bluuebunny/crossref_metadata_2025_split huggingface dataset:
TREATMENT WITH BLOCKERS OF THE RENIN-ANGIOTENSIN SYSTEM DOES NOT AFFECT RENAL FUNCTION IN PATIENTS WITH SEVERE COVID-19 ADMITTED TO INTENSIVE CARE UNIT
Authors: Salvo Francesco , Gallo Elisa , Botto Anna , Risoli Alessio , Parola Paolo , Tenio Rita , Nicoletti Ilaria , Valesano Paolo , Blangetti Ilaria , Morganti Alberto 
Published: June 2022

Objective:
Patients with severe COVID-19 admitted to Intensive Care Units (ICU) are often challenging because of the complications related to co-existing diseases. Among these hypertension is highly prevalent and blockers of renin-angiotensin system (RAS-B) are frequently reported as home drug therapy. However the influence of these medications on renal function and mortality is matter of debate.

Design and method:
We retrospectively analyzed clinical data and drug treatment of 90 patients (F/M 25/65) admitted in our ICU for severe COVID-19, with lung disease severity expressed as pO2/fractional inspired oxygen (P/F) below 300 mmHg. In normotensive (n = 35) and hypertensive patients previously treated with (n = 35) or without (n = 20) RAS-B, we compared systolic and diastolic blood pressure (SBP and DBP, mmHg), serum creatinine (SC, mg/dl) and potassium (SK, mEq/L) baseline and SC peak values reached during the admission in ICU. Rate of renal replacement therapy (RRT) and mortality were also recorded.

Results:
Baseline mean SBP and DBP were within the normal limits and similar in normotensive and in both groups of hypertensive patients while P/F was 157 ± 71 in normotensives and 137 ± 64 vs. 94 ± 30 respectively in hypertensives with and without RAS-B. In the latter two groups, baseline, SC and SK were similar (respectively 1 ± 0.5 vs. 1 ± 0.8 and 4 ± 0.6 vs. 4 ± 0.6) and peak SC values were similar as well (respectively 1.74 ± 1.3 vs. 1.71 ± 1.7). Among the seven patients who needed RRT three and four respectively were on and off treatment with RAS-B. Overall mortality was slightly but not significantly higher in hypertensive than in normotensive patients (31/55, 56% and 15/35, 43%) but similar in those with and without RAS-B (19/35, 54% and 12/20, 60%).

Conclusions:
These preliminary data suggest that in patients with severe COVID-19 admitted to ICU, the use of RAS blockers for the treatment of hypertension prior to the infection does not affect renal function, the need of RRT and mortality.
NIGHT-TIME BLOOD PRESSURE ASSESSED BY HOME VS. AMBULATORY MONITORING IN ADULTS WITH TYPE 2 DIABETES: ASSOCIATION WITH PRECLINICAL TARGET ORGAN DAMAGE
Authors: Bountzona Ioanna , Kollias Anastasios , Kyriakoulis Konstantinos , Destounis Antonios , Asimakopoulou Athina , Ntineri Angeliki , Stergiou George S. 
Published: June 2022

Objective:
To evaluate the relationship of night-time blood pressure (BP) assessed by home (HBP) or ambulatory BP (ABP) monitoring with preclinical target organ damage in adults with type 2 diabetes (DM2).

Design and method:
Hypertensive adults with DM2 or pre-diabetes on stable treatment were subjected to (i) 24 h ABP monitoring (20 min intervals, Microlife WatchBP O3), (ii) HBP monitoring (7 days with duplicate morning/evening measurements and 3 nights with 3 measurements/night, Microlife WatchBP Home-N), and measurement of (iii) echocardiographic left ventricular mass index (LVMI), (iv) carotid intima-media thickness (cIMT), (v) aortic pulse wave velocity (PWV) and ankle-brachial index (ABI), (Microlife PWV/ABI), (vi) urine albumin-creatinine ratio (ACR) in 2 different morning samples.

