bluuebunny/crossref_metadata_2025_split huggingface dataset:
185 BETA-BLOCKERS OR CALCIUM CHANNEL BLOCKERS IN HYPERTROPHIC CARDIOMYOPATHY
Authors: Pinto Giuseppe , Chiarito Mauro , Bacher Anne , Puscas Tania , Condorelli Gianluigi , Reant Patricia , Donal Erwan , Hagege Albert 
Published: December 2022

Abstract

Background
Guidelines recommend betablockers (BB) as first line therapy in symptomatic patients with hypertrophic cardiomyopathy (HCM). A secondary role in the therapeutic algorithm is assigned to non-dihydropyridine calcium channel blockers (ND-CCB). Since no randomized comparison trials between the two drugs have been made so far, the aim of the present analysis was to evaluate the prognostic impact of BB and ND-CCB in a cohort of patients with HCM, either obstructive or not.

Methods
From a cohort of 1434 patients with a diagnosis of HCM included in the French register REMY, we retrospectively analysed 601 individuals treated with BB or ND-CCB. Patients taking both BB and ND-CCB or none, patients who already had an implantable cardioverter defibrillator or a pacemaker and who had already undergone a procedure of atrial fibrillation (AF) ablation or of septal reduction therapy were excluded.

Results
Out of 601 HCM patients, 545 (91%) were treated with BB and 56 (9%) with ND-CCB. At 8-year follow-up no differences were observed as regard the composite endpoint of cardiovascular death, hospitalization for heart failure and hospitalization for AF (133 [24%] vs. 9 [16%] for patients taking BB or ND-CCB respectively, HR 1.84, 95% CI 0.94–3.63). Patients taking ND-CCB were less symptomatic at long-term follow-up but experienced more drug interruptions or changes.

Conclusions
In a real-world cohort of patients with HCM, ND-CCB therapy was not associated with a higher incidence of adverse events compared to BB therapy.
1059 FAMILIAL RISK OF DILATED AND HYPERTROPHIC CARDIOMYOPATHY: A NATIONAL FAMILY STUDY IN SWEDEN
Authors: Ricci Fabrizio , Banihashemi Behzad , Pirouzifard Mirnabi , Sundquist Jan , Sundquist Kristina , Sutton Richard , Fedorowski Artur , Zoller Bengt 
Published: December 2022

Abstract

Aims
To determine the familial incidence of dilated (DCM) and hypertrophic cardiomyopathy (HCM) in first-, second- and third-degree relatives of affected individuals.

Methods and results
In this population-based multigenerational cohort study, full-siblings, half-siblings, and cousin pairs born to Swedish parents between 1932 and 2015 were included and register-based DCM and HCM diagnoses among relatives were ascertained. Adjusted odds ratios (ORs) for DCM and HCM were calculated for relatives of individuals with DCM and HCM compared with relatives of individuals without DCM and HCM for reference. Total study population included 6,334,979 subjects and consisted of 5,577,449 full-siblings, 1,321,414 half-siblings, and 3,952,137 cousins. Overall, 10,272 (0.16%) unique individuals were diagnosed with DCM and 3,769 (0.06%) with HCM. Of these, 7,716 (75.12%) and 2,375 (63.01%) were males, respectively. Familial risk odds ratios (ORs) for DCM were 5.35 (95% confidence intervals (CI): 4.85-5.90) for full-siblings, 2.68 (95%CI:1.86-3.87) for half-siblings, and 1.72 (95%CI:1.12-2.64) for cousins of affected individuals. The ORs for HCM were 42.44 (95%CI:37.66-47.82) for full-siblings, 32.70 (95%CI:21.32-50.15) for half-siblings, and 36.96 (95%CI:29.50-46.31) for cousins of affected individuals. In sex-stratified analysis, relatives of affected females were found more likely to be affected than were relatives of affected males, with stronger aggregation observed for HCM.

Conclusions
Familial risk of HCM and DCM is high and associated with genetic resemblance, with strongest aggregations observed in relatives of affected females with HCM, whereas this association was distinctly attenuated for DCM. The finding of a Carter effect, more pronounced in HCM, suggests a multifactorial threshold model of inheritance.
933 ASSESSMENT OF NON-INVASIVE MEASUREMENTS OF OXYGEN SATURATION AND HEART RATE WITH AN APPLE SMARTWATCH: COMPARISON WITH A STANDARD PULSE OXIMETER
Authors: Mancuso Cinzia , Spaccarotella Carmen , Polimeni Alberto , Pelaia Girolamo , Esposito Giovanni , Indolfi Ciro 
Published: December 2022

Abstract

Background
The most commonly used method to assess peripheral oxygen saturation (SpO2) in clinical practice is pulse oximetry. Smartwatches are widespread and are increasingly being used for digital health information. The smartwatch Apple Watch 6 was developed with a new sensor and an app that allows taking on-demand readings of blood oxygen and background readings, day and night.

