1.Idiopathic ventricular fibrillation with fragmented QRS complex and J wave in resting electrocardiogram
Jing WANG ; Min TANG ; Kexiu MAO ; Jianmin CHU ; Wei HUA ; Yuhe JIA ; Yingjie ZHAO ; Wei WEI ; Xuhua CHEN ; Jielin PU ; Shu ZHANG
Journal of Geriatric Cardiology 2012;09(2):143-147
Objective To describe the clinical characteristics of idiopathic ventricular fibrillation (IVF) with fragmented QRS complex (f-QRS) and J wave in resting electrocardiogram. Methods We reviewed data from 21 case subjects in our hospital who were resuscitated after cardiac arrest due to IVF and assessed the prevalence of f-QRS and J wave in resting electrocardiogram (ECG). All the case subjects were classified among three groups based on the electrocardiographic morphology: group I, both f-QRS and J wave were observed (n = 6), group II, only J wave was observed (n = 9), group III, neither f-QRS nor J wave was observed (n = 6). Population characteristics, history of syncope or sudden cardiac arrest, incidence of ventricular fibrillation (VF), and circumstance of VF were evaluated among the three groups. Results The incidence of index events (syncope, survived cardiac arrest and VF episodes recorded in implantable cardioverter defibrillator (ICD) or pacemakers) was 13.4 ± 5.6 per-year in group I, 10.8 ± 3.9 per-year in group II, and 9.8 ± 4.2 per-year in group III. There were significant differences in incidences among the three groups, the most frequent index events were observed in group I. The hazard ratio for incidence was 3.2 (95%CI, 1.1-7.9; P = 0.01). The history and circumstance of the index events were different among the groups. In group I, all the index events occurred during sleep in early morning. In group II, four subjects suffered VF during strenuous physical activities or agitation state, two during sleep in early morning, three in usual activity. In group III, one subject suffered VF during sleep in early morning, one in agitation state, four in usual activity. Conclusions This study suggests that the IVF patients with the combined appearance of f-QRS and J wave in the resting ECG suffer an increased risk of VF, this subgroup of IVF patients has a unique clinical feature.
2.Influencing factors of peritoneal dialysis associated peritonitis and distribution characteristics of pathogenic bacteria
Yuhe MAO ; Dan XIAO ; Shengjing DENG ; Shaoqing XUE
Journal of Xinxiang Medical College 2024;41(3):257-261
Objective To analyze the influencing factors of peritoneal dialysis associated peritonitis(PDAP)and the distribution characteristics of pathogenic bacteria.Methods The clinical data of 257 patients who underwent peritoneal dialysis(PD)and regular follow-up in Meizhou People's Hospital from January 2012 to October 2022 were retrospectively analyzed.According to the occurrence of PDAP,the patients were divided into the PDAP group(n=102)and the non-PDAP group(n=155).The exhaled liquid(5-10 mL)was extracted with a sterile syringe,and the pathogen was identified by blood culture method.General data such as gender,age,primary disease,education level,whether complicated with hypertension/diabetes/cardiovascular diseases,whether keeping pets or poultry,body mass index(BMI)and dialysis duration were collected.Fasting elbow venous blood was drawn in the morning of the next day after diagnosis,the levels of hemoglobin(Hb),albumin(ALB),serum potassium,serum phosphorus,and serum calcium were detected.The estimated glomerular filtration rate(eGFR)and urea clearance index(UCI)were recorded.Multivariate logistic regression was used to analyze the risk factors of PDAP in PD patients.Results There were 217 cases of PDAP in 102 patients with PDAP,and 124 cases(57.14%)were positive for pathogen culture.A total of 127 pathogenic bacteria were isolated,including 84 Gram-positive strains(66.14%),39 Gram-negative strains(30.71%)and 4 Fungi strains(3.15%).Among the 84 strains of Gram-positive bacteria,there were 25 strains of staphylococcus epidermidis(29.76%),17 strains of staphylococcus aureus(20.24%),12 strains of staphylo-coccus haemolyticus(14.29%),8 strains of staphylococcus warneri(9.52%),10 strains of streptococcus salivarius(11.90%),5 strains of streptococcus sanguis(5.95%),and 7 other strains(8.33%).Among the 39 strains of Gram-nega-tive bacteria,there were 20 strains of escherichia coli(51.28%),6 strains of pseudomonas aeruginosa(15.38%),6 strains of acinetobacter baumannii(15.38%),5 strains of klebsiella pneumoniae(12.82%),and 2 strains of enterobacter cloacae(5.13%).Among the 4 strains of Fungi,there were 3 strains of near-smooth candida(75.00%)and 1 strain of candida glabrata(25.00%).There was no significant difference in gender,age,primary disease,education level,BMI,and the propor-tion of comorbidities with hypertension,diabetes and cardiovascular diseases between the PDAP and non-PDAP groups(P>0.05).The proportion of patients keeping pets or poultry in the PDAP group was higher than that in the non-PDAP group,and the dialysis duration was longer than that in the non-PDAP group(P<0.05).There was no significant difference in serum phosphorus,serum calcium,eGFR and UCI between the PDAP and non-PDAP groups(P>0.05).The levels of Hb,ALB and serum potassium in the PDAP group were significantly lower than those in the non-PDAP group(P<0.05).Logistic regression analysis showed that keeping pets or poultry and long dialysis duration were risk factors for PDAP in PD patients(P<0.05).High Hb and ALB levels were protective factors for PDAP in PD patients(P<0.05).There was no correlation between serum potassium and PDAP in PD patients(P>0.05).Conclusion Gram-positive bacteria are the main pathogenic bacteria of PDAP,among which staphylococcus epidermidis is the predominant one.Keeping pets or poultry and long dialysis duration are risk factors for PDAP,while high Hb and ALB levels are protective factors for PDAP in PD patients.