bluuebunny/crossref_metadata_2025_split huggingface dataset:
PARTICULARITIES OF HYPERTENSIVE PATIENTS WITH METABOLIC SYNDROME, ADMITTED FOR SARS-COV-2 INFECTION TO A CLINICAL EMERGENCY HOSPITAL
Authors: Stirban Raluca , Grigore Cristiana , Dragoi Doina , Balaceanu Beatrice , Gurau Cristian-Dorin , Voiculet Cornelia , Zaharia Magda , Dediu Giorgiana , Zara Octavian , Giuglea Carmen , Calin Camelia , Dina Ion , Balaceanu Alice 
Published: June 2022

Objective:
The aim of the study was to assess the clinical particularities and the lab tests in hypertensive patients with metabolic syndrome, admitted for SARS-COV2 infection.

Design and method:
We performed a retrospective study on 217 patients admitted to a Clinical Emergency Hospital between January 2021 and October 2021.

Results:
We had 217 patients admitted in internal medicine clinic for infection with SARS-COV2 virus, most of them with moderate and severe form of disease. From them, 148 patients (68.20%) had hypertension on admission and 114 patients (52.53%) had metabolic syndrome. Patients were aged between 23 and 99 (average age of 65 years). In comparison, the patients in the hypertensive subgroup were aged between 37 and 97 (average age of 70).
The gender distribution was similar in the large group and hypertensive subgroup: 52.07% male, 47.92% female in the large group, and 52.03% male, 47.97% female in the hypertensive subgroup.
At admission, the stages of SARS-COV2 infection in patients with metabolic syndrome, according CT examination, were severe in 54.41% of cases, moderate in 27.94%, and mild in 17.64%.
According the IDF definition of the metabolic syndrome, 8.33% of the patients had 5 criteria, 35.29% patients had 4 criteria, and 58.82% patients had 3 criteria of disease. Hypertension was encountered in 80.95% of patients with metabolic syndrome, obesity in 56.75% and diabetes mellitus in 52.70% of cases.
As comorbidities: cancer in 5.88% of patients, chronic heart failure in 26.47% of cases (72.22% NYHA II class and 27.78% NYHA III class), atherosclerosis in 55.88%, COPD in 7.35%, depression in 7.35% and dementia in 5.88% of cases.
High levels of the inflammatory markers or specific lab tests were encountered: CRP in 98.53% of cases, pro-calcitonin in 86.76%, ferritin 80.88%, IL-6 in 83.33%, D-dimers in 85.29%, NT-proBNP 71.92%, troponin 70.59%, LDH in 91.17%, uric acid in 11.76%.

Conclusions:
The most reliable comorbidity factor who predict evolution/prognosis of SARS-COV2 infection in patients with metabolic syndrome was diabetes mellitus (the levels of glycaemia and the need of high units of insulin), despite the fact that hypertension and obesity were more prevalent.
ASSOCIATION OF IN-PATIENT OUTCOMES AND RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM INHIBITOR USE AMONG HYPERTENSIVE PATIENTS WITH CORONAVIRUS DISEASE 2019 (COVID-19)
Authors: Lozada Ma. Cecilia , Medina Henry , Sucaldito Ma Sergia Fatima , Santos Lourdes Ella , David-Ona Deborah Ignacia , Oliva Raymond 
Published: June 2022

Objective:
RAAS inhibitors were speculated to increase expression of ACE2 receptors in the respiratory tract which was feared to lead to poorer outcomes among hypertensive patients infected with COVID-19. Current evidence has not confirmed Renin-Angiotensin-Aldosterone System inhibitors exposure as harmful in patients with COVID-19 infection. This study aims to determine the association between use of RAAS inhibitors and in-patient outcomes of adult hypertensive patients admitted for COVID-19.

Design and method:
A cross-sectional analytical study using case records was done on adult hypertensive patients admitted for COVID19 starting from March 2020 to March 2021 in a tertiary government hospital. The association of RAAS inhibitor use and in-patient outcomes was determined using Fisher’s chi-square test.

