[Show abstract][Hide abstract] ABSTRACT: Obesity, along with other unhealthy living habits, nowadays represents one of the greatest risk factors for various diseases. Vojvodina is a part of Serbia where a high percentage of the overweight has been recorded since the period of former Yugoslavia. The aim of this study therefore was to determine the percentage of adults with potential health risk using the indices of obesity. The anthropological study was conducted from 2001 to 2006. The tested group consisted of 4504 individuals, 1965 men and 2539 women. The mean age of the sample was 40.61 +/- 11.29. The data were collected in 46 villages in Backa and Banat, in the central and north-east parts of Vojvodina, situated in the north of Serbia. The investigation included the height, weight, waist and hip circumference. Nutritional condition was determined using the body mass index (BMI kg/m2), while the waist circumference and WHR were used for assessing the central obesity. According to the average BMI (26.86 kg/m2 males, 25.80 kg/m2 females), the population of Backa and Banat is characterised with pre-obesity. In total, 58.47% individuals of both sexes are with excessive body weight, 38.52% of them being classified as overweight and 19.48% as obese. Central obesity is more frequent in males aged up to 40, while in females it is more present above the age of 50. A higher waist circumference (males > 94 cm; females > 80 cm) is observed in 58% of males and 55% of females, with the risk value (males > 102 cm; females > 88 cm) recorded in 32% of men and women. The indices of obesity indicate a potential health risk for more than a half of the subjects in this study. The data therefore point to the necessity of introducing educational programs for promoting good nutrition and healthy living habits that would ultimately reduce the number of individuals with health risk.
Collegium antropologicum 03/2014; 38(1):227-33. · 0.61 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Studies conducted on children and adults have pointed to the correlation of BMI (kg/m2) with risk factors for certain diseases. Other studies have stressed a more intense correlation between the risk factors and indicators of subcutaneous fat obtained in other ways. The aim Of the study was to compare the intensity of correlation between the risk factors and triceps and subscapular skinfold thickness in relation to BMI. The study included 53 postmenopausal and 107 premenopausal women, the risk factors were assessed upon systolic and diastolic blood pressure, glucose concentration, triglyceride and cholesterol levels. Statistically significant differences were established in almost all variables referring to premenopausal and postmenopausal women, except in body height, subscapular skinfold thickness and tryglyceride concentration. Significant correlation with the risk factors was detected in BMI and both skinfold thicknesses, while the subscapular thickness correlates more intensively with the risk factors than it is the case with the triceps thickness. The results indicate that BMI equally correlates with risk factors as well as skinfold thickness.
Collegium antropologicum 05/2013; 37 Suppl 2:119-24. · 0.61 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: From the clinical and epidemiological point of view it is very important to define easily measurable and simple anthropometric parameters of mass and distribution of adipose tissue that will also be good predictors of future complications of obesity. The aim of our study was to correlate anthropometric indicators of mass and distribution of adipose tissue with the risk of developing cardiovascular diseases and diabetes.
The study group consisted of 155 women aged 45.4 +/- 13.04y. The anthropometric measurements were performed in order to assess adipose tissue mass and its specific distribution. The 10-year risk of developing cardiovascular diseases was assessed by using two score-systems: Framingham and Prospective Cardiovascular Munster Study while the 10-year risk of development of diabetes was assessed by QDScore system.
According to our results, the waist-to-stature ratio was the best predictor of cardiovascular and diabetes risk (r = 0.617-0.780; AUC = 0.872). The estimated cut-off value for the waist-to-stature ratio in cardiovascular and diabetes risk prediction was 0.486. Apart from the waist-to-stature ratio, the body mass index, body fat mass, waist circumference and indicators of upper extremity adiposity also correlated strongly with the assessed risk. The anthropometric indicators of lower body adiposity had no significant diagnostic values.
The waist-to-stature ratio is the best anthropometric indicator of cardiovascular and diabetes risk.
[Show abstract][Hide abstract] ABSTRACT: Obesity represents one of the frequent health problems in developed countries today. It is related to cardiovascular diseases, diabetes and various cancer forms. The aim of the study was to determine the prevalence of overweight and obesity in adult population of the northern Badka and Banat.
On the basis of a multistage stratified random sampling, 4505 individuals of the age 40.61 +/- 11.29 years took part in the study. The study included 46 rural settlements. The overweight and obesity prevalence was obtained using the anthropometric indicators of body mass index (BMI), waist circumference (WC) and the waist to hip ratio (WHR). The correlations among BMI, WC and WHR were determined by the Pearson's correlation coefficient while the multiple regression analysis was used for correlating sociodemographic parameters and the obesity index.
