11 research outputs found
UÄinak dipping profila gestacijske hipertenzije na majÄine simptome i fizikalne nalaze, poroÄajnu težinu i prijevremeni poroÄaj
The study aimed to determine if the non-dipping pattern of blood pressure (BP)
influences preterm delivery in gestational hypertension (GH), but also maternal clinical findings and
birth weight. Sixty women with GH, i.e. 30 women with a dipping BP profile (control group) and 30
non-dippers (study group), were included in the study. Echocardiography was performed in all subjects,
as well as ambulatory blood pressure monitoring (ABPM) during third trimester. ABPM was
repeated 6-8 weeks after delivery. Thirteen women with preterm delivery were classified as non-dippers
and only four as dippers (p=0.01). The average and peak systolic and diastolic night-time BP had
negative linear correlation with birth weight (p<0.0005). Total vascular resistance (p<0.0005) and
mass index (p=0.014) were significantly higher as compared with women with term delivery, while
ejection fraction (EF) (p=0.007) and circumferential systolic velocity (p=0.042) were significantly reduced
in the preterm delivery group. Multivariate binary logistic regression identified the average
night-time systolic BP, left ventricular mass index and EF as independent predictors of preterm delivery.
Study results suggested a relationship of the non-dipping BP pattern in GH with preterm delivery,
birth weight, and maternal clinical findings.Cilj ovoga istraživanja bio je utvrditi povezanost non-dipping profila krvnog tlaka (KT) s prijevremenim poroÄajem,
poroÄajnom težinom novoroÄenÄeta te kliniÄkim i ehokardiografskim parametrima kod žena s gestacijskom hipertenzijom
(GH). Istraživanje je obuhvatilo 60 žena s GH, 30 s dipping profilom KT (kontrolna skupina) i 30 non-dippera (ispitna skupina).
Sve žene podvrgnute su kompletnoj ehokardiografiji i 24-satnom ambulantnom praÄenju krvnog tlaka (ambulatory
blood pressure monitoring, ABPM) tijekom treÄeg trimestra, a ABPM je ponovljen 6-8 tjedana nakon poroÄaja. Ukupno 17
žena imalo je prijevremeni poroÄaj. Trinaest žena s prijevremenim poroÄajem imalo je non-dipping profil KT, dok su samo
Äetiri žene imale dipping profil KT (0,01). ProsjeÄni i maksimalni sistoliÄki i dijastoliÄki noÄni KT imali su negativnu linearnu
korelaciju s poroÄajnom težinom (p<0,0005). Ukupna vaskularna rezistencija (p<0,0005) i indeks mase miokarda lijeve
klijetke (p=0,014) bili su znatno viÅ”i u skupini žena s prijevremenim poroÄajem, dok su parametri sistoliÄke funkcije, tj.
ejekcijska frakcija (EF) (p=0,007) i brzina cirkumferentnog skraÄenja miokarda lijevog ventrikla (p=0,042) bili statistiÄki
znaÄajno sniženi u skupini žena s prijevremenim poroÄajem. Multivarijatna regresijska analiza pokazala je da su prosjeÄni
noÄni sistoliÄki KT, indeks mase lijevog ventrikla i EF identificirani kao nezavisni prediktori prijevremenog poroÄaja. Rezultati
istraživanja pokazali su da postoji povezanost izmeÄu non-dipping profila KT s prijevremenim poroÄajem, poroÄajnom
težinom novoroÄenÄeta i poremeÄajem hemodinamskog statusa majke u GH
Spatial-temporal and Trend Analysis of the Traffic Accidents in the AP Vojvodina (northern Serbia)
The objective of this paper is to analyse the spatial-temporal pattern of traffic
accidents using ten years of data from 2011 to 2020 for the Autonomous Province of Vojvodina, northern part of Serbia. The spatial pattern of traffic accident hot spots and their temporal evolution were identified on the municipality level of the study area using hot spot analysis (GetisāOrd Gi*) techniques within the GIS environment. Trends in the traffic accidents on the municipality level were analysed using Mann-Kendall statistic. In majority of municipalities there were no trend detected. In 15 out of 45 local administrative units some kind of trend in the number of traffic accidents, fatalities and injuries was detected. In only two municipalities, BaÄki Petrovac and Žabalj, trend in the number of traffic accidents is decreasing, while in seven is increasing, BaÄka Palanka, BaÄka Topola, Kanjiža, Kikinda, Mali IÄoÅ”, Novi Kneževac and Vrbas. In only three municipalities decreasing trend in the number of traffic fatalities was detected, BaÄka Topola, Novi BeÄej and Titel. Also, five municipalities have decreasing trend in traffic injuries, Opovo, SeÄanj, VrÅ”ac, Zrenjanin and Žabalj. Hot spot analysis on the number of traffic accidents and
