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 su...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- 4.2 per-year in group HI. 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.展开更多
Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in pa...Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in patients with unstable angina pectoris （UAP）. This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diag- nosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of ad- verse cardiovascular （CV） events, including hospital readmission for angina pectoris, acute myocardial infarction （AMI）, congestive heart failure （CHF）, stroke and all-cause mortality. Results During a mean follow-up time of 26.3±8.6 months, 98 adverse CV events occurred （84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality）. In a multivariate Cox model, LAAI [OR： 1.140, 95% CI： 1.01±1.279, P = 0.026], diastolic blood pressure （OR： 0.976, 95% CI： 0.956-0.996, P = 0.020） and pulse pressure （OR 1.020, 95% CI： 1.007-1.034, P = 0.004） were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.展开更多
In recent years, the retired veteran cadres have grown older and older, and their numbers have also increased year by year. In this case, how to maintain the physical and mental health of empty nest veteran cadre, and...In recent years, the retired veteran cadres have grown older and older, and their numbers have also increased year by year. In this case, how to maintain the physical and mental health of empty nest veteran cadre, and further improve the quality of their life has been a realistic problem many primary health care doctors have to face and solve.展开更多
We have read the article which entitled ＂Neutrophil-to- lymphocyte ratio compared to N-terminal pro-brain natri- uretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure...We have read the article which entitled ＂Neutrophil-to- lymphocyte ratio compared to N-terminal pro-brain natri- uretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure＂ published in Journal of Geriatric Cardiology with great interest, However, we have some comments regarding this study.展开更多
Land was important--in the course of spreading and seeking new converts--for both Missionaries of Africa （White Fathers） and Church Missionary Society （C.M.S.） in Buha, Western Tanzania. This paper examines the la...Land was important--in the course of spreading and seeking new converts--for both Missionaries of Africa （White Fathers） and Church Missionary Society （C.M.S.） in Buha, Western Tanzania. This paper examines the land question as one of the challenges that the White Fathers encountered in their attempt to evangelize communities in Western Tanzania. I argue that the land question remained throughout the late-colonial period one of the unresolved issues, and at some mission stations, impeded the activities of the White Fathers and C.M.S. missionaries. This paper relies on archival documents first, to examine the land question and White Fathers-C.M.S. relations in Buha from 1934 to 1959. Second, I intend to demonstrate the fact that land issues remained at the heart of the missionary enterprise in Buha. Both Catholic and Anglican missionaries were determined to have more mission plots for medical, education and religious purposes.展开更多
Psychological trauma refers to the catastrophic or traumatic events harmful to individuals＇ inner world. Strong emotional and psychological reaction caused by traumatic factors will form psychological shadows, and th...Psychological trauma refers to the catastrophic or traumatic events harmful to individuals＇ inner world. Strong emotional and psychological reaction caused by traumatic factors will form psychological shadows, and the improper coping of these events will lead to a post-traumatic stress disorder. In this paper, the author makes an exploration on the roots of psychological trauma and of post-traumatic stress reaction or disorders, which were caused by natural traumatic event, such as floods, snowstorms, earthquakes and other man-made factors such as wars, accidents from a psychological point of view. Finally, some suggestions of intervention are provided for the relevant departments to make relevant rebuilding policies.展开更多
