From Heart Murmur to Echocardiography - Congenital Heart Defects Diagnostics Using Machine-Learning Algorithms.

The most common clinical sign in pediatric cardiology is heart murmur, which can often be uncharacteristic. The aim of this research was to present the results of development of a classifier based on machine learning algorithms whose purpose is to classify organic murmur that occur in congenital heart defect (CHD). The study is based on the data collected at Pediatric Clinic, Clinical Center University of Sarajevo during three-year period. Totally, 116 children aged from 1 to 15 years were enrolled in the study. Input parameters for classification are parameters obtained during basic physical examination and assessment of patient. First, analysis of relevance of the feature for classification was done using InfoGain, GainRatio, Relief and Correlation method. In the second step, classifiers based on Naive Bayes, Logistic Regression, Decision Tree, Random Forest and Support Vector Machine were developed and compared by performance. The results of this research suggest that high accuracy (>90%) classifier for detection of CHD based on 16 parameters can be developed. Such classifier with appropriate user interface would be valuable diagnostic aid to doctors and pediatricians at primary healthcare level for diagnostic of heart murmurs.

Successful dilatation of underexpanded stent with super-high-pressure balloon: A case report.

Dilatation and percutaneous coronary intervention in the presence of calcified lesions is particularly demanding and presents a challenge in the daily work of an interventional cardiologist. Coronary calcification is a marker of the progress of the atherosclerotic process. The existence of calcifying lesions predicts a poorer clinical outcome and is associated with increased mortality and the occurrence of postprocedural major adverse cardiovascular events (MACEs). A male patient who was 61 years old was admitted as a result of ST-elevation myocardial infarction (STEMI) complicated by cardiac arrest caused by in-stent thrombosis of a previously suboptimally expanded stent. The lesion did not respond to a dilation attempt with a noncompliant (NC) balloon; however, an optimal result was obtained with inflation from a super-high-pressure NC balloon (OPN NC) for ultra-high-pressure inflations. Resistant, calcified lesions require a careful and comprehensive approach. The OPN NC balloon has a place in the treatment of this type of lesion. An optimized therapeutic modality after the procedure is imperative to prevent a MACE.

Significance of copper level in serum and routine laboratory parameters in estimation of outspreading of Hodgkin's lymphoma.

BACKGROUND: The degree of spreading of Hodgkin's lymphoma (HL) is usually estimated according to An Arbor classification system and its modifications. Some laboratory parameters are routinely determined at diagnosis and their abnormal values tries to correlate with disease activity or extension. OBJECTIVES of the research were to identify relationship between common laboratory parameters used in patients with HL, with focus on Serum copper level (SCL) and the degree of spreading of disease expressed through clinical stage (CS). MATERIALS AND METHODS: Research was carried out through retrospective analysis of medical records of 47 previously untreated HL patients. The study evaluated descriptive statistical parameters, mean, median, standard deviation, minimum and maximum values, ANOVA, X2 test, Man-Whitney test and Spearman's correlation. Statistical analyzes performed using SPSS statistical software v.13.0. Results have presented in form of tables and graphs. Significance level less than 0.05 considered significant. RESULTS: The results of study shown good sensitivity of SCL (61,9%), and very high specificity (95,3%) in diagnosis of HL. PPV of SCL in our study was 92,9%, and NPV-- 71,9%. On the other hand, the results did not confirm correlation between serum copper level and spreading of disease. Serum levels of albumin, gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) showed good correlation with clinical stage. CONCLUSION: Our results did not confirm significance of serum copper level in term of staging of HL. Sensitivity and significance of serum copper in HL was very good and real prognostic impact of its elevated level in these patients should be assessed, and the research conducted on a larger number of subjects. Key words: Hodgkin's