Browsing by Author "Zdravkovic, Nebojsa"

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Admission Predictors of Mortality in Hospitalized COVID-19 Patients—A Serbian Cohort Study
(2022) Poskurica, Mina; Stevanovic, Dejan; Zdravkovic, Vladimir; Cekerevac, Ivan; Ćupurdija, Vojislav; Zdravkovic, Nebojsa; Nikolić, Tomislav; Markovic M.; Jovanovic M.; Popovic M.; Vesić, Katarina; Azanjac Arsic A.; Lazarevic, Snezana; Jevtovic, Andra; Patrnogić A.; Anđelković, Maja; Petrovic, Marina
Background: Early prediction of COVID-19 patients’ mortality risk may be beneficial in adequate triage and risk assessment. Therefore, we aimed to single out the independent morality predictors of hospitalized COVID-19 patients among parameters available on hospital admission. Methods: An observational, retrospective–prospective cohort study was conducted on 703 consecutive COVID-19 patients hospitalized in the University Clinical Center Kragujevac between September and December 2021. Patients were followed during the hospitalization, and in-hospital mortality was observed as a primary end-point. Within 24 h of admission, patients were sampled for blood gas and laboratory analysis, including complete blood cell count, inflammation biomarkers and other biochemistry, coagulation parameters, and cardiac biomarkers. Socio-demographic and medical history data were obtained using patients’ medical records. Results: The overall prevalence of mortality was 28.4% (n = 199). After performing multiple regression analysis on 20 parameters, according to the initial univariate analysis, only four independent variables gave statistically significant contributions to the model: SaO2 < 88.5 % (aOR 3.075), IL-6 > 74.6 pg/mL (aOR 2.389), LDH > 804.5 U/L (aOR 2.069) and age > 69.5 years (aOR 1.786). The C-index of the predicted probability calculated using this multivariate logistic model was 0.740 (p < 0.001). Conclusions: Parameters available on hospital admission can be beneficial in predicting COVID-19 mortality.
Analysis of knee joint forces in different types of jumps of top futsal players at the beginning and at the end of the preparation period
(2021) Radakovic, Radivoje; Mijailović, Bratislav; Petrović N.; Vulović, Aleksandra; Filipovic, Nenad; Zdravkovic, Nebojsa
In this study, we will consider the forces in the knee joints of futsal players at the beginning and at the end of the training process focusing on two types of jumps: jumps without swing and jumps with swing. This study has two main objectives. The first objective is to compare the forces in the knee joint at the beginning and at the end of the training process in jumps without a swing and in jumps with a swing. The second objective is to show the distribution of deformations and stresses in the menisci of the knee joint at the beginning and at the end of the training process. Professional futsal players performed jumps that were analyzed using a force plate and high-speed video camera system. For this purpose, a 3D model of the human knee joint was developed from medical scans consisting of femur, fibula, tibia, articular cartilage, ligaments and menisci. Loads and material characteristics were adopted from the literature. Using finite element analysis, we were able to obtain a better insight into the distribution of deformation and stress in particular parts of the knee joint.
Improving Blood Pressure Control Using Digital Communication Methods in Serbia
(2022) Tasic N.; Tasic D.; Kovacevic Z.; Filipović M.; Arsić M.; Bozovic-Ogarevic S.; Despotovic B.; Bojic M.; Maksimović Z.; Zdravkovic, Nebojsa; Mijailović V.; Zivkovic, Vladimir; Nikolic Turnic, Tamara; Jakovljevic, Vladimir
Background: The purpose of this study was to compare home and office BP in the adjustment of antihypertensive treatment. Methods: This study was an open, prospective, noninterventional, multicenter clinical trial that occurred between July 2019 and February 2020, in 34 cities in the territory of the Republic of Serbia, which monitored 1581 participants for 6 months. Depending on the used blood pressure monitoring method used, all patients were divided into control (office BP monitoring) and experimental (home BP telemonitoring) groups. We collected anamnestic data and data about systolic blood pressure (SP), in mmHg, diastolic blood pressure (DP), in mmHg, and heart rate (HR), in beats/minute, from all patients. Results: SP values were significantly different at baseline, and at the second, third, and fourth visits between the two tested groups. Home and office BP decreased significantly (p < 0.000) during the 6-month follow-up. We observed a statistically significant influence of the presence of diabetes mellitus and dyslipidemia on the dynamics of differences between SP monitoring values. Conclusions: Our study suggests that novel technologies in BP monitoring can be excellent alternatives for BP assessment in hypertensive patients with other cardiovascular risk factors such as diabetes and dyslipidemia.