Objective Cardiovascular complications contribute to postoperative morbidity and mortality in elderly hip fracture patients. Limited data are available regarding which preoperative risk factors predict cardiovascular ...Objective Cardiovascular complications contribute to postoperative morbidity and mortality in elderly hip fracture patients. Limited data are available regarding which preoperative risk factors predict cardiovascular course following hip fracture surgery （HFS）. We used high sensitive troponin I （hs-TnI） assays and clinical parameters to identify preoperative risk factors associated with major adverse cardiac events （MACE） in elderly hip frac^u＇e patients. Method From August 2014 to November 2016, 575 patients with hip fracture were enrolled in a retrospective, single-center registry. A total of 262 of these patients underwent HFS and hs-TnI assays. MACE was defined as postoperative all-cause deaths, heart failure （HF）, new-onset atrial fibrillation （AF）, myocardial infarction （MI） and cardiovascular re-hospitalization that occurred within 90 days postoperative. Results Of 262 HFS patients, MACE developed following HFS in 65 （24.8%）. Patients with MACE were older and had higher rates of renal insufficiency, coronary artery disease, prior HF, low left ventricular ejection fraction and use of beta blockers; higher levels of hs-Tnl and N-terminal pro-brain natriuretic peptide （NT-proBNP） and higher revised cardiac risk index. A preoperative hs-TnI≥ 6.5 ng/L was associated with high risk of postoperative HF, new-onset AF and MACE. In multivariable analysis, pre-operative independent predictors for MACE were age 〉 80 years [adjusted hazard ratio （HR）： 1.79, 95% confident interval （CI）： 1.03-3.13, P = 0.04], left ventricular ejection fraction （LVEF） 〈 50% （adjusted HR： 3.17, 95% CI： 1.47-5.82, P 〈 0.01） and hs-TnI 〉 6.5 ng/L （adjusted HR： 3.75, 95% CI： 2.09~5.17, P 〈 0.01）. Conclusion In elderly patients with hip fracture who undergo HFS, a preoperative assessment of hs-TnI may help the risk refinement of cardiovascular complications.展开更多
Approximately 15,000-17,000 thousand people die worldwide in traffic accidents as a consequence of all types of injuries. This study has a descriptive nature. It is based on data obtained from archives including the t...Approximately 15,000-17,000 thousand people die worldwide in traffic accidents as a consequence of all types of injuries. This study has a descriptive nature. It is based on data obtained from archives including the treatment database of the Emergency Center. The period January 2009 to December 2012 has been considered for this research. The aim of this study is to assess the prevalence of fatal road traffic accidents in Pristine, Kosovo, and describe their determinants. The number of injured in traffic accidents who have sought emergency medical assistance in the Emergency Center from January 2009 to December 2012 is increasing significantly. It is concluded that except reasons mentioned above and among others, there also are the following factors： enormous increase of number of persons equipped with driving license, driving speeds above limits which are considered to be the primary cause of the road traffic accidents. These findings can serve as a basis for health care professionals and policymakers to create preventive measures for traffic accidents.展开更多
文摘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- 4.2 per-year in group HI. 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.
文摘Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in patients with unstable angina pectoris （UAP）. This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diag- nosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of ad- verse cardiovascular （CV） events, including hospital readmission for angina pectoris, acute myocardial infarction （AMI）, congestive heart failure （CHF）, stroke and all-cause mortality. Results During a mean follow-up time of 26.3±8.6 months, 98 adverse CV events occurred （84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality）. In a multivariate Cox model, LAAI [OR： 1.140, 95% CI： 1.01±1.279, P = 0.026], diastolic blood pressure （OR： 0.976, 95% CI： 0.956-0.996, P = 0.020） and pulse pressure （OR 1.020, 95% CI： 1.007-1.034, P = 0.004） were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.
文摘In recent years, the retired veteran cadres have grown older and older, and their numbers have also increased year by year. In this case, how to maintain the physical and mental health of empty nest veteran cadre, and further improve the quality of their life has been a realistic problem many primary health care doctors have to face and solve.
文摘We have read the article which entitled ＂Neutrophil-to- lymphocyte ratio compared to N-terminal pro-brain natri- uretic peptide as a prognostic marker of adverse events in elderly patients with chronic heart failure＂ published in Journal of Geriatric Cardiology with great interest, However, we have some comments regarding this study.