traffic injuries detected hot spots in seven municipalities ā BaÄki Petrovac, BeoÄin, Irig, Novi Sad, Sremski Karlovci, Temerin and Žabalj. In the hot spot analysis on the number of traffic fatalities, there were no hot spots detected. The hot spot analysis on the traffic casualties weighted number showed similar results to the hot spot analysis on the traffic accidents, with only difference regarding persons in tractors. In this category, hot spots were detected in two municipalities ā Nova Crnja and Žabalj. This research holds potential to enhance traffic safety by directing targeted safety measures toward identified hot spots. Such measures could ultimately lead to a reduction in traffic accidents, consequently curbing the number of both fatalities and injuries
Spatial-temporal and trend analysis of traffic accidents in AP Vojvodina (North Serbia)
The objective of this study is to analyse the spatial-temporal patterns of traffic accidents using data from 2011 to 2020 for the AP Vojvodina. The spatial-temporal patterns of traffic accident hotspots were identified at the municipality level using the GetisāOrd Giā statistic in ArcGISPro software. Trends in traffic accidents were analysed using the Mann-Kendall (MK) statistic. A certain trend in the number of traffic accidents, fatalities, and injuries was detected in 15 out of 45 municipalities. In two municipalities, the trend in the number of traffic accidents is decreasing, while in seven, it is increasing. In three municipalities, a decreasing trend in the number of traffic fatalities was observed. A decreasing trend in traffic injuries was identi fied in five municipalities. Hotspot analysis on the number of traffic accidents and traffic injuries revealed hotspots in seven municipalities, while no hotspots were detected in the number of traffic fatalities. In the traffic casualties weighted number, persons in tractors, hotspots were identified in two municipalities. This research has the potential to enhance traffic safety by directing targeted safety measures towards identified hotspots. Such measures could ultimately lead to a reduction in traffic accidents, consequently curbing the number of both fatalities and injuries
Spatial-temporal and Trend Analysis of the Traffic Accidents in the AP Vojvodina (northern Serbia)
The objective of this paper is to analyse the spatial-temporal pattern of traffic
accidents using ten years of data from 2011 to 2020 for the Autonomous Province of Vojvodina, northern part of Serbia. The spatial pattern of traffic accident hot spots and their temporal evolution were identified on the municipality level of the study area using hot spot analysis (GetisāOrd Gi*) techniques within the GIS environment. Trends in the traffic accidents on the municipality level were analysed using Mann-Kendall statistic. In majority of municipalities there were no trend detected. In 15 out of 45 local administrative units some kind of trend in the number of traffic accidents, fatalities and injuries was detected. In only two municipalities, BaÄki Petrovac and Žabalj, trend in the number of traffic accidents is decreasing, while in seven is increasing, BaÄka Palanka, BaÄka Topola, Kanjiža, Kikinda, Mali IÄoÅ”, Novi Kneževac and Vrbas. In only three municipalities decreasing trend in the number of traffic fatalities was detected, BaÄka Topola, Novi BeÄej and Titel. Also, five municipalities have decreasing trend in traffic injuries, Opovo, SeÄanj, VrÅ”ac, Zrenjanin and Žabalj. Hot spot analysis on the number of traffic accidents and
traffic injuries detected hot spots in seven municipalities ā BaÄki Petrovac, BeoÄin, Irig, Novi Sad, Sremski Karlovci, Temerin and Žabalj. In the hot spot analysis on the number of traffic fatalities, there were no hot spots detected. The hot spot analysis on the traffic casualties weighted number showed similar results to the hot spot analysis on the traffic accidents, with only difference regarding persons in tractors. In this category, hot spots were detected in two municipalities ā Nova Crnja and Žabalj. This research holds potential to enhance traffic safety by directing targeted safety measures toward identified hot spots. Such measures could ultimately lead to a reduction in traffic accidents, consequently curbing the number of both fatalities and injuries
Spatial-temporal and trend analysis of traffic accidents in AP Vojvodina (North Serbia)