Aims
The primary aim of the study was the head-to-head comparison of the measurements of SpO2 and heart rate (HR) by the smartwatch and the standard pulse oximeter. The secondary aim was the comparison of the measurements of SpO2 and HR between subgroups (lung disease, cardiovascular disease, healthy subjects).

Methods and results
We enrolled study participants with lung or cardiovascular disease and healthy subjects. A total of 265 subjects were screened for enrollment in this study. After screening, 257 subjects were included in the present study. The measurements of SpO2 and HR were obtained with the Apple Watch 6 and the Nellcor system and taken within 1 minute of each other in order to ensure comparability between the two devices. The correlation between the two technologies was assessed using linear regression and estimated with Pearson analysis for normally distributed data and Spearman analysis for nonparametric data. A plot of the differences between techniques was created according to the method described by J.M. Bland and D.G. Altmann. We observed a strong positive correlation between the smartwatch and the standard commercial device in the evaluation of SpO2 measurements (r=0.89, p&lt; 0.0001; Figure 1A) and HR measurements (r=0.98, p&lt; 0.0001; Figure 1B). A very good concordance was found between SpO2 (bias, -0.2289; SD, 1.66; lower limit, -3.49; and upper limit, 3.04; Figure 2A) and HR (bias, -0.1052; SD, 2.93; lower limit, -5.84; and upper limit, 5.63; Figure 2B) measured by the smartwatch in comparison with the standard commercial device using Bland–Altman analysis. We observed similar agreements and concordance even in the different subgroups.

Conclusions
In conclusion, our study demonstrates the feasibility and agreement of the Apple Watch 6 compared with the standard device used to assess SpO2 in patients with cardiovascular or lung diseases and in healthy subjects.
698 MONITORING OF CARDIOVASCULAR EVENTS IN COVID 19 POSITIVE SUBJECTS: THE BIOBEAT SYSTEM
Authors: Pecchioli Valerio , Lomartire Nazzareno , Valente Lucia , Gemmiti Maria Paola , Corsi Maria Pia , Pecchioli Lorenzo , Fedele Francesco 
Published: December 2022

Abstract

Background
Connected health technology can enable healthcare professionals to provide multiple solutions to meet the growing demand of care and control of COVID-19 infected patients, by optimizing economic resources and extending the scope of monitoring beyond the hospital. A connected patient has the ability to monitor his state of health with tools that remotely transmit data to his doctor, help him to perform the right therapy thanks to reminder systems or electronic alerts and identifies cardiovascular alterations predictive of a worsening of the disease.
An innovative mobile device, the BioBeat System® with an APP that can be downloaded directly to the Smart Phone, is characterized by sensors already validated according to the regulations of the Food and Drug Administration for vital signs, the European Society Hypertension for the detection of blood pressure.

Purpose
Wearable medical devices and the BioBeat software platform are appropriate for use in different settings for the management of acute, chronic cardiovascular, respiratory and inflammatory pathology, a tool capable of early identification of the instrumental signs of deterioration even before the exclusively clinical recognition that becomes even more difficult if we consider the patients at home.
The aim of this study is to test the sensitivity and specificity of the biobeat wearable system applied in patients with paucisymptomatic COVID-19 infection (group A) and in those with previous SARS-COV2 disease discharged from the hospital who still needed post-acute monitoring (group B) and compared with clinical control, managing to determine early the clinical signs of worsening.

Methods
The data recorded by individual patients are systolic and diastolic blood pressure, heart and respiratory rate, peripheral oxygen saturation and body temperature. Thanks to these parameters it is possible to calculate the NEWS by being able to predict any adverse events early with the automatic calculation of the score. The criteria of deterioration or worsening of the clinical condition are represented by the need to hospitalize the patient, alteration of one of the criteria grouped in the ABCDE.

Results
Table 1 summarises the demographic data of the cases enrolled. We calculated the sensitivity of the methodology related to the alerts detected and the outcome of the patients.
Sensitivity was 86.3% with a 95% CI of 0.71 to 1.03 and a specificity of 7.7%.