A significant positive correlation was found in relation to all anthropometric parameters in both sexes. The data indicated that 66.32% of males and 49.68% of females had an overweight problem. On average, approximately 38.52% of subjects of both sexes were overweight, while 19.48% were obese. The factors that largely contributed to higher values of the obesity index were the age of male subjects and the age, education and origin in females. Ragarding the female subjects, the level of education negatively correlated with the level of nutritional condition.
The prevalence values of the overweight and obese subjects, obtained on the basis of the anthropometric parameters, vary. However, regardless methods applied, the percentage of the overweight and obese persons is very high, being among the highest recorded in European populations. The obtained results indicate the necessity of introducing better education programmes and conducting regular health controls among citizens in these regions.
[Show abstract][Hide abstract] ABSTRACT: Fabry Disease is a rare, X-chromosomal inherited lysosomal storage disease with a consequent intracellular accumulation of neutral glycosphingolipids in various tissues. This can cause skin and ocular lessions, progressive renal, cardiac or cerebrovascular disorders. If a person in a family has Fabry disease, other family members including even extended relatives, may also be at risk.
We presented three cases pointed out various manifestation of Fabry disease, that illustrate a possible cause for otherwise unexplained cardiac hypertrophy and various rhythm and conduction abnormalities.
Although most symptoms begin in childhood, various manifestations often lead to misdiagnosis and clinical diagnosis is frequently delayed for many years, even decades. Enzyme replacement therapy has become available, pointing out the importance of early diagnosis so that treatment can be initiated before irreversible organ damage.
[Show abstract][Hide abstract] ABSTRACT: In this paper, a mobile telemedicine application implemented for Android based devices is presented. The main application's functionality of ECG transmission is extended by real time ECG analysis, as well as real time analyze of acceleration data captured by embedded acceleration sensor. In this paper are presented efficient algorithms for ECG and acceleration data analysis. The ECG analysis is focused on arrhythmic heartbeats detection and pathological ST-T segment detection. Arrhythmic heartbeats detection is performed on the estimated ECG model features using Artificial Neural Networks (ANN). In the mobile application alarms could be defined, which triggering can send e-mail messages with attached ECG images and excel formatted data reports. Data from the acceleration sensor are analyzed regarding to monitor user walking activity. Mobile application is integrated in the existing telemedical system using predefined interfaces, but she also provides high autonomy to the end users with or without medical knowledge.
[Show abstract][Hide abstract] ABSTRACT: An efficient ECG modeling algorithm is presented in this paper. The model is based on fitting polynomial functions to real ECG. This algorithm describes a segmentation of a heartbeat and fitting an appropriate polynomial function to the segments. The model performances are evaluated in terms of PRD, preserve of ST-T segment clinical information and the execution time. When comparing this model with the existing one, the PRD improvements can be seen, especially in those signals with high morphological diversity heartbeats. Moreover, the computing time is significantly reduced. Using appropriate model features, ST-T analysis achieves an average accuracy of more than 94%. The obtained data shows that this model is applicable to other ECG processing like: heartbeat analysis, compression and filtering.
[Show abstract][Hide abstract] ABSTRACT: Various beta-blockers with distinct pharmacological profiles are approved in heart failure, yet they remain underused and underdosed. Although potentially of major public health importance, whether one agent is superior in terms of tolerability and optimal dosing has not been investigated. The aim of this study was therefore to compare the tolerability and clinical effects of two proven beta-blockers in elderly patients with heart failure.
We performed a double-blind superiority trial of bisoprolol vs. carvedilol in 883 elderly heart failure patients with reduced or preserved left ventricular ejection fraction in 41 European centres. The primary endpoint was tolerability, defined as reaching and maintaining guideline-recommended target doses after 12 weeks treatment. Adverse events and clinical parameters of patient status were secondary endpoints. None of the beta-blockers was superior with regards to tolerability: 24% [95% confidence interval (CI) 20-28] of patients in the bisoprolol arm and 25% (95% CI 21-29) of patients in the carvedilol arm achieved the primary endpoint (P= 0.64). The use of bisoprolol resulted in greater reduction of heart rate (adjusted mean difference 2.1 b.p.m., 95% CI 0.5-3.6, P= 0.008) and more, dose-limiting, bradycardic adverse events (16 vs. 11%; P= 0.02). The use of carvedilol led to a reduction of forced expiratory volume (adjusted mean difference 50 mL, 95% CI 4-95, P= 0.03) and more, non-dose-limiting, pulmonary adverse events (10 vs. 4%; P < 0.001).
Overall tolerability to target doses was comparable. The pattern of intolerance, however, was different: bradycardia occurred more often in the bisoprolol group, whereas pulmonary adverse events occurred more often in the carvedilol group. This study is registered with controlled-trials.com, number ISRCTN34827306.