Results:
A total of 2,264 charts were reviewed for all COVID 19 patients admitted from March 2020 to March 2021, and 671 patients were determined to be hypertensive. Majority of hypertensive COVID-19 patients were male (52%), elderly (58%) and with moderate disease severity (51%). The most common comorbidities were community acquired pneumonia (59%), type 2 diabetes mellitus (44%) and chronic kidney disease (22%). A total of 66% (n = 442) of the hypertensive patients admitted for COVID were on RAAS inhibitors with losartan (40%) as the most commonly used agent. RAAS inhibitor use was not found to be associated with mortality (OR 0.74, 95% CI 0.57–1.10) and development of acute kidney injury (OR 1.12, 95% CI 1.12–1.69) among hypertensive COVID19 patients. However, RAAS inhibitor use was associated with decreased mortality among hypertensive patients classified with COVID-19 moderate disease (OR 0.42, 0.19–0.92, p-value 0.02).

Conclusions:
RAAS inhibitor use was not associated with increased mortality and development of acute kidney injury.
THE EFFECT OF DAPAGLIFLOZIN ON THE LEVEL OF SYSTOLIC BLOOD PRESSURE AND GLYCEMIC CONTROL IN PATIENTS WITH ARTERIAL HYPERTENSION AND TYPE 2 DIABETES
Authors: Zhuravlyova Larysa , Rogachova Tetyana , Sokolnikova Nelya , Filonenko Maryna 
Published: June 2022

Objective:
to determine the influence of dapagliflozin (D) on the level of blood pressure (BP) in patients with arterial hypertension (AH) and type 2 diabetes mellitus (T2DM).

Design and method:
A total of 57 patients with AH, stage II and concomitant non-severe T2DM were examined (fasting plasma glucose < 9 mmol/L, glycosylated hemoglobin (HbA1c) - 7.45 ± 1.3%, mean age 52.4 ± 2.8, mean BP 162/102 ± 3.5/2.3 mm Hg, BMI 28.3 ± 2.7 kg/m2, disease duration 6.6 ± 1.7 years,). Patients were divided into 2 groups: the comparison group included 23 patients who received metformin 850 mg 2/day, lisinopril 10 mg 1/day and amlodipine 10 mg 1/day. Patients of the main group (D-group, n = 34), received dapagliflozin 10 mg in addition to standard therapy.

Results:
6 months after beginning of therapy, the following results were obtained: HbA1C in the D-group was 6.28 ± 0.6%, in the comparison group – 6.56 ± 0.48% (p < 0.05). A slight decrease of BMI was observed in both groups (26.3 ± 1.2 kg/m2 and 27.4 ± 1.3 kg/m2, respectively), however, the changes were insignificant. Systolic blood pressure (SBP) in the D-group was 132 ± 7.24 mm Hg., and in the comparison group - 145.5 ± 9.17 mm Hg., (p < 0.05). The diastolic blood pressure (DBP) was 83.5 ± 3.8 mm Hg and 89,6 ± 4.2 mm Hg, respectively.

Conclusions:
the obtained data demonstrate that adding of dapagliflozin to a standard therapy of hypertension and concomitant type 2 diabetes leads both to significant decrease of SBP and improvement of glycemic control. The outcomes of our research suggest that dapagliflozin has a potential to reduce cardiovascular risk in hypertensive patients with type 2 diabetes.
THE SPECIFICS OF HEMODIALYSIS IN DIABETICS. EASTERN ALGERIAN EXPERIENCE
Authors: Zemmouchi Souheila 
Published: June 2022

Objective:
The management of diabetics on hemodialysis is particularly difficult due to frequent hypoglycaemia and significant inter and perdialytic glycemic variability that is difficult to predict. The aim of our study is to describe the clinical-biological profile and to assess the cardiovascular risk of diabetics undergoing chronic hemodialysis and to compare them to non-diabetic hemodialysis patients.

Design and method:
This cross-sectional, descriptive and analytical study was carried out between January 01 and December 31, 2018, involving 309 hemodialysis patients spread over 4 centers The data were collected prospectively then compiled and analyzed by the SPSS Version 10 software The FRAMINGHAM RISK SCORE has been used to assess cardiovascular risk in all hemodialysis patients

Results:
The survey involved 309 hemodialysis patients, including 83 diabetics, for a prevalence of 27% The average age 53 ± 10.2 years. The sex ratio is 1.5. 50% of diabetic hemodialysis patients retained residual diuresis against 32% in non-diabetics. In the group of diabetics, we noted more hypertension (70% versus 38% non-diabetics P 0.004), more intradialytic hypoglycemia (15% versus 3% non-diabetics P 0.007), initially vascular exhaustion was found. in 4 diabetics versus 2 non-diabetics. 70% of diabetics with anuria had postdialytic hyperglycemia. The study found a statistically significant difference between the different levels of cardiovascular risk according to the diabetic status.