Conclusions
Continuous monitoring with biobeat watch showed a high sensitivity in detecting early any alerts predictive of worsening of the disease.
156 IMPACT OF TRANSCATHETER EDGE-TO-EDGE MITRAL VALVE REPAIR ON GUIDELINE DIRECTED MEDICAL THERAPY OPTIMIZATION IN PATIENT WITH SECONDARY MITRAL REGURGITATION
Authors: Pancaldi Edoardo 
Published: December 2022

Abstract

Background
Guideline-directed medical therapy (GDMT) optimization is mandatory before transcatheter edge-to-edge mitral valve repair (M-TEER) in patients with secondary mitral regurgitation (SMR) and heart failure with reduced ejection fraction (HFrEF). However, the effect of M-TEER on GDMT is unknown.

Objective
To evaluate frequency and prognostic implications and predictors of GDMT optimization after M-TEER in patients with SMR and HFrEF.

Methods
This is a retrospective analysis of prospectively collected data from the EuroSMR Registry. The primary events were all-cause death and the composite of all-cause death or HF hospitalization.

Results
Among the 1641 EuroSMR patients, 810 had full datasets regarding GDMT and were included in this study. GDMT optimization occurred in 307 (38%) patients after M-TEER. Proportion of patients receiving ACEi/ARB/ARNI, betablockers and MRA was 78%, 89% and 62% before M-TEER and 84%, 91% and 66% 6-month after M-TEER (All p&lt;0.001). Patients with GDMT optimization had a lower risk of all-cause death (adjusted hazard ratio [HR] 0.62; 95% confidence interval [CI] 0.41-0.93; p=0.020) and the composite of all-cause death or HF hospitalization (adjusted HR 0.54; 95% CI 0.38-0.76; p&lt;0.001) compared with those without. Degree of MR reduction between baseline and 6-month follow-up was an independent predictor of GDMT optimization after M-TEER (adjusted OR 1.71; 95% CI 1.08-2.71; p=0.022).

Conclusions
GDMT optimization after M-TEER in HFrEF patients with SMR occurred in a considerable proportion of patients and is independently associated with lower rates for mortality and HF hospitalizations. A greater decrease in MR was associated with increased likelihood for GDMT optimization.
694 DRUG INDUCED KIDNEY INFARCTION: A CASE REPORT
Authors: Amati Francesca , Santoro Daniela , Ciccone Marco Matteo 
Published: December 2022

Abstract
Isotretinoin (ISO) is a synthetic analog of vitamin A. Notwithstanding the well-known long-term efficacy in the treatment of severe resistant cystic acne, ISO induces several side effects too. Dyslipidemia, increased liver enzymes, as well as reduction of biotidinase have been already reported [1]. Homocysteine (HCY), a sulfur-containing amino acid, is recycled into methionine by a transmethylation reaction requiring folate and vitamin B12. Given that during ISO treatment elevated liver enzymes (SGOT, SGPT) are often observed, it has been hypothesized that iatrogenic liver dysfunction could affect cystathionine-b-synthase, an enzyme involved in HCY metabolism, [2]. Several studies have highlighted that elevated plasma HCY concentrations are associated with an increased risk of premature occlusive vascular disease.
We hereby report a case of drug-induced kidney infarction after ISO therapy.
A previously healthy 18-year-old male, on therapy with 40 mg/die isotretinoin for acne, was admitted to the Emergency Unit for abdominal pain, nausea and vomiting and dyspnea. A trans-thoracic echocardiogram showed dilated and hypocontractile left ventricle. During the hospitalization he had a total body CT that showed the presence of an ischemic lesion on left kidney without other pathological findings. He started therapy with 12 IU/kg UFH as soon as a surgical emergency was excluded. Subsequently, he underwent a coronary angiogram that resulted unremarkable. Cardiac MRI showed extensive delayed gadolinium late enhancement with intramural linear pattern.
In the hypothesis of drug-induced vasculitis, an extensive serological testing was performed. Elevation of serum liver enzymes (SGOT, SGPT), CRP, LDH was found. Mutations on MTHFR gene and Leiden Factor were not detected, neither alteration in coagulation parameters. Finally the dosage of plasmatic HCY resulted over the range of normality and ISO was discontinued. The patient was discharged on optimized medical therapy for heart failure. He is currently managed as outpatient.
HCY levels could be found elevated in patients with ischemic events during ISO treatment. Given the widespread use of this drug for acne, it could be reasonable to dose HCY in patients with suspected liver dysfunction. Physicians should be aware of this scenario and should act swiftly to avoid uneventful outcomes.
[1] Schulpis KH et al. Elevated plasma homocysteine levels in patients on isotretinoin therapy for cystic acne. Int J Dermatol. 2001 Jan;40(1):33-6.
[2] Polat M, et al. Plasma homocysteine level is elevated in patients on isotretinoin therapy for cystic acne: a prospective controlled study. J Dermatolog Treat. 2008;19(4):229-32.
1004 AN UNUSUAL, UNAVOIDABLE BUT SUCCESSFUL MANAGEMENT OF TYPE A AORTIC DISSECTION. A CASE REPORT
Authors: Lepre Veronica , De Biasio Marzia , Imazio Massimo , Sinagra Gianfranco 
Published: December 2022

