy remains unclear. We aimed to compare the efficacy and safety of therapeutic versus standard prophylactic anticoagulation in this population.

Methods and Results
This was a single-center, open-label, two-arms, randomized controlled study conducted from 1st April to 15th July 2021. Two-hundred fifty severe COVID-19 patients with coagulopathy were randomly assigned (1:1 ratio) to receive either prophylactic anticoagulation (subcutaneous unfractionated heparin/UFH 5000IU b.i.d or fondaparinux 2.5mg o.d) or therapeutic anticoagulation (weight-adjusted dose UFH or fondaparinux). Anticoagulation was administered until hospital discharge or at the treating physician’s discretion. All patients received international COVID-19 guideline-driven therapy throughout the study. Baseline characteristics were not significantly different (p &gt; 0.05) between both arms, except for the D-dimer and CRP level at admission (p = 0.04; p = 0.001; respectively). During a 30-day follow-up, therapeutic arm revealed significant higher need for NIV/invasive MV (41.3% vs. 29%, p = 0.02), higher progression to ARDS (34.1% vs. 16.1%, p = 0.001), and increased 30-day all-cause mortality (58.7% vs. 15.3%, p &lt; 0.001) as compared with prophylactic arm. There was no significant difference between both arms in the incidence of acute MI (20% vs. 13.6%, p = 0.07), VTE (4.8% vs. 0.8%, p = 0.09), arterial thromboembolism (3.2% vs. 0%, p = 0.29) and overall bleeding (17.6% vs. 6.4%, p = 0.18) at 30-days.

Conclusion
Therapeutic anticoagulation was considered safe and effective in preventing thromboembolic events, but not in the need for NIV/invasive MV, progression to ARDS and 30-day all-cause mortality in hospitalized patients with severe COVID-19 and coagulopathy.
OR35. Exercise Effect on Global Myocardial Function Score in Patients with Refractory Angina Undergoing Extracorporeal Shockwave Myocardial Revascularization (ESMR): A Study focusing on Speckle Tracking and Exercise Stress Echocardiography
Authors: Tantawi P , Pratama A P , Maulana C A 
Published: April 2022

Abstract

Aims
Refractory angina pectoris (RAP) is defined as the occurrence of frequent angina attacks uncontrolled by optimal drug therapy. Extracorporeal shockwave myocardial revascularization (ESMR) is one of the alternative therapies that can be performed to treat RAP. Stress echocardiography is necessary to determine the inducible myocardial segments. To date, study evaluating the effect of exercise on myocardial function using WMSI and GLS was still limited. The aim of this study was to show the effect of exercise on global myocardial function evaluated using GLS and WMSI from echocardiography.

Methods and Results
This is a cross sectional and single center study of 9 Refractory Angina Pectoris patients underwent stress echocardiography from April - June 2021 in Mohammad Hoesin General Hospital, Palembang. Pre and post exercise WMSI and GLS were obtained and analyzed using McNemar non-parametric test. There were no significant differences between both pre and post GLS (p = 0.500) and WMSI (p = 0.250) through exercise stress echocardiography.

Conclusion
Our study showed no significant difference of global myocardial function evaluated by GLS and WMSI, pre and post exercise. Segmental myocardial function analysis seems to be more potential as useful assessment for RAP undergoing ESMR procedure.
OR39. High Level of Non-High-Density Lipoprotein Cholesterol Was Associated with Severe Coronary Artery Stenosis in Chronic Coronary Syndrome Patients at Sanglah General Hospital
Authors: Gunarsa M , Aryadana W , Artha J R 
Published: April 2022

Abstract

Aims
(1)To prove the association between non-HDL cholesterol level and severity of coronary artery lesions in chronic coronary syndrome (CCS) patients who undergo coronary angiography (2) Determine optimal cutoff value for non-HDL, LDL and TG cholesterol levels that were associated with severe coronary artery lesions in CCS patients.

Methods and Results
This is an analytic observational study using consecutive sampling technique that was conducted from June to November 2020. The relationship between non-HDL cholesterol and degree of coronary stenosis was assessed using Chi-square test. Of the subjects that were included, 90.3% (65/72) are men, mean age of 59.43 ± 8.9 years. Non HDL-C (cut off 104.5 mg/dL), has area under curve 0.846, sensitivity 80% and specificity 78.1%, (p &lt; 0.001). Bivariate analysis showed that high non-HDL cholesterol was related to the degree of severe coronary stenosis (prevalence ratio of 3.385; CI95% 1.819-6.296, p &lt; 0.001). Multivariate logistic regression analysis showed high non-HDL cholesterol is an independent predictor of severe coronary artery stenosis in CCS patients (OR of 25.8; 95% CI 6,46-103; p &lt; 0.001). Sub-analysis based on lipid fraction showed that high non-HDL cholesterol (&gt; 104.5 mg / dL) had better AUC (0.846), sensitivity (80%) and specificity (78.1%) compared to high LDL (LDL &gt;81 mg/dL with AUC 0.793, p &lt; 0.001/ Se 70%/ Sp 68.8%) and high TG (TG &gt; 132.5 mg/dL with AUC 0.623, p = 0.111/ Se 57.5% / Sp 53.1%).

Conclusion
High non-HDL cholesterol is independently associated with severe coronary stenosis in CCS patients, while having better association to severe coronary artery stenosis. Optimal cut off point for non-HDL-C, LDL-C and TG were 104.5 mg/dL, 81 mg/dL and 132.5 mg/dL.
OR52. Prolonged QRS duration as an independent predictor of extended in-hospital length of stay in congestive heart failure patients in the rural hospital
Authors: Sukmadja D , Hartoko B 
Published: April 2022

Abstract

Aims
This study was conducted to determine whether prolonged QRS duration in electrocardiography (ECG) measurement could be used as a predictor for extended in-hospital length of stay (LOS) in congestive heart failure (CHF) patients.

Methods and Results
We obtained data of 147 patients who were diagnosed with CHF for January 2019-December 2020 from medical records. Patients who were referred and not survived were excluded. Predictor analysis was performed using bivariate chi-square test and multivariate logistic regression. The median age of all patients was 56.0 ± 12.26 years, with predominantly male patients (66.7%). There were 13.3% cases with prolonged QRS duration (≥120 ms) and 45.9% cases with extended LOS (&gt;6 days). Bivariate chi-square test showed significant correlation between prolonged QRS duration and extended LOS in CHF patients (OR: 0.28, 95% CI: 0.09 to 0.82, p: 0.016). Multivariate logistic regression demonstrated that prolonged QRS duration was significantly associated with extended LOS in CHF patients (OR: 4.56, 95% CI: 1.46 to 13.96, p: 0.009).

Conclusion
Prolonged QRS duration was found to be an independent predictor of extended in-hospital length of stay in congestive heart failure patients, particularly in the rural area setting in which resources are limited.