The objective of this study is to analyse the spatial-temporal patterns of traffic accidents using data from 2011 to 2020 for the AP Vojvodina. The spatial-temporal patterns of traffic accident hotspots were identified at the municipality level using the GetisāOrd Giā statistic in ArcGISPro software. Trends in traffic accidents were analysed using the Mann-Kendall (MK) statistic. A certain trend in the number of traffic accidents, fatalities, and injuries was detected in 15 out of 45 municipalities. In two municipalities, the trend in the number of traffic accidents is decreasing, while in seven, it is increasing. In three municipalities, a decreasing trend in the number of traffic fatalities was observed. A decreasing trend in traffic injuries was identi fied in five municipalities. Hotspot analysis on the number of traffic accidents and traffic injuries revealed hotspots in seven municipalities, while no hotspots were detected in the number of traffic fatalities. In the traffic casualties weighted number, persons in tractors, hotspots were identified in two municipalities. This research has the potential to enhance traffic safety by directing targeted safety measures towards identified hotspots. Such measures could ultimately lead to a reduction in traffic accidents, consequently curbing the number of both fatalities and injuries
Clinical use of optical coherence tomography and fractional flow reserve
Introduction. The aim of each diagnostic method is to serve as a guide in
deciding about the right patient treatment. During myocardial
revascularization the decision to perform revascularization is usually not
easy to make, especially in case of borderline stenosis. It has been proven
that it is not enough to base morphological evaluation of coronary artery
vessel stenosis solely on angiography. It is necessary to include additional
modern diagnostic methods for functional analysis and detailed morphological
analysis using fractional flow reserve (FFR) and optical coherence tomography
(OCT), respectively. Case reports. In the first case report we showed the
significance of morphological analysis using OCT and proved that it was not
lumen stenosis. The second and the third case reports showed the
complementarity between functional analysis (FFR) and morphological analysis
(OCT) of stenosis in solving a complex coronary disease. The fourth case
report showed the significance of OCT in dealing with the recurrent stent
restenosis. Conclusion. By these short case reports we confirmed that
percutaneous coronary intervention (PCI) guided by angiography is definitely
not enough in deciding about myocardial revascularization especially in
patients with a complex coronary disease. In certain cases FFR and OCT
procedures can be complementary methods and improve quality of
revascularization, particularly in the case of recurrent in-stent restenosis
Recanalization of coronary artery chronic total occlusion by retrograde approach
Introduction. Chronic total occlusion (CTO) is defined as a 100% obstruction of the blood vessel lumen with Thrombolysis in Myocardial Infarction grade 0 flow in the occluded segment at least three months old. Advancement of technological devices and techniques used during the percutaneous coronary interventions (PCI) in the past years brought more success in blood vessel recanalization. According to the latest guidelines for myocardial revascularization, the CTO treatment should be considered when there are symptoms or objective proof of viability or ischemia in the occluded area. The aim of this work is to present two cases with a recanalization of the coronary artery CTO by the retrograde approach. Outline of cases. The first patient had a single vessel coronary disease which led to a decision to first attempt PCI. During the attempt of antegrade recanalization, the guidewire penetrated subintimally, risking blood vessel dissection below the occluded area as well as serious complications. Retrograde approach enabled easier and safer passing of guidewire through the occlusion and then successful establishment of the antegrade flow. In the second case, the antegrade approach was also first attempted. Since it could not pass through the occluded area despite changing several guidewires, the strategy was changed during the intervention. It was continued with the retrograde approach, which led to the successful revascularization. Conclusion. These two cases demonstrate that retrograde approach and new technological improvements in dedicated guidewires can be implemented in everyday angiography practice for successful recanalization of CTO lesions