Abstract

Background
Cardiac tamponade complicates 18,7% of patients with type A aortic dissection and is associated with dramatically worse outcome and a nearly doubling of in-hospital mortality. Immediate surgical repair with intra-operative pericardial drainage is the treatment of choice. Nevertheless, the management of unstable patients who cannot undergo cardiac surgery in short time is controversial.

Case report
Here we present a case report of an 82-year woman with type A aortic dissection complicated by cardiac tamponade. The patient alerted the emergency system because of a sudden epigastric pain. On her arrival to the hospital, her systolic blood pressure was 50 mmHg; despite intravenous fluids and inotropic support, she remained hypotensive. Transthoracic echocardiography revealed an intimal flap involving ascending aorta and aortic arch, and a hemodynamically significant pericardial effusion. Immediate surgical repair was not possible due to the lack of available operating rooms. To stabilize the patient, percutaneous pericardiocentesis from apical approach was attempted, unsuccessfully. A second attempt of percutaneous pericardiocentesis was made from substernal approach, with removal of just 150 cc of pericardial fluid and insertion of a pigtail drainage catheter. Thanks to this procedure systolic blood pressure raised up to 100 mmHg and the patient was stabilized. A CT Angiography scan was performed, showing an aortic dissection extending from the aortic valvular plane to the origin of the right iliac artery. The patient maintained hemodynamical stability until surgical intervention, which started four hours later her arrival. The patient underwent substitution of ascending aorta, aortic hemiarch, non-coronary sinus and aortic valve. There were no complications related to the pericardial drainage and in 34th post-operative day she was discharged in good condition.

Conclusion
Percutaneous pericardiocentesis should be considered in unstable patients with type A dissection complicated by cardiac tamponade who cannot await surgical treatment, providing that very small amount of pericardial fluid is removed, in order to maintain systolic blood pressure around 90 mmHg.
Hidradenitis Suppurativa Reddit Support Group: Finding New Meaning in Social Media During the COVID-19 Pandemic
Authors: Yesantharao Lekha V , Suresh Rachana , Lerman Sheera F , Cox Carrie , Caffrey Julie 
Published: December 2022

AbstractHidradenitis suppurativa (HS) can significantly impact quality of life. Reddit allows users with common interests, like HS, to form a community and share information. This has become increasingly important with pandemic-related social isolation. We administered a survey from May 2021 to July 2021 to characterize patients with HS use of Reddit and social media more broadly before and during the COVID-19 pandemic. An analysis of a popular HS support page on Reddit from January 2019 to August 2021 was also conducted, analyzing subscribers over time. The rate of subscriber increase was higher before the pandemic. Of 42 patients contacted, 20 patients enrolled (90% female, mean age of 32.4 years) and 18 of the 20 fully completed the survey that was administered. Participants were stratified into two groups: online support group users (n = 8) and nonusers (n = 12). There were no differences in sex, age, education level, antidepressant usage, and overall social media usage between these groups. However, there was a difference in Hurley staging, with more than four times as many users reporting a Hurley III staging compared to nonusers (p = .003). Nonusers ranked the following as desired features of a social media group more frequently than current users: bandaging/dressing boils, living with HS, medical advice from professionals, causes of HS, and diet (P = .047, P = .043, P = .043, P = .047, and P = .013, respectively). This study demonstrates that online support group use is associated with HS of higher clinical severity. Based on the needs/expectations identified in this study, recommendations can be made to providers to help fill any lacunae in clinical care.
Investigation of Anxiety and Depression Predictors in Burn Patients Hospitalized at Velayat Hospital, a Newly Established Burn Center
Authors: Farzan Ramyar , Hossein-Nezhadi Mitra , Toloei Mohammad , Rimaz Siamak , Ezani Fazel , Jafaryparvar Zakiyeh 
Published: December 2022