Results:
Seventy individuals were analyzed (mean age 65.2 ± 9.7 years, 47 males, body mass index 31.6 ± 4.8 kg/m2, 59 with DM2 and 11 with pre-DM). Daytime HBP was slightly higher than daytime ABP (mean difference 2.4 ± 9.3/0.5 ± 4.9 mmHg, systolic/diastolic, p < 0.05/NS). Similarly, night-time HBP was slightly higher than night-time ABP (2.1 ± 6.5/0.8 ± 5.0 mmHg, p < 0.05/NS). There was strong correlation between ABP and HBP (daytime r = 0.77/0.77 and night-time 0.88/0.80, systolic/diastolic) (all p < 0.05). Night-time ambulatory/home pulse pressure presented the following correlation coefficients with indices of target organ damage: LVMI r = 0.23/0.15; cIMT 0.28/0.28; ABI -0.21/-0.23; PWV 0.04/0.05; ACR 0.57/0.50 (p = NS for HBP-ABP comparisons). The agreement between night-time HBP and ABP in identifying individuals with nocturnal hypertension was 81% (kappa statistic = 0.63) and in detection of non-dippers 73% (kappa = 0.44).

Conclusions:
Night-time HBP monitoring in hypertensive adults with DM2 is feasible, strongly associated with night-time ABP and gives similar correlations with preclinical target organ damage. These methods also present substantial agreement in identifying individuals with nocturnal hypertension.
THE RISK OF COMBINED PATHOLOGY OF DIABETES MELLITUS AND TUBERCULOSIS
Authors: Semianiv Marianna , Semianiv Ihor 
Published: June 2022

Objective:
The aim of the study is a comprehensive retrospective assessment of the prevalence, features, course of treatment of multidrug-resistant tuberculosis and diabetes mellitus.

Design and method:
Our study is based on analysis of statistical data obtained from a retrospective study of 762 case histories and cases of MDR-TB in the register of tuberculosis patients for 2015-2019.

Results:
Depending on the type of TB case in our patients, we found that in both groups of the study the recurrence of TB prevailed – 49 cases (55.7%) against TB 39 cases (44.3%) of people in the main group; 363 cases (53.9%) against 311 (46.1%) in the control group (p < 0.05). The rate of successful treatment in gr.2 is probably higher than in gr. 1 (64.7% vs. 61.4%; (p < 0.05)). However, a more significant probable difference is characterized by the treatment rate, which in the main group is 27.3% versus 40.3% in the control group (almost 2 times; p < 0.05). The rate of ineffective treatment, which in patients with comorbidity was 27.3% (almost every third patient) against 17.6% in group 2 is also important for scientists and practitioners.

Conclusions:
There is a clear tendency to an increase the combined pathology and chemoresistance in the structure of the incidence of tuberculosis, the proportion of recurrences of tuberculosis in the presence of diabetes mellitus The pulmonary tuberculosis developed significantly more often in middle-aged patients with type 2 diabetes mellitus with moderate and severe states, the subcompensated form, with a complicated course. In patients with diabetes more often was registered a common tuberculous process in the lungs (79.5% of patients) and in all 100% of patients with syntropy bacterial excretion was registered, as well in all 100% of patients with syntropy bacterial excretion was registered. The rate of successful treatment for the presence of MDR-TB / diabetes syntropy is probably lower in the main group (61.4% vs. 64.7%; (p < 0.05)).
EFFECT OF EMPAGLIFOZIN ON 24-HOUR BLOOD PRESSURE, BRACHYAL ENDOTHELIAL DYSFUNCTON, AND LEFT VENTRICULAR DIASTOLIC FUNCTION, IN PATIENTS WITH TYPE-2 DIABETES MELLITUS
Authors: Rus Horatiu , Poinareanu Ionut , Bobescu Elena 
Published: June 2022

Objective:
Arterial hypertension is present in the majority patients with type-2 diabetes mellitus (DM) and is an important risk factor for heart failure and cardiovascular mortality. Previous data suggests that sodium-glucose transporter 2 (SGLT-2) inhibitors can effectively manage hyperglycemia, but also reduce blood pressure (BP) levels and the incidence of heart failure and death in these patients. The aim of this study is to evaluate the effects of empaglifozine on ambulatory blood pressure (BP) levels and endothelial dysfunction in patients with type-2 DM.