European Journal of Heart Failure 03/2011; 13(6):670-80. DOI:10.1093/eurjhf/hfr020 · 6.53 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Pericarditis is a condition with inflammation of the pericardium; however, most of these conditions are not infective and many of them are not even inflammatory. Pericarditis by its development can be acute, sub-acute and chronic, and later, recurring or relapsing. Apart from idiopathic, the causes of pericarditis are numerous, very often inflammatory, most frequently caused by viruses, or tumours and neoplasms, diseases of connective tissue, vasculitis, different allergic reactions, radiation, thyroid gland diseases, uraemia, dissection of aorta etc.
Accumulation of fluid in the pericardium in the amount sufficient to cause significant obstruction of blood inflow in chambers can cause cardiac tamponade. If it is not treated immediately, the outcome may be fatal. The most common causes are tumours, viruses or uraemia. Cardiac tamponade should be suspected in patients with a decrease in systemic arterial pressure or presence of hypotension, tachycardia, silent and discreet heart beats, increase in systemic venous pressure (Beck triad). Electrocardiogram may result in tachycardia, QRS complex is of smaller voltage, often of reversed polarity. The amount of effusion is estimated by echocardiography
The cause of pericarditis should always be searched for. On the other hand, during monitoring or treatment of numerous conditions which could be a frequent cause of pericarditis, the presence of pericardial effusion or cardiac tamponade should be suspected and detected in due time. A timely intervention--pericardiocentesis, can prevent the fatal outcome. Besides non-steroid anti-inflammatory medication, many prospective randomised studies propose colchicine as addition to the standard therapy. When opting for the proper treatment for pericarditis always keep in mind the current diagnosis and cause of this condition.
[Show abstract][Hide abstract] ABSTRACT: INTRODUCTION; Sudden cardiac death or, as it is also called, a modern man's killer occurs a few hours after the beginning of the disease. Sudden death is the one that happens within an hour from the onset of the subjective discomforts regardless of the existence of any previous disease. According to modern statistics, 450.000 people die suddenly in the USA and 150,000 in Germany. CAUSES OF SUDDEN DEATH: The most frequent causes of sudden death are cardiologic or, in other words, a heart rhythm disorder such as ventricular tachycardia, ventricular fibrillation and bradycardiac rhythm disorder. All these reasons can be efficiently prevented by the implantation of the cardioverter defibrillators. IMPLANTABLE CARDIOVERTER DEFIBRILLATOR: In comparison with the already known medications, the defibrillator seems to be the most efficient in prevention of sudden cardiac death. This fact has been confirmed by large multicentre studies. The implantation itself is a routine procedure. It lasts about an hour and it often passes without any complications. The patient leaves the hospital a few days after the procedure. About 150 of these procedures are performed per year at the Institute of Cardiovascular Diseases Vojvodina. The Social Insurance Fund bears medical costs and the patient only pays the participation fee, which is symbolical if compared to the value and use of the device. Owing to this fact, this device is available to every patient thus making the efficient sudden cardiac death prevention possible.
[Show abstract][Hide abstract] ABSTRACT: Apolipoprotein E displays polymorphism with three common alleles, e2, e3, and e4. The aim of this research was to determine apoE gene polymorphism in a group of healthy patients and a group of patients with CHD, and to reveal the relation between anthropometric and biochemical parameters and the apoE genotype. In CHD group significantly higher values of blood pressure, waist circumference, BMI and fat %, triglycerides, insulin (HOMA IR) and CRP were found. A statistically significant higher presence of the e3e4 genotype and e4 allele was detected in the CHD group. Statistically significant differences between waist circumference, BMI, insulin and HOMA IR were found between subjects with e3e3 and e3e4 genotypes.
[Show abstract][Hide abstract] ABSTRACT: INTRODUCTION: Infective endocarditis is defined as an infection of the endothelial surface of the heart and heart valves, above all. It is a great challenge for doctors to diagnose infective endocarditis especially in primary health care, because this is a disease in evolution, bearing in mind changes in epidemiological and clinical characteristics, which developed in the last decades. Even today this is a very severe and insidious disease, with poor prognosis and high mortality. PREVENTION OF INFECTIVE ENDOCARDITIS: Although previous guidelines proposed a limitation to prophylaxis in patients at increased risk of adverse outcome of infective endocarditis, new guidelines recommend the principles of antibiotic prophylaxis when performing procedures at risk of infective endocarditis in patients with predisposing cardiac conditions, and limit its indication to patients at the highest risk of infective endocarditis undergoing the highest risk procedures. CONCLUSION: Despite the fact that previous guidelines for diagnostics and treatment of infective endocarditis were published only several years ago, the Task Force on Prevention, Diagnosis and Treatment of Infective Endocarditis of the European Society of Cardiology identify infective endocarditis as a clearly evolving disease, with changes in its microbiological profile and higher incidence of health care associated cases which has brought about a need for new recommendations to help health care providers in making clinical decisions including preventive measures and antibiotic prophylaxis. As a novelty, a group of patients at the highest risk of infective endocarditis was defined as well as the type of procedures at risk divided into four categories.