Clinical characteristic and management of elderly patients with myocardial infarction
Introduction/Objective. Population of elderly people is increasing and modern medicine is faced with the problem of large morbidity and mortality from cardiovascular diseases in this age group. Modern treatment strategies have not been sufficiently investigated in the elderly, therefore these people often receive suboptimal treatment. The aim of the study was to evaluate clinical characteristic, cardiac risk factors, management strategies and early outcome in the elderly patient with ST elevated myocardial infarction (STEMI). Methods. This retrospective study included 217 consecutive patients, aged ā„ 70 years (mean age 77.6 Ā± 4.9 years, 103 men, 114 women) with STEMI admitted to the Institute of Cardiovascular Diseases of Vojvodina. We have analyzed patientsā clinical characteristics, risk factors, left ventricular function and treatment strategies in relation to in-hospital outcome. Results. First clinical symptom was chest pain in 209 (96.3%) of patients. On admission, 35 (16.1%) patients were with severe signs of heart failure (Killip class IIIāIV). Duration of symptom onset to hospital admission was 14.7 Ā± 28.6 hours. Out of 217 patients, 168 (77.4%) patients received reperfusion treatment, including primary percutaneous coronary ntervention (PPCI) in 164 (75.6%) patients, and fibrinolytic therapy in 4 (1.8%) patients. Hospital mortality was 26.3% (57 patients). PPCI was univariate predictor of lower in-hospital mortality, whereas multivariate predictors of in-hospital mortality were cardiogenic shock (OR 67.095; 95% CI (6.845ā657.646); p < 0.001) and low ejection fraction (OR 0.901; 95% CI (0.853ā0.963); p = 0.001). Conclusion. In elederly patients presenting with STEMI, PPCI was asscoiated with lower mortality, whereas cardiogenic shock and lower ejection fraction were independent predictors of worse prognosis after STEMI
Left Atrial Strain as a Predictor of Left Ventricular Diastolic Dysfunction in Patients with Arterial Hypertension
Background and Objectives: There is emerging evidence of the usefulness of left atrial strain (LAS) in the assessment of diastolic dysfunction (DD). In this study we assess the sensitivity and specificity of LAS, to determine cut-off values and their association to DD with increased left atrial pressure (LAP) in patients with well-treated arterial hypertension. Materials and Methods: We performed a cross-sectional study on 180 subjects with well-treated arterial hypertension. All patients underwent transthoracic echocardiography. Patients were divided into two groups: a group without increased LAP and/or DD and a group with increased LAP DD. Results: In multivariate logistic regression, LAS proved to be the strongest statistically significant predictor of DD with increased LAP (OR 0.834, p 24.27% was significantly highly prevalent in the group of DD with increased LAP 78.9% when compared to the group without increased LAP 15.4%, p Conclusion: The findings of this study suggest that LAS could be a useful and highly sensitive and specific marker in the evaluation of DD. There is the potential for using LAS in everyday practice as a standard parameter in diastolic function assessment
Characteristics and Outcomes of Patients with Acute Coronary Syndrome and COVID-19
Acute coronary syndrome (ACS) in patients with COVID-19 is triggered by various mechanisms and can significantly affect the patientās further treatment and prognosis. The study aimed to investigate the characteristics, major complications, and predictors of mortality in COVID-19 patients with ACS. All consecutive patients hospitalized from 5 July 2020 to 5 May 2021 for ACS with confirmed SARS-Co-2 were prospectively enrolled and tracked for mortality until 5 June 2021. Data from the electronic records for age and diagnosis, matched non-COVID-19 and COVID-19 ACS group, were extracted and compared. Overall, 83 COVID-19 ACS patients, when compared to 166 non-COVID ACS patients, had significantly more prevalent comorbidities, unfavorable clinical characteristics on admission (acute heart failure 21.7% vs. 6.6%, p p p p p p < 0.01. Concomitant ACS and COVID-19 is linked to underlying comorbidities, adverse presenting features, and poor outcomes. Urgent strategies are needed to improve the outcomes of these patients