Conclusions:
There are many challenges in the management of diabetics on hemodialysis, both to optimize glycemic control according to an individualized target, and to coordinate comprehensive and effective care.
CARDIOVASCULAR OUTCOMES WITH FINERENONE ACCORDING TO STATUS OF GLYCEMIA AT BASELINE AND PRIOR TREATMENT WITH NEWER ANTIDIABETICS AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Stavropoulos Konstantinos , Imprialos Konstantinos , Koutsampasopoulos Konstantinos , Boulmpou Aristi , Toumpourleka Maria , Siskos Fotios , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Type 2 diabetes mellitus (T2DM) and cardiovascular disease are closely interconnected. We sought to determine the cardio-protective action of finerenone according to prior treatment with newer antidiabetics and level of glycemic status.

Design and method:
We searched PubMed and Cochrane Library from inception to 1st October 2021 for randomized controlled trials (RCTs) assessing the effect of finerenone on major adverse cardiovascular outcomes in patients with T2DM. We set as primary endpoint the composite of major adverse cardiovascular event, defined as the composite of death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure (MACE).

Results:
We finally included 2 RCTs in our quantitative synthesis. Finerenone compared to placebo induced a 23% risk reduction for the composite cardiovascular endpoint, regardless of prior glycemia. We also showed that finerenone provided significant cardiovascular benefit for obese patients with T2DM, compared to placebo, which was diminished for subjects with a body mass index (BMI) lower than 30 kg/m2. Finally, combination of finerenone with SGLT-2 inhibitors or GLP-1RAs did not produce a significant risk reduction for MACE.

Conclusions:
Finerenone provides significant cardiovascular benefit for patients with T2DM, especially for those being obese, while the level of glycemia or treatment with newer antidiabetics at baseline does not seem to affect the observed cardio-protective action.
EFFECT OF SODIUM-GLUCOSE CO-TRANSPORTER-2 INHIBITORS ON ARTERIAL STIFFNESS UNDER STATIC OR AMBULATORY CONDITIONS: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS
Authors: Patoulias Dimitrios , Katsimardou Alexandra , Imprialos Konstantinos , Stavropoulos Konstantinos , Koutsampasopoulos Konstantinos , Siskos Fotios , Boulmpou Aristi , Toumpourleka Maria , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2022

Objective:
Arterial stiffness represents an emerging cardiovascular risk factor with independent prognostic implications. Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are a novel drug class with significant cardio-protective effects, but largely unknown mechanism underlying this effect. Herein we sought to determine the effect of SGLT-2 inhibitors on pulse wave velocity (PWV), the “gold-standard’’ measure of arterial stiffness.

Design and method:
We searched PubMed, Cochrane Library and grey literature from inception to 10th October 2021 for parallel group randomized controlled trials (RCTs) enrolling adult subjects with or without type 2 diabetes mellitus (T2DM), assigned to a SGLT-2 inhibitor versus placebo or active comparator and addressing their effect on PWV under static or ambulatory conditions. We set as primary efficacy outcome the change in PWV with SGLT-2 inhibitors versus placebo or control.

Results:
We pooled data from 4 trials for a total of 301 enrolled participants assigned either to SGLT-2 inhibitor or control. Treatment with a SGLT-2 inhibitor compared to placebo or active control led to a significant decrease in PWV by 0.25 m/s (mean difference = -0.25, 95% CI; -0.49 to -0.01, I2 = 24%, p = 0.04). Certainty of evidence was graded as low.

Conclusions:
SGLT-2 inhibitors produce a slight, however statistically significant decrease in PWV in patients with established cardiovascular disease or cardiovascular risk factors, such as hypertension and T2DM.
THE SYSTOLIC RISE TIME MEASURED WIH PPG TO SCREENING PERIPHERAL ARTERY DISEASE: APPLICATION TO THE POPMETRE
Authors: Obeid Hasan , Amrani Samantha , Eveilleau Kornelia , Abi-Nasr Imad , Hallab Magid , Leftheriotis Georges 
Published: June 2022

Objective:
Screening for Peripheral Artery Disease (PAD) remains a challenge in the prevention and care of patients with arteriosclerosis. The Ankle Brachial Index (ABI) is currently the gold standard. However, ABI is time consuming and requires some expertise to perform which is a limiting factor for global screening. The measurement of the Systolic Rise Time (SRT) of the pulse wave of the lower limb may provide an easier alternative to detect PAD. In a retrospective pilot study, we analyzed the possibility of detecting PAD using the SRT of the toe waveform using the Photo-PlethysmoGraphic signal (PPG).