[Show abstract][Hide abstract] ABSTRACT: In this paper, an efficient heart beat classification algorithm suitable for implementation on mobile devices is presented. A simplified ECG model is used for feature extraction in the time domain. The QRS complex is modeled using straight lines, while P and T waves are modeled using parabolas. The model parameters are estimated by minimizing the root mean square (RMS) of the model error. Heart beats are classified as one of the following: normal (N), supraventricular (S) and Ventricular (V) ectopic beats using a feed-forward neural network. A series of tests have been performed to evaluate the classification algorithm using the MIT-BIH arrhythmia database ECG signals subset and expressed in the terms of sensitivity (Se), specificity (Sp) and accuracy (Acc). The best results were achieved when the classification algorithm was applied on the third model set. The proposed algorithm has been implemented as a J2ME mobile application. It has been tested on signals recorded by a telemedicine health care system and have achieved an average accuracy above 93%.
[Show abstract][Hide abstract] ABSTRACT: In this paper an efficient heart beat classification algorithm for mobile devices is presented. A simplified ECG model is used for feature extraction in the time domain. QRS complex is modeled by two straight lines while P and T waves are modeled by parabolas. The T wave asymmetry is achieved using a fourth degree parabola, whereas the P wave is modeled by the second degree parabola. The model parameters are estimated using the linear least squares fitting technique.Heart beats are classified using the following classes: Normal, Supraventricular and Ventricular ectopic beats. Classification of model parameters is done using a feed forward neural network The inputs used by the classifier are the following: QRS slopes, duration, P wave coefficients, adjacent and averaged RR intervals. Patient specific adaptation is achieved using a dominant heart beat as an additional classifier input. A series of tests have been performed to evaluate the classification algorithm. Three model sets were used for that purpose. The first one contains QRS parameters only. The second one contains the dominant QRS model as well and in the third model set the P wave and appropriate dominant P wave model are included. Training and testing is done using the MIT BIH arrhythmia database ECG signals subset and expressed in sensitivity (Se), specificity (Sp) and accuracy (Ace). It can be concluded that the best results are achieved when applying the classification algorithm on the third model set. The following results were obtained: SeN = 99.15% (sensitivity for normal heart beat); SpN = 97.5%; AccN = 98.65%; SeV = 94.69% (ventricular heart beat), SpV = 95.66%; AccV = 95.31%, SeS = 928%; SpS = 96.41%; AccS = 94.48%.
[Show abstract][Hide abstract] ABSTRACT: In this paper a mobile system designed for continuous health monitoring of individuals is presented. The system is self configurable, supports multiple simultaneous measurements and can be easily adapted to suit specific circumstances and requirements of each patient. The architecture of the system is described. Experience gained during a prototype implementation is presented as well. A particular focus is given to a XML based communication framework the system is based on. XML gives a considerable flexibility required to describe a variety of sensor types and their parameters
Computer as a Tool, 2005. EUROCON 2005.The International Conference on; 02/2005
[Show abstract][Hide abstract] ABSTRACT: Heparin rebound phenomenon was named to illustrate unstable angina pectoris (UAP) reactivation after stopping heparin. Reinfarction clustering, as well as sharp increase of both thrombin production and activity in the early hours after heparin abandoning have been described (after thrombolysis), which has been partially attributed to heparin rebound. The aim of the study was to show importance of problem of heparin rebound, to suggest possible directions of its avoidance and to present our own initial results with low molecular weight heparin (LMWH) Nadroparin in this context, because data on these topics have been completely lacking in our literature. Total number of pts analyzed was 45 (27 men, 18 women), average age 59.4 ± 4.3, all of them with gastric protection with H 2 blocker. With close inhospital follow-up there was no heparin rebound phenomenon had negative result found, which might be related to the solid duration of therapy. In addition to careful heart rate and blood pressure control, adequate antithrombin therapy seem to improve their prognosis. Side effects were only minor haemorrhages: 5 injection site ecchymoses and 1 gingival haemorrhage, while 39 pts experienced no manifest bleeding, including 9 pts with ulcer history. There are some practical suggestions to reduce heparin-rebound phenomenon: 1) to decrease prothrombotic tendencies in the blood, unrelated to heparin; 2) to improve therapy with standard heparin and to 3) to use newer antithrombotic drugs. We conclude that prevalence of heparin rebound can be lowered probably with adequate duration and dose of standard and LMWH, together with other suggested actions to decrease coagulation and platelet activation. Literature and own data suggest low incidence of heparin rebound phenomenon with enough long LMWH usage. They may be given with easily, with low bleeding rates, and without a need for aPTT monitoring. Thus, LMWHs for a few weeks seems justified in pts at high rethrombosis risk.