Design and method:
We evaluate 100 adult patients type-2 DM on monotherapy or combination therapy with metformin, sulphonylurea, DDP-4 inhibitor, or insulin, 50 from them (active group) being treated with empaglifozin 10 mg/day for 12 weeks. All study participants underwent 24-h ambulatory BP monitoring, endothelial dysfunction appreciated through flow mediated vasodilation(FMD) at the level of brachial artery, and left ventricular diastolic function with tissue Doppler derived E/e’ ratio at baseline and study-end.

Results:
Baseline demographic, clinical and laboratory parameters were similar in the two groups (age 62.72 ± 7.73 vs. 56.64 ± 10.35; p = 0.514). During follow-up, 24-hour brachial SBP decreased in the active (131.97 ± 12.42 vs. 124.27 ± 11.25; p < 0.001), but was similar in control group (129.85 ± 11.41 vs. 128.74 ± 12.25, p = 0.822).
Endothelial dysfunction significantly improve only in the empaglifozin group (5.1 ± 2.9/6.1 ± 3.00 vs 5.2 ± 2.8/5.1 ± 3.1; p = 0.001. Left ventricular diastolic function appreciated through E/e’ ratio improve in empaglifozin group (12.5 ± 8.00 /7.5 ± 6.00; p = 0,004), and remain altered in control group (11.8 ± 9.00 /11.3 ± 10.00; p = 0,862).

Conclusions:
Treatment with empaglifozin in diabetic patients produce clinically meaningful reductions in 24-hour brachial pressure, improve endothelial function and has an positive effect on left ventricular diastolic function. Besides Improvement in glycemic control, the positive effect on left ventricular function and vascular function and reactivity, may contribute to the cardiovascular benefits of the medication.
CANAGLIFLOZIN IS MORE EFFECTIVE THAN PERINDOPRIL TO IMPROVE RENAL HYPERFILTRATION AND URINARY ALBUMIN EXCRETION IN TYPE 2 DIABETES PATIENTS
Authors: Ramirez Agustin Jose , Pessana Franco , Sanchez Maria Jose , Sanchez Ramiro Ariel 
Published: June 2022

Objective:
Introduction: Albumin urinary excretion and glomerular hyperfiltration is frequently found in diabetes and hypertension. Although converting enzyme inhibitors and iSGLT2 could stabilize renal function in long term trials, short information was available in comparative studies.
Aims: To evaluate, in type 2 diabetic patients (T2DM) with arterial hypertension, the effects of either canagliflozin or perindopril on glomerular filtration rate (GFR) and microalbuminuria, after 6 months treatment

Design and method:
Methods: 15 patients with T2DM (59 ± 4y; 10 females) received, on top of their treatment, canagliflozin 300 mg daily while other 15 T2DM patients (62 ± 4y, 8 females), received perindopril 10 mg daily. Laboratory parameters determined at baseline and after a 6-month continued treatment included: HbA1C, fasting blood glucose, GFR, 24hs microalbuminuria and 24 h ambulatory blood pressure monitoring.

Results:

Results:
After 6 months under canagliflozin a decrease in HbA1C (from 8.1 ± 0.5 to 7.0 ± 0.4%; p < 0.05), SUA (from 7.9 ± 1 to 6.7 ± 2mg%; p < 0.05), microalbuminuria (from 90 ± 28 to 48 ± 14 mg/24 h; p < 0.01), GFR (from 148 ± 6 to 131 ± 4 ml.min; p < 0.01) and mean 24 h blood pressure (from 154 ± 6/96 ± 5 to 141 ± 3/86 ± 4mmHg; p < 0.05). However, under perindopril a decrease was only observed on GFR (from 137 ± 4 to 123 ± 7 ml.min; p < 0.01) microalbuminuria (from 88 ± 32 to 70 ± 27 mg/24hs; p < 0.05) and 24 h blood pressure (from 152 ± 7/98 ± 7 to 139 ± 6/84 ± 5mmHg; p < 0.05). Perindopril failed to change SUA or Hb A1C.

