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Sladojevic S.,University of Novi Sad | Arsenovic M.,University of Novi Sad | Loncar-Turukalo T.,University of Novi Sad | Sladojevic M.,Institute of Cardiovascular Diseases Vojvodina | Culibrk D.,University of Novi Sad
Studies in Health Technology and Informatics

The burden of chronic disease and associated disability present a major threat to financial sustainability of healthcare delivery systems. The need for cost-effective early diagnosis and disease prevention is evident driving the development of personalized home health solutions. The proposed solution presents an easy to use ECG monitoring system. The core hardware component is a biosensor dongle with sensing probes at one end, and micro USB interface at the other end, offering reliable and unobtrusive sensing, preprocessing and storage. An additional component is a smart phone, providing both the biosensor's power supply and an intuitive user application for the real-time data reading. The system usage is simplified, with innovative solutions offering plug and play functionality avoiding additional driver installation. Personalized needs could be met with different sensor combinations enabling adequate monitoring in chronic disease, during physical activity and in the rehabilitation process. © 2016 The authors and IOS Press. All rights reserved. Source

The hematopoietic cell transplantation comorbidity index (HCT-CI) is predictive of early death and survival in elderly patients with acute myeloid leukemia (AML). The aim of this study was to determine the prognostic role of the HCT-CI for early death and survival in adult AML patients. In the single-center retrospective study, we analyzed the outcome of 233 adult AML patients. The results indicated that the HCT-CI score is an independent predictor of early death in entire cohort of adult patients with AML. In subgroup analysis, HCT-CI is an independent predictor for early death in elderly patients but not in patients younger than 60 years. A high HCT-CI score predicts shorter survival in adult patients with AML. © 2011 Elsevier Ltd. Source

Sladojevic M.,Institute of Cardiovascular Diseases Vojvodina | Sladojevic S.,University of Novi Sad | Culibrk D.,University of Novi Sad | Tadic S.,Institute of Cardiovascular Diseases Vojvodina | Jung R.,Institute of Cardiovascular Diseases Vojvodina
The Scientific World Journal

Different ways have been used to stratify risk in acute coronary syndrome (ACS) patients. The aim of the study was to examine the usefulness of echocardiographic parameters as predictors of in-hospital outcome in patients with ACS after percutaneous coronary intervention (PCI). A data of 2030 patients with diagnosis of ACS hospitalized from December 2008 to December 2011 was used to develop a risk model based on echocardiographic parameters using the binary logistic regression. This model was independently evaluated in validation cohort prospectively (954 patients admitted during 2012). In-hospital mortality in derivation cohort was 7.73%, and 6.28% in validation cohort. Developed model has been designed with 4 independent echocardiographic predictors of in-hospital mortality: left ventricular ejection fraction (LVEF RR = 0.892; 95%CI = 0.854 - 0.932, P < 0.0005), aortic leaflet separation diameter (AOvs RR = 0.131; 95%CI = 0.027 - 0.627, P = 0.011), right ventricle diameter (RV RR = 2.675; 95%CI = 1.109 - 6.448, P = 0.028) and right ventricle systolic pressure (RVSP RR = 1.036; 95%CI = 1.000 - 1.074, P = 0.048). Model has good prognostic accuracy (AUROC = 0.84) and it retains good (AUROC = 0.78) when testing on the validation cohort. Risks for in-hospital mortality after PCI in ACS patients using echocardiographic measurements could be accurately predicted in contemporary practice. Incorporation of such developed model should facilitate research, clinical decisions, and optimizing treatment strategy in selected high risk ACS patients. © 2014 Miroslava Sladojevic et al. Source

Velicki L.,University of Novi Sad | Velicki L.,Institute of Cardiovascular Diseases Vojvodina | Cemerlic-Adjic N.,University of Novi Sad | Cemerlic-Adjic N.,Institute of Cardiovascular Diseases Vojvodina | And 7 more authors.
Thoracic and Cardiovascular Surgeon