文摘Land was important--in the course of spreading and seeking new converts--for both Missionaries of Africa （White Fathers） and Church Missionary Society （C.M.S.） in Buha, Western Tanzania. This paper examines the land question as one of the challenges that the White Fathers encountered in their attempt to evangelize communities in Western Tanzania. I argue that the land question remained throughout the late-colonial period one of the unresolved issues, and at some mission stations, impeded the activities of the White Fathers and C.M.S. missionaries. This paper relies on archival documents first, to examine the land question and White Fathers-C.M.S. relations in Buha from 1934 to 1959. Second, I intend to demonstrate the fact that land issues remained at the heart of the missionary enterprise in Buha. Both Catholic and Anglican missionaries were determined to have more mission plots for medical, education and religious purposes.
文摘Psychological trauma refers to the catastrophic or traumatic events harmful to individuals＇ inner world. Strong emotional and psychological reaction caused by traumatic factors will form psychological shadows, and the improper coping of these events will lead to a post-traumatic stress disorder. In this paper, the author makes an exploration on the roots of psychological trauma and of post-traumatic stress reaction or disorders, which were caused by natural traumatic event, such as floods, snowstorms, earthquakes and other man-made factors such as wars, accidents from a psychological point of view. Finally, some suggestions of intervention are provided for the relevant departments to make relevant rebuilding policies.
文摘Objective Cardiovascular complications contribute to postoperative morbidity and mortality in elderly hip fracture patients. Limited data are available regarding which preoperative risk factors predict cardiovascular course following hip fracture surgery （HFS）. We used high sensitive troponin I （hs-TnI） assays and clinical parameters to identify preoperative risk factors associated with major adverse cardiac events （MACE） in elderly hip frac^u＇e patients. Method From August 2014 to November 2016, 575 patients with hip fracture were enrolled in a retrospective, single-center registry. A total of 262 of these patients underwent HFS and hs-TnI assays. MACE was defined as postoperative all-cause deaths, heart failure （HF）, new-onset atrial fibrillation （AF）, myocardial infarction （MI） and cardiovascular re-hospitalization that occurred within 90 days postoperative. Results Of 262 HFS patients, MACE developed following HFS in 65 （24.8%）. Patients with MACE were older and had higher rates of renal insufficiency, coronary artery disease, prior HF, low left ventricular ejection fraction and use of beta blockers; higher levels of hs-Tnl and N-terminal pro-brain natriuretic peptide （NT-proBNP） and higher revised cardiac risk index. A preoperative hs-TnI≥ 6.5 ng/L was associated with high risk of postoperative HF, new-onset AF and MACE. In multivariable analysis, pre-operative independent predictors for MACE were age 〉 80 years [adjusted hazard ratio （HR）： 1.79, 95% confident interval （CI）： 1.03-3.13, P = 0.04], left ventricular ejection fraction （LVEF） 〈 50% （adjusted HR： 3.17, 95% CI： 1.47-5.82, P 〈 0.01） and hs-TnI 〉 6.5 ng/L （adjusted HR： 3.75, 95% CI： 2.09~5.17, P 〈 0.01）. Conclusion In elderly patients with hip fracture who undergo HFS, a preoperative assessment of hs-TnI may help the risk refinement of cardiovascular complications.
文摘Approximately 15,000-17,000 thousand people die worldwide in traffic accidents as a consequence of all types of injuries. This study has a descriptive nature. It is based on data obtained from archives including the treatment database of the Emergency Center. The period January 2009 to December 2012 has been considered for this research. The aim of this study is to assess the prevalence of fatal road traffic accidents in Pristine, Kosovo, and describe their determinants. The number of injured in traffic accidents who have sought emergency medical assistance in the Emergency Center from January 2009 to December 2012 is increasing significantly. It is concluded that except reasons mentioned above and among others, there also are the following factors： enormous increase of number of persons equipped with driving license, driving speeds above limits which are considered to be the primary cause of the road traffic accidents. These findings can serve as a basis for health care professionals and policymakers to create preventive measures for traffic accidents.