Lethal outcome in a healthy man infected with covid-19
(2020) Opancina, Valentina; Sazdanovic, Predrag; Baskic, Dejan; Opančina Miljan; Zdravkovic, Nebojsa; Vojinovic, Radisa
© 2020, University of Kragujevac, Faculty of Science. All rights reserved. COVID-19 is defined as a respiratory infection which is spread by droplets and immediate contact with an infected per-son. The first case of COVID-19 infection in Serbia was reported on March 6th, 2020. Herein, we present the case of confirmed COVID-19 infection in a previously healthy man, whose three other family members showed mild symptoms of coronavirus disease, without the need for hospitalization. The patient was treated at the tertiary medical center, four days after the onset of symptoms. During the hospi-talization, he developed serious complications and fatal outcome. In this case, hypoxia-induced cardiac arrest was secondary to severe COVID-19 pneumonia with the development of acute respiratory distress syndrome and sepsis. Laboratory and flow cytome-try results indicate the presence of the cytokine storm, while the mechanical ventilation might potentially increase the risk of lethal outcome. This case report is important because it should give clinicians the insight into the treatment of the previously healthy individuals with COVID-19, especially in terms of possible laboratory markers that could indicate the presence of the cytokine storm phenom-enon.
Mortality characteristics in sumadija district from 2010 – 2017
(2021) Mihailovic, Natasa; Zdravkovic, Nebojsa; Milicic, Biljana; Kocic, Sanja; Milicic, Vesna; Rakic Olivera
Mortality rate represents a number of deaths on a particular territory per time unit. There are general and specific mortalities. The aims at analysing the characteristics of mortality in Sumadija District for the time period ranging from 2010 – 2017. The study includes all death cases in the District of Sumadija in period 2010-2017, 34681 cases. The data are described and analysed with χ² test and linear trend. The trend analysis does not indicate any significant vari-ations during the given time span. The gender analysis re-veals that there is a significantly higher number of deceased persons among male population (52.2%, 47.8%, р<0.05). The average age of the deceased females (76.2±13.4) was higher than the average age of males (73.8±14.1) (р<0.05). The cause-specific analysis shows that natural causes of death dominate absolutely (96.5%) over violent deaths (2.7%) and undetermined causes (0.8%). The distribution of death causes according to ICD 10 shows that the most frequent causes of death are heart and blood vessel diseases, respiratory and neoplasm diseases. The life expectancy of the inhabitants of Sumadija District is increasing over time. There was a slight decrease in the mortality rates during the observed time period. The highest number of the deceased people is 65 or more years old. Men have higher mortality rates throughout their lives. Natural death and non-communicable diseases are dominant. The most common causes of death are heart and blood vessels diseases, in women, and respiratory and neo-plasm diseases, in men.
Performance Analysis of MVDR Beamformer Applied on an End-fire Microphone Array Composed of Unidirectional Microphones
(2021) Šarić, Zoran; Subotić M.; Bilibajkic R.; Barjaktarovic, Marko; Zdravkovic, Nebojsa
Microphone array with minimum variance (MVDR) beamformer is a commonly used method for ambient noise suppression. Unfortunately, the performance of the MVDR beamformer is poor in a real reverberant room due to multipath wave propagation. To overcome this problem, we propose three improvements. Firstly, we propose end-fire microphone array that has been shown to have a better directivity index than the corresponding broadside microphone array. Secondly, we propose the use of unidirectional microphones instead of omnidirectional ones. Thirdly, we propose an adaptation of its adaptive algorithm during the pause of speech, which improves its robustness against the room reverberation and deviation from the optimal receiving direction. The performance of the proposed microphone array was theoretically analyzed using a diffuse noise model. Simulation analysis was performed for combined diffuse and coherent noise using the image model of the reverberant room. Real room tests were conducted using a four-microphone array placed in a small office room. The theoretical analysis and the real room tests showed that the proposed solution considerably improves speech quality.