Abstract
Burns are a leading cause of global mortality and disability. Burns have the mental, psychological and physical impact on the sufferers. Burn patients need special care, both physical and mental, and majority of them are suffering from symptom of difficulty, such as depression, anxiety, post-traumatic stress disorder, and isolation. Finding the predictors of post-burn anxiety and depression can accelerate the treatment and recovery process and maintain the mental health of the patients. The present study investigated the depression and anxiety predictors in burn patients admitted to a medical facility in northern Iran. The present study is a descriptive-analytical study with a cross-sectional methodology on all the burn patients (n = 611) admitted to the Velayat Subspecialty Burn and Reconstructive Surgery Center, Rasht, Iran during 2013–2019. The study tools included the demographic and clinical questionnaire and the Symptom Checklist-90-Revised (SCL-90-R) for anxiety and depression. Data were collected using interviews. Data analysis was performed using the SPSS version 19 and the statistical tests of Chi-square and logistic regression test. The present study included 611 patients, with 61% males and 39% females. The mean age of the participants was 38.86 ± 18.39, while most participants were in the age group of 20–40 years. The most common cause of admission was burning by flames (36.7%), and most patients had third-degree burns (67%). Five hundred forty three patients showed mental symptoms, of which 343 (52.6%) had anxiety disorder symptoms, and 309 (47.4%) had symptoms suggestive of depression. The independent predictors of depression were found to be the gender (OR = 0.253), age group (OR = 0.706), and the degree of burn (OR = 0.406), while the independent predictors of anxiety disorder included the gender (OR = 1.669), age group (OR = 1.58), the classified burn area (OR = 0.653), marital status (OR = 0.532), and education level (OR = 0.773). It is important to identify predictors of depression and anxiety after burn. The predictors can serve as indicators that these patients may benefit from mental health evaluations and treatment.
Dynamic Nonparametric Clustering of Multivariate Panel Data
Authors: Custodio João Igor , Schaumburg Julia , Lucas André , Schwaab Bernd 
Published: December 2022

Abstract
We introduce a new dynamic clustering method for multivariate panel data characterized by time-variation in cluster locations and shapes, cluster compositions, and possibly the number of clusters. To avoid overly frequent cluster switching (flickering), we extend standard cross-sectional clustering techniques with a penalty that shrinks observations toward the current center of their previous cluster assignment. This links consecutive cross-sections in the panel together, substantially reduces flickering, and enhances the economic interpretability of the outcome. We choose the shrinkage parameter in a data-driven way and study its misclassification properties theoretically as well as in several challenging simulation settings. The method is illustrated using a multivariate panel of four accounting ratios for 28 large European insurance firms between 2010 and 2020.
Update on Enrollment of Older Adults Onto National Cancer Institute National Clinical Trials Network Trials
Authors: Mishkin Grace E , Denicoff Andrea M , Best Ana F , Little Richard F 
Published: December 2022

AbstractBackgroundOlder adults are a large and growing proportion of cancer cases in the United States, but concerns persist about whether older adults are adequately represented in the cancer clinical trials that test new options for treatment and cancer care.MethodsThis paper describes adult patient enrollments by age group to the National Cancer Institute’s National Clinical Trials Network (NCTN) from 2016 to 2021, compares patient enrollment by age with the estimated incident cancer population across cancer types, and explores possible associations between patient age and patient race, ethnicity, and sex.ResultsThis analysis found that patients aged 18 to 69 years were overrepresented in NCTN trials, whereas patients aged 70 years and older were underrepresented compared with the estimated incident cancer population. Underrepresentation of older patients was seen across cancer types. Older patients who enrolled to NCTN trials were more likely to be non-Hispanic White than the estimated incident cancer population.ConclusionsCompared with earlier analyses, NCTN trials are enrolling greater proportions of older adults, primarily driven by higher enrollment among patients aged 65 to 74 years. There is still significant room for improvement, however, especially among patients aged 75 years and older. Additionally, patient demographics should not be viewed in isolation: older Hispanic patients, for instance, were particularly underrepresented among patients enrolled to NCTN trials. The intersection between trial enrollment and age, race, and ethnicity warrants further study so that more targeted enrollment enhancement efforts can be developed that enhance trial diversity across demographic groups.