Design and method:
We measured 79 subjects (41 patients diagnosed with different stages of PAD and 38 healthy volunteers without known PAD). In each subject, at least one lower limb was assessed with classical ABI. All subjects underwent a PPG assessment on the finger and the toe simultaneously using popmètreâ (Axelife – France). In-house software (JAVA) was used to calculate the SRT of all recorded signals.

Results:
146 lower limbs were analyzed including 72 healthy and 74 subjects with PAD. The mean age of the population was 69 ± 12 years with 75% men, 28% diabetics, 47% hypertensive, 49% without clinical PAD defined as stage 0 in this study; 16% in stage 1; 32% in stage 2; 2% in stage 3 and 1% in stage 4 according to the Leriche classification. The SRT cut-off value of 160 ms identifies PAD according to Leriche starting at stage 1 with a sensitivity of 78% vs 73% for ABI < 0.9 and a specificity of 86% vs 87%; a positive predictive value (PPV) of 85% vs 86% and a negative predictive value (NPV) of 79% vs 75%. In addition, the ratio between toe-SRT and finger-SRT cut-off value of 1 identifies PAD with a sensitivity of 76% and a specificity of 74%.

Conclusions:
SRT measured using a PPG pulse signal of the toe is promising as a facile non-invasive method to diagnose PAD (duration < 14 seconds) and determine PAD stages 1 to 4 with similar specificity and sensitivity as the reference method.
STUDY OF EARLY RETINAL CHANGES IN PATIENTS WITH NEWLY DIAGNOSED TYPE 2 DIABETES MELLITUS
Authors: Nikolaidou Barbara , Triantafyllou Areti , Anyfanti Panagiota , Gavriilaki Eleni , Lazaridis Antonios , Stoimeni Anastasia , Dolgyras Panagiotis , Douma Stella , Gkaliagkousi Eugenia 
Published: June 2022

Objective:
Retina and endothelium constitute fields in which the hyperglycemia’s pathological effects of type 2 diabetes mellitus (T2DM) can be detected. However, the precise time of these lesions’ appearance and factors contributing to it are still under investigation. Thus, we studied the early retinal lesions and endothelial function in patients with a recent diagnosis of T2DM (<6 months) and their association with adverse prognostic factors.

Design and method:
Patients with a recent diagnosis of T2DM receiving no other diabetic medication except from Metformin, and volunteers matched for age and blood pressure (BP) participated in the study. Somatometric data, BP measurements (ambulatory and office) and hematological parameters (lipids, renal function, fasting glucose, glycosylated hemoglobin) were recorded. Endothelial function was assessed by Asymmetric Dimethylarginine (ADMA). Retinal vessel diameters (central retinal arteriolar equivalent-CRAE / central retinal venular equivalent-CRVE) and their ratio (arteriovenous ratio-AVR) were assessed with a non-mydriatic fundus camera using special software.

Results:
We studied 165 participants, 81 T2DM patients and 84 non-T2DM volunteers. No differences were found between the 2 groups in retinopathy and ADMA measurements. ADMA was associated with female sex (p = 0.037), Body Mass Index (p = 0.033) and AVR (p = 0.047). AVR was significantly associated with age, male sex, ADMA, estimated Glomerular Filtration Rate (eGFR), smoking, office, day and nighttime diastolic, 24-hour, and nighttime systolic BP. Linear regression analysis showed the independent correlation of AVR with nighttime systolic blood pressure (p = 0.002) and age (p = 0.019) taking into consideration gender, smoking, eGFR, ADMA and T2DM.

Conclusions:
In patients with a very recent diagnosis of Type 2 Diabetes Mellitus, the retinal vessels diameters do not differ compared with individuals of similar age and blood pressure. However, the AVR index correlates with age and nighttime BP, highlighting the important contribution of the latter in early target organ damage in this population.
LEVEL OF ADHERENCE TO THE PHARMACOLOGICAL AND NON-PHARMACOLOGICAL TREATMENT OF PATIENTS WITH DIABETES MELLITUS
Authors: Rodero Eulalia Maria Amador , Esmeral Leslie Piedad Montealegre , Contrera Marco Eulalio , Charris Martha Arteta , de Oro Aguado Carlos , Rebolledo Roberto , Pulido Tammy 
Published: June 2022

Objective:
To identify the level of adherence to pharmacological and non-pharmacological treatments according to age, sex and time of evolution in patients with diabetes mellitu

Design and method:
Cross-sectional observational analytical descriptive study, population 739 patients, with a sample of 272, which were randomly selected. Bonilla questionnaire validated with a Crombach alpha of 0.86 was applied. Tests were made for the variables age, sex and time of evolution to compare it with the variable level of adherence, with the corresponding descriptive statistics. Additionally, bivariate analysis to determine the association of the level of adherence with the variables age, sex and time of evolution.