Conclusions:

Conclusions:
Compared to perindopril, canagliflozin seems to be more effective in improving renal function by involving additional mechanisms including amelioration of glycemia and uric acid plasma levels.
PREVALENCE OF DIABETES AND PREDIABETES AMONG ADULTS WITH HIV IN AFRICA: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Peer Nasheeta , Nguyen Kim , Hill Jillian , Kengne Andre-Pascal 
Published: June 2022

Objective:
Debate is ongoing on the relationship between HIV infection and type 2 diabetes mellitus with increased risk and no difference described in European populations. A systematic review and meta-analysis were conducted to 1) determine the pooled prevalence of diabetes and prediabetes among people living with HIV (PLWH) in Africa, and 2) examine the magnitude of diabetes and prediabetes by sociodemographic characteristics, body mass index, definitions used for diabetes and prediabetes diagnoses, and HIV-related characteristics.

Design and method:
A comprehensive search of major databases was conducted for original research articles published between 2000 and 2021. Relevant studies in English and French were included, irrespective of study design, data collection techniques and diagnostic definitions used. Study-specific estimates were pooled using random effects models to generate the overall prevalence of diabetes and prediabetes for each diagnostic definition and relevant sub-groups. Data analyses were conducted using the R statistical software and the “meta’’ package.

Results:
Of the 2211 records initially screened, 54 were selected from 346 full-text articles assessed for eligibility. Most included studies were from South Africa (n = 15), Tanzania (n = 7), Ethiopia (n = 6), with four each from Cameroon, Malawi and Uganda. All studies were cross-sectional by design and clinic-based, except for four population-based studies. The proportion of men ranged from 16–52%. Mean/median age ranged from 29–62 years. Diabetes prevalence was 4.8% (95%CI: 4.02–5.59) among 101,704 participants; biochemical testing combined with self-reported diabetes yielded a higher prevalence (oral glucose tolerance test: 6.2%, 95%CI: 2.5–11.3; fasting blood glucose: 6.4%, 95%CI: 4.9–8.1) than self-reported diabetes prevalence alone (3.7%, 95%CI: 2.5–5.2). Prediabetes prevalence was 13.7% (95%CI: 10.21–17.59) among 13,502 participants. There were no statistically significant differences in diabetes or prediabetes prevalence by sub-groups examined, including CD4 count, and antiretroviral treatment status and duration.

Conclusions:
Diabetes prevalence in PLWH in Africa probably reflects that of general populations with similar influences. The lower prevalence of self-reported diabetes vs. biochemical testing with self-report possibly demonstrates suboptimal diabetes detection in this vulnerable group who are in regular contact with healthcare services. The high prevalence of prediabetes likely foreshadows a substantial increase in future diabetes in African PLWH.
CARDIOVASCULAR EFFICACY OF GLUCAGON-LIKE PEPTIDE-1 RECEPTOR AGONISTS: A META-ANALYSIS OF CARDIOVASCULAR OUTCOME TRIALS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Boulmpou Aristi , Siskos Fotios , Stavropoulos Konstantinos , Imprialos Konstantinos , Koutsampasopoulos Konstantinos , Kassimis George , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Type 2 diabetes mellitus (T2DM) has gradually evolved as a metabolic pandemic. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are currently considered an attractive treatment option for diabetic patients with established atherosclerotic cardiovascular disease or for those with multiple risk factors.

Design and method:
We sought to update previous relevant meta-analyses, pooling data from the published cardiovascular outcome, placebo-controlled trials until 12th December 2021. We utilized data from published reports, also searching relevant supplementary appendices for any missing data. We evaluated the composite outcome of a major adverse cardiovascular event (MACE).