The impact of different diuretics on regression of myocardial reperfusion injury in spontaneously hypertensive rats
(2022) Dragasevic N.; Savic, Maja; Mihajlović K.; Zivkovic, Vladimir; Andjic, Marijana; Draginic, Nevena; Zdravkovic, Nebojsa; Bolevich, Sergey; Bolevich, Stephani Sergeevna; Jakovljevic, Vladimir; Nikolic Turnic, Tamara
The study's objective was to ascertain the results of sub-chronic therapy of various diuretics on the ischemia/reperfusion dysfunction of the heart in hypertensive rats by a global ischemia in an isolated rat heart model. The research included 40 spontaneously hypertensive male rats (Wistar Kyoto strain, body mass 250 ± 30 g, 8 weeks old) grouped into four groups. The animals were treated for 4 weeks with 10 mg/kg of hydrochlorothiazide, indapamide, or spironolactone per os. After a period of sub-chronic treatment, we analyzed hemodynamic measurements, echocardiography, and myocardial function according to the Langendorff retrograde perfusion method. The hearts were subjected to 20 min of global ischemia and then reperfused for 30 min (I20:R30). Cardiovascular parameters that depict the left ventricle functions were continuously monitored, while flowmetry was used to determine coronary flow values. Markers of oxidative stress were estimated from coronary venous effluent using spectrophotometry. All three examined diuretics (hydrochlorothiazide, spironolactone, indapamide) lowered the production of the majority of the detected prooxidants, reducing myocardial oxidative damage. The cardiological examination of heart function in vivo demonstrated that treatment with indapamide and spironolactone mitigates left ventricular hypertrophy but without significant lowering of blood pressure or increment in ejection fraction. Additionally, monitoring of cardiac function ex vivo indicated the cardiodepressant effect of spironolactone in spontaneously hypertensive rats.
THE ROLE OF HMG COA REDUCTASE INHIBITORS ON THE PROGRESSION OF CORONARY ARTERY DISEASE: FOCUS ON PREDICTION MODEL
(2021) Stojic, Vladislava; Andjelkovic Cirkovic, Bojana; Zdravkovic, Nebojsa; Dimitrijević J.; Kocic V.; Filipovic, Nenad
Currently, an integrated site-specific and patient-specific comprehensive predictive model of plaque progression in various CVD is not available. In this study, we considered medical records of 256 patients obtained within the EU H2020 SMARTool project which is carefully designed to collect the features from various domains relevant for disease which are used in everyday clinical practice. The database contains detailed information of patients with suspected CAD disease regarding the clinical status, risk factors, routine blood analyses, CAD morphology and progression and current therapy. Results showed that there was statistically significant difference of values of this parameter for the SMARTool patients with and without disease progression, measured at the follow-up, F(1,250)=33.39, p < 0.001, while the CAD Score in the follow-up is significantly different from the score measured at the initial time point, F(1,254)=76.244, p < 0.001. The significant interaction of statins is achieved with aspirin F(1,252)= 3.921, p=0.049, while interactions with other medicaments are insignificant for CAD Score. The results showed that there was no significant interaction of statins and dyslipidemia, F(1,251)=0.877, p = 0.350. Also, there was no significant interaction of statins and hypertension, F(1,245)=0.283, p=0.596. The CAD score in the baseline was significantly different among patients who were further prescribed with therapy than those who were not, and this trend remained unchanged after a given time period, i.e. those patients who were at risk had progression in addition to statins, but the combination of statins and aspirin was shown as effective in decreasing the CAD Score. The Random Forest classifier applied on 24 selected features is the most reliable among all tested ML algorithms for the prediction of CAD progress.