PREDICTORS OF CAROTID INTIMA MEDIA THICKNESS IN OBESE ADOLESCENTS

Our aim was to assess cardiovascular risk factors that may predict increased carotid intima media thickness (cIMT) in obese children and adolescents. Children and adolescents were included in the cross-sectional study if they were aged 9-19 years and had primary obesity. Besides anthropometric and biochemical measurements, ambulatory blood pressure monitoring, measurement of carotid intima media thickness and exercise stress test were performed. We included 103 obese patients and divided them according to the ambulatory blood pressure findings in two groups: obese patients with and without ambulatory hypertension. There were 49 obese patients with and 54 without ambulatory hypertension Univariate analysis showed that there was a significant positive correlation of cIMT with age (r = 0.334, p= 0.001), body mass index (r = 0.288, p = 0.004), waist circumference (r = 0.352, p = 0.000), hip circumference (r = 0.288, p = 0.004), night-time systolic blood pressure (r = 0.226, p = 0.027), and peak diastolic blood pressure on exercise test (r = 0.241, p = 0.018). In a stepwise model, age, waist circumference and peak diastolic blood pressure on exercise test were independent predictors of cIMT

CASE REPORT OF A 17 - YEAR OLD GIRL WITH ATYPICAL CLINICAL PRESENTATION OF - ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY

We report a case of a 17-year-old girl diagnosed with arrhythmogenic right ventricular cardiomyopathy (ARVC), who has been wrongly considered as having idiopathic ventricular extrasystoles for 13 years. The only noteworthy clinical finding until the final diagnosis was made, were complex ventricular arrhythmias (VA) during exercise as well as nonspecific repolarisations changes in inferolateral leads. We would like to increase paediatricians alertness to children presenting with so called “idiopathic” exercise induced VA that at time could turn out to be markers of arrhythmogenic condition.Key words: arrhythmogenic right ventricular cardiomyopathy, ventricular arrhythmias

Fractional flow reserve of intermediate lesions on collateral donor coronary arteries after myocardial infarction

Fractional flow reserve (FFR) is the gold standard for the functional assessment of coronary arteries. The aim of this study was to evaluate the relation between angiography, QCA and FFR in borderline lesions on collateral donor coronary arteries. In addition, FFR is compared with the angiographic appearance of collaterals to infarction-related arteries and echocardiographically assessed viability of infarct related the LV wall. In 60 patients with previous IM and occluded IRA, functional assessment of borderline coronary stenosis (30-70% DS) on collaterals donor artery was performed. We have not found statistically significant differences in these parameters between groups with different angiographic appearances of collaterals and different viability of distal myocardium. However, we found higher FFR values in diabetic patients (p=0.018). Higher FFR values in diabetic patients reveal the negative effects of diabetes on collateral growth and myocardial viability

Oral propranolol for infantile hemangiomas: a prospective study on the role of 48-hour Holter monitoring in additional safety assessment

Purpose: Oral propranolol has been recently approved for infantile hemangiomas (IHs), but potential side effects stay a challenge. We sought to make an additional assessment on oral propranolol safety for this indication. Materials and methods: Prospective study included 108 infants consecutively treated for IHs at the University Children’s Hospital Tirsova, Belgrade from January 2010 to December 2013. Propranolol was administered orally at a daily dose of 0.5 mg/kg and doubled every 48 hours in the absence of side effects until reaching the maximum dose of 2 mg/kg daily. Systolic and diastolic blood pressure and heart rate were measured every 48 hours with clinical observation. Heart rate was monitored by standard electrocardiogram (ECG) and 48-hour Holter ECG. Results: Statistically significant, but asymptomatic decreases in systolic blood pressure and heart rate recorded by Holter ECG were observed during the first doubling of dose and then remained stable. Arrhythmias were not detected. Despite mild sleep disturbance observed in 31% of infants in the hospital milieu, Holter monitoring indicated circadian rhythm maintenance. Conclusions: Oral propranolol for IHs does not remarkably affect heart rhythm including circadian variations throughout hospital initiation. Therefore, there is no necessity for Holter monitoring in additional safety assessment

Multi-purpose ECG telemetry system

Abstract Background The Electrocardiogram ECG is one of the most important non-invasive tools for cardiac diseases diagnosis. Taking advantage of the developed telecommunication infrastructure, several approaches that address the development of telemetry cardiac devices were introduced recently. Telemetry ECG devices allow easy and fast ECG monitoring of patients with suspected cardiac issues. Choosing the right device with the desired working mode, signal quality, and the device cost are still the main obstacles to massive usage of these devices. Methods In this paper, we introduce design, implementation, and validation of a multi-purpose telemetry system for recording, transmission, and interpretation of ECG signals in different recording modes. The system consists of an ECG device, a cloud-based analysis pipeline, and accompanied mobile applications for physicians and patients. The proposed ECG device’s mechanical design allows laypersons to easily record post-event short-term ECG signals, using dry electrodes without any preparation. Moreover, patients can use the device to record long-term signals in loop and holter modes, using wet electrodes. In order to overcome the problem of signal quality fluctuation due to using different electrodes types and different placements on subject’s chest, customized ECG signal processing and interpretation pipeline is presented for each working mode. Results We present the evaluation of the novel short-term recorder design. Recording of an ECG signal was performed for 391 patients using a standard 12-leads golden standard ECG and the proposed patient-activated short-term post-event recorder. In the validation phase, a sample of validation signals followed peer review process wherein two experts annotated the signals in terms of signal acceptability for diagnosis.We found that 96% of signals allow detecting arrhythmia and other signal’s abnormal changes. Additionally, we compared and presented the correlation coefficient and the automatic QRS delineation results of both short-term post-event recorder and 12-leads golden standard ECG recorder. Conclusions The proposed multi-purpose ECG device allows physicians to choose the working mode of the same device according to the patient status. The proposed device was designed to allow patients to manage the technical requirements of both working modes. Post-event short-term ECG recording using the proposed design provide physicians reliable three ECG leads with direct symptom-rhythm correlation