Background The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II has been recently introduced as an update to the previous versions. We sought to evaluate the predictive performance of the EuroSCORE II model against the original additive and logistic EuroSCORE models. Patients and Methods The study included 1,247 consecutive patients who underwent cardiac surgery procedures during a 14-month period starting from the beginning of 2012. The original additive and logistic EuroSCORE models were compared with the EuroSCORE II focusing on the accuracy of predicting hospital mortality. Results The overall hospital mortality rate was 3.45%. The discriminative power of the EuroSCORE II was modest and similar to other algorithms (C-statistics 0.754 for additive EuroSCORE; 0.759 for logistic EuroSCORE; and 0.743 for EuroSCORE II). The EuroSCORE II significantly underestimated the all-patient hospital mortality (3.45% observed vs. 2.12% predicted), as well as in the valvular (3.74% observed vs. 2% predicted), and combined surgery cohorts (6.87% observed vs. 3.64% predicted). The predicted EuroSCORE mortality significantly differed from the observed mortality in the third and the fourth quartile of patients stratified according to the EuroSCORE II mortality risk (p<0.05). The calibration of the EuroSCORE II was generally good for the entire patient population (Hosmer-Lemeshow [HL] p=0.139), for the valvular surgery subset (HL p=0.485), and for the combined surgery subset (HL p=0.639). Conclusion The EuroSCORE II might be considered a solid predictive tool for hospital mortality. Although, the EuroSCORE II employs more sophisticated calculation methods regarding the number and definition of risk factors included, it does not seem to significantly improve the performance of previous iterations. © 2014 Georg Thieme Verlag KG Stuttgart. New York. Source

Kovacevic P.,Institute of Cardiovascular Diseases Vojvodina | Redzek A.,Institute of Cardiovascular Diseases Vojvodina | Kovacevic-Ivanovic S.,Clinical Center Vojvodina | Velicki L.,Institute of Cardiovascular Diseases Vojvodina | And 2 more authors.
European Review for Medical and Pharmacological Sciences

Background and Objective: Due to increased life expectancy, the risk profile of the patients undergoing cardiac surgery changed dramatically. This is especially important in case of concomitant coronary artery disease and carotid artery stenosis (CAS). Careful decision making and appropriate surgical strategy in these patients is critical for the success of the operation. Controversy about relationship between staged and concomitant carotid endarterectomy (CEA) and coronary artery bypass grafting (CABG) still exists. In the current study, we present our case lood in treating patients with concomitant carotid artery stenosis and coronary artery disease. Patients and Methods: CABG with additional CEA due to neurologic symptoms or high grade (>80%) CAS has been performed in 835 patients in the period of 1982-2010. Results of evaluation of perioperative mortality and morbidity in regard to the surgical approach have been discussed. Results: The average patient age was 62.6 ± 8.7 years. Echocardiography revealed that 28% of the patients had poor left ventricle ejection fraction (<30%). Coronarography demonstrated that 21.4% of the operated patients had significant left main coronary artery stenosis (>60%). In terms of neurological status, majority of the patients (88.3%) were neurologically asymptomatic. The overall mortality regardless the sequence of procedures was 2.3% (19 patients). In the group of concomitantly treated patients 44.6% (50 patients) required triple coronary bypass while the mean number of coronary bypasses was 2.6. Postoperative neurologic complications were present in 102 patients (12.2%). Eighty-four patients (10.0%) have had TIA, while 18 patients (2.2%) have had permanent neurologic deficit while 4 patients (0.5%) died as a result of it. Conclusions: It is imperative that every patient being considered for CABG should undergo ultrasonic evaluation of the carotid arteries regardless the neurological symptomatology. Concomitant surgery on patients with severe CAS and coronary disease carries a slightly higher operative risk and, therefore, should be avoided. Concomitant surgical treatment should only be considered in patients with unstable angina and significant CAS in whom we may expect higher morbidity and mortality. Source

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