Results:
63% were female, 37% were male. The average age was 54.93 +/- 12.44 years and the evolution time was 7.6 +/- 3.7 years. Regarding the level of adherence, the 272 participants had an average score of 70.53 +/- 11.38, which indicates that they are at risk of non-adherence to treatments

Conclusions:
Non-adherent behavior in patients with diabetes continues to be a concern, which is why governments continue to invest in educational programs for patients and their families to control diabetes and prevent its complications.
A COMPARISON OF ATRIAL FIBRILLATION INCIDENCE AMONG INTENSIVIST AND THE GENERAL POPULATION: UNRAVEL THE HEALTH MYTHS FOR PHYSICIANS
Authors: Syun Hu Wei 
Published: June 2022

Objective:
Purpose: To explore the association of atrial fibrillation (AF) among physician specialist.

Design and method:
We used Cox proportional hazards models to estimate the incidence rate and the adjusted hazard ratios (aHR) with 95% confidence intervals (CIs) to determine the risk of atrial fibrillation in the physician study cohort relative to the comparison cohort, and further analyzed stratified by age and comorbidities.

Results:
The Cox proportional hazard regression model revealed that male physician was significantly associated with an increased risk of AF than non-physician after adjusting for potential confounders (adjusted HR, 1.05; 95% CI: 1.00– 1.11). In age-specific analysis, male physician age less than 35 years old showed the strongest association with AF (adjusted HR, 3.70; 95% CI: 3.01– 4.55). When stratified by comorbidity, the male physician cohort exhibited a significantly higher risk of AF than controls (adjusted HR, 1.45; 95% CI: 1.34– 1.57).

Conclusions:
Association of AF among physicians was shown.
LATVIA’S DOCTORS EXPERIENCE ON PROVIDING REMOTE CONSULTATIONS DURING COVID-19 PANDEMICS
Authors: Jeniceka Aleksandra , Homka Dzintra , Bikava Ieva , Sen Sevinç Elif , Sokolova Emma 
Published: June 2022

Objective:
Major challenge for health care service became a situation of a pandemic caused by COVID-19 infection, when doctors continued to provide care switching to remote consultations when possible. This provided better accessibility to receive consultation form doctor, and those consultations where sometimes the only way to be consulted for the patient.
Aims of the study: To explore and analyze Latvia’s doctors experience on providing remote consultations during COVID-19 pandemics.

Objective:
1) To detect the volume and type of work physicians are able to manage remotely. 2) To find out what technical, GDPR-associated and other difficulties face doctors during the process. 3) To define the general attractiveness of remote consulting.

Design and method:
Two groups of doctors filled in the questionnaires in year 2021.

Results:
In one group, which consisted of 200 general practitioners, most respondents consider they could provide remote medical consultation about healthy lifestyle - 89,0% (n = 178); regarding check-ups, screening results - 86,5% (n = 173); to manage recommendations of other healthcare specialists - 66% (n = 132). Difficulties faced: 54,0% (n = 108) were not satisfied with payment, 22,5% (n = 45) admitted lack of specific skills, 45,5% (n = 91) found it problematic to make e-referrals. 61,0% (n = 122) like the idea of implementing services in practice on a regular basis. Another group, which consisted of 62 doctors of different specialties working in Clinical University Hospital. All doctors (62) were consulting by phone, 18 doctors only by phone, however 44 were consulting via e-mails, social network on video-conference platforms as well.
Research revealed that the process of patient identification, search of patient’s data and sensitive data transfer is complicated, time consuming and requires different approaches to manage.

Conclusions:
Latvian doctors have experience in remote consulting. When consulting remotely Latvian doctors were facing technical, legal, social and other difficulties. Some Latvian doctors are interested in introducing remote consulting services in their practice, if the restrictive moments for their provision would be eliminated. As well as there is need for amendments in normative regulation for providing remote consultations, and challenges relates to payment system implementations especially for state paid services.