Results:
We pooled data from 9 trials for a total of 64,236 enrolled participants with T2DM assigned either to GLP-1RA treatment or placebo. GLP-1RA treatment resulted in a significant decrease in the risk for MACE by 11% (RR = 0.89, 95% CI; 0.82–0.95, I2 = 53%). No subgroup difference was detected between once-daily, once-weekly or continuous subcutaneous infusion of a GLP-1RA vs. placebo (p = 0.06). No publication bias was detected.

Conclusions:
Herein we demonstrated that GLP-1RAs provide a significant reduction in the risk for MACE in patients with T2DM regardless of type or frequency of administration.
“WHICH ONE SHOULD I CHOOSE, A GLP-1RA OR A SGLT2 INHIBITOR? OR MAYBE BOTH?’’. A POOLED ANALYSIS OF CARDIOVASCULAR OUTCOME TRIALS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Toumpourleka Maria , Imprialos Konstantinos , Stavropoulos Konstantinos , Karagiannis Asterios , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Glucagon-like peptide 1 receptor agonists (GLP-1RAs) and sodium–glucose cotransporter 2 (SGLT2) inhibitors are prioritized for the treatment of patients with type 2 diabetes mellitus (T2DM) to reduce major adverse cardiovascular events (MACE), hospitalization for heart failure (HF), cardiovascular death, or chronic kidney disease (CKD) development and progression, regardless of glycemic control. A question that inevitably arises is whether these drug classes can be combined in clinical practice, and if there is a synergistic cardio-protective effect with such a combination.

Design and method:
We sought to determine whether the SGLT-2 inhibitor/GLP-1RA combination confers or not a greater risk reduction on “hard’’ cardiovascular outcomes, compared to each drug class alone, by pooling relevant data from intention to treat analyses of the relevant cardiovascular outcome trials. We set as primary efficacy outcome the occurrence of a major adverse cardiovascular event (MACE), defined as the composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and as secondary efficacy outcome the occurrence of hospitalization for HF.

Results:
Concerning the primary efficacy outcome, we showed that treatment with SGLT-2 inhibitor/GLP-1RA combination compared to GLP-1RA/placebo resulted in a non-significant decrease in the risk for MACE (RR = 0.89, 95% CI; 0.67 – 1.19, I2 = 0%). When we compared treatment with SGLT-2 inhibitor/GLP-1RA combination with SGLT-2 inhibitor/placebo combination, we demonstrated again a non-significant effect in the risk for MACE (RR = 0.87, 95% CI; 0.68 – 1.10, I2 = 0%). Regarding the secondary efficacy outcome, treatment with SGLT-2 inhibitor/GLP-1RA combination conferred a significant risk reduction by 71% (RR = 0.29, 95% CI; 0.13 – 0.65, I2 = 5%), compared to GLP-1RA/placebo combination. In addition, a similarly significant decrease by 66% was shown for the SGLT-2 inhibitor/GLP-1RA combination compared to SGLT-2 inhibitor/placebo combination (RR = 0.34, 95% CI; 0.15 – 0.76, I2 = 0%).

Conclusions:
SGLT-2 inhibitor/GLP-1RA combination is not superior to SGLT-2 inhibitor or GLP-1RA monotherapy treatment for the prevention of MACE. However, subjects with HF might benefit from such a combination, since that combination is associated with a significant decrease in the risk for HF hospitalization, ranging from 66 to 71%.
BENEFICIAL EFFECT OF SODIUM-GLUCOSE CO-TRANSPORTER-2 INHIBITORS ON RIGHT VENTRICULAR SYSTOLIC FUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS: A PILOT, OBSERVATIONAL STUDY
Authors: Patoulias Dimitrios , Toumpourleka Maria , Katsimardou Alexandra , Zografou Ioanna , Imprialos Konstantinos , Stavropoulos Konstantinos , Karagiannis Asterios , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Cardiovascular disease remains the leading cause of mortality among patients with type 2 diabetes mellitus (T2DM). Sodium-glucose co-transporter-2 (SGLT-2) inhibitors is a new class of antidiabetics, conferring a significant cardiovascular risk reduction. However, underlying mechanisms are not fully understood. Right ventricular (RV) function is adversely affected early in the course of diabetes. Herein we sought to determine the effect of long-term use of SGLT-2 inhibitors on RV function.