PREDICTORS OF CAROTID INTIMA MEDIA THICKNESS IN OBESE ADOLESCENTS

Our aim was to assess cardiovascular risk factors that may predict increased carotid intima media thickness (cIMT) in obese children and adolescents. Children and adolescents were included in the cross-sectional study if they were aged 9-19 years and had primary obesity. Besides anthropometric and biochemical measurements, ambulatory blood pressure monitoring, measurement of carotid intima media thickness and exercise stress test were performed. We included 103 obese patients and divided them according to the ambulatory blood pressure findings in two groups: obese patients with and without ambulatory hypertension. There were 49 obese patients with and 54 without ambulatory hypertension Univariate analysis showed that there was a significant positive correlation of cIMT with age (r = 0.334, p= 0.001), body mass index (r = 0.288, p = 0.004), waist circumference (r = 0.352, p = 0.000), hip circumference (r = 0.288, p = 0.004), night-time systolic blood pressure (r = 0.226, p = 0.027), and peak diastolic blood pressure on exercise test (r = 0.241, p = 0.018). In a stepwise model, age, waist circumference and peak diastolic blood pressure on exercise test were independent predictors of cIMT

The prevalence and socioeconomic correlates of depressive and anxiety symptoms in a group of 1,940 Serbian university students

© 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. Mental health of university students is under increasing concern worldwide, because they face challenges which predisposes them to depression and anxiety. The aim of this study was to identify demographic and socioeconomic variables associated with depressive and anxiety symptoms among university students. Methods. This cross-sectional study on 1,940 university students was performed using a questionnaire including demographic and socioeconomic variables, Beck Depression Inventory and Beck Anxiety Inventory. Results. The prevalence of depressive symptoms in students was 23.6%, while the prevalence of anxiety symptoms was 33.5%. The depressive symptoms were significantly related to the study year (p = 0.002), type of faculty (p = 0.014), satisfaction with college major choice (p < 0.001), satisfaction with grade point average (p < 0.001). Female students (odds ratio – OR = 1.791, 95% confidence interval – CI = 1.351–2.374), older students (OR = 1.110, 95% CI = 1.051-1.172), students who reported low family economic situation (OR = 2.091, 95% CI = 1.383–3.162), not owning the room (OR = 1.512, 95% CI = 1.103–2.074), dissatisfaction with graduate education (OR = 1.537, 95% CI = 1.165–2.027) were more likely to show depressive symptoms. The anxiety symptoms were significantly related to study year (p = 0.034), type of faculty (p < 0.001), family economic situation (p = 0.011), college residence (p = 0.001) satisfaction with the college major choice (p = 0.001), and satisfaction with graduate education (p < 0.001). Female students (OR = 1.901, 95% CI = 1.490–2.425), and students who reported parents high expectations of academic success (OR = 1.290, 95% CI = 1.022–1.630) were more likely to show anxiety symptoms. Conclusion. This is one of the largest study examining mental disorders in a sample of university students in Serbia. These findings underscore the importance of early detections of mental problems and prevention interventions in university students

The impact of somatic symptoms on depressive and anxiety symptoms among university students in central Serbia

© 2018, Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved. Background/Aim. Depression and anxiety problems are a major public health concern due to their high prevalence rates, difficult treatment, and often chronic course. This study examined the impact of somatic symptoms on depressive and anxiety symptoms among university students in Serbia. Methods. A cross-sectional study was performed among 1,940 students using a questionnaire specially designed for this study which included presence of Somatic and Non-specific Mental Symptoms (SNMS), Beck Depression Inventory and Beck Anxiety Inventory. The presence of somatic and associated non-specific mental symptoms over the last six months served as the basis for creating a new variable called SNMS score. Results. Receiver operating characteristic (ROC) curve showed that the SNMS score might be a very good marker for the distinction of students with or without depressive symptoms (area = 0.754, p < 0.05). The threshold value was 8.50 (sensitivity 67.6%, specificity 69.4%). Binary logistic regression showed that Odds ratio was 1.052 [95% confidence interval (CI) 1.045–1.059], which means that an increase in the value of the SNMS score by 1 increases the risk of depressive symptoms by 5.2%. ROC curve showed that the SNMS score might be an excellent marker for the distinction of students with or without anxiety symptoms (area = 0.800, p < 0.05). Limit value (cut-off) was 7.50 (sensitivity 74.2%, specificity 71.6%). Binary logistic regression showed that odds ratio was 1.056 (95% CI 1.049–1.064), which means that increasing the value of SNMS score by 1 increases the risk of anxiety symptoms by 5.6%. Conclusion. The SNMS score might be a state marker for the screening and distinction of students with depressive symptoms, and excellent state marker for screening and making distinction between students with anxiety symptoms and the students who do not have these symptoms