Design and method:
In this pilot, observational study, we enrolled 20 patients with T2DM and stable antidiabetic and antihypertensive treatment over the last 6 months. Patients were planned to undergo a thorough echocardiographic assessment of RV function twice, before and 6 months after initiation of a SGLT-2 inhibitor. We set as primary efficacy outcome the change in tricuspid annular plane systolic excursion (TAPSE).

Results:
Mean age of participants was 62.8 ± 7.9 years, with a mean T2DM duration of 8.7 ± 6.1 years. Thirteen subjects were administered dapagliflozin, while the rest 7 were prescribed empagliflozin. Due to special regulations imposed in the context of coronavirus disease-19 (COVID-19) pandemic, mean treatment duration and follow-up period was 9.35 ± 3.4 months. SGLT-2 inhibitors led to a significant increase in TAPSE from 2.01 ± 0.23 to 2.12 ± 0.15 cm (p = 0.022). The result was significant for dapagliflozin (p = 0.015), while administration of empagliflozin resulted in a non-significant increase in TAPSE (p = 0.28). However, no significant difference between the two SGLT-2 inhibitors was shown (p = 0.7). Change in TAPSE was significant in subjects with prior history of cardiovascular disease (p = 0.024), while it was non-significant for subjects without previous cardiovascular disease (p = 0.26). Other parameters of RV function or RV dimensions were unchanged.

Conclusions:
This is the first study to assess the effect of long-term treatment with SGLT-2 inhibitors on RV function in subjects with T2DM, demonstrating a significant increase in TAPSE.
INCREASED INCIDENCE OF IMPAIRED FASTING GLUCOSE (IFG) AMONG HYPERTENSIVE PATIENTS NAÏVE TO HYPOLIPIDEMIC TREATMENT
Authors: Papadakis John A. , Ioannou Petros , Theodorakopoulou Vasiliki , Papanikolaou Kostas , Papazachariou Antria , Malikides Onoufrios , Filippatos Theodosios 
Published: June 2022

Objective:
Impaired fasting glucose (IFG) predisposes to future development of type 2 diabetes mellitus (T2DM) and may also be associated with increased cardiovascular disease (CVD) risk. Hypertension is an established CVD risk factor. The aim of this study was to assess the prevalence of IFG and the associated anthropometric and metabolic disturbances in patients with hypertension.

Design and method:
Consecutive hypertensive patients not on any hypolipidemic treatment and without a diagnosis of T2DM were included. IFG was defined as a serum glucose > 100 mg/dl according to American Diabetes Association criteria.

Results:
The total sample consisted of 1381 participants; between them 78 patients were diagnosed to have T2DM and they were excluded from the analyses leaving a final sample of 1303 hypertensive patients [41.0% men; median age 58 (range: 15–90) years] not on any hypolipidemic treatment and without a diagnosis of T2DM. IFG was identified in 469 patients (36%). IFG was more prevalent in males than in females (42.4% vs 31.8%, p < 0.001). Patients with IFG had greater body mass index (BMI), waist-to-hip ratio, systolic blood pressure, pulse pressure, triglycerides, alanine aminotransferase, gamma-glutamyl transferase and uric acid serum levels compared with patients with normal serum glucose levels.

Conclusions:
This study reveals that in a sample of patients with hypertension one out of three has IFG. This is more prevalent among men. IFG is associated with the presence of a more aggravated anthropometric and biochemical profile possibly associated with an increased CVD risk.