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Chu SY, Wang HC, Hsieh MH, Chang CC. Taste Disorder and Tongue Numbness After Lithium Overdose. Acta Neurol Taiwan 2024; 33(4):185-187. [PMID: 38030229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
PURPOSE Drug-induced taste disturbances are prevalent in clinical practice, with dysgeusia being a frequent manifestation. This study aims to present a case of taste disorders and tongue numbness induced by a lithium overdose. CASE REPORT A 33-year-old woman with bipolar II disorder attempted suicide by ingesting multiple drugs, including lithium and benzodiazepines. She exhibited weakness but was conscious after admission. Laboratory analyses indicated elevated serum lithium and urine benzodiazepine levels. Admitted to a psychiatric ward, her symptoms included diarrhea, poor appetite, and postprandial nausea. Two weeks later, she reported altered taste sensations and tongue numbness following the overdose. Her ongoing medication included venlafaxine, valproate sodium, and clozapine. Symptoms improved over time without specific treatment, aligning with increased appetite and weight gain. CONCLUSION Drug-induced taste disturbances have a substantial impact on patients' quality of life and medication adherence. This case brings attention to taste disorders induced by lithium and suggests potential mechanisms that could contribute to taste alterations. It underscores the importance of conducting thorough assessments in patients experiencing gustatory symptoms, particularly during the ongoing pandemic.
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Affiliation(s)
- Si-Yu Chu
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Huang-Chi Wang
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ming-Hong Hsieh
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Cheng-Chen Chang
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
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2
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Chang CC, Hsu K, Chen CM, Huang SS, Wu IC, Hsu CC, Hsiung AC, Chang HY. Gender difference on the mediation effects of filial piety on the association between chronic obstructive pulmonary disease and depressive symptoms in older adults: A community-based study. PLoS One 2024; 19:e0298360. [PMID: 38386662 PMCID: PMC10883558 DOI: 10.1371/journal.pone.0298360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
Filial piety is viewed as strong family support for older Chinese people, and strongly associated with depressive symptoms. It is unknown if there exists gender difference in the mediation effects of filial piety on the relationship between chronic obstructive pulmonary disease (manifested as lung function) and depression. We investigated whether filial piety mediates the association between lung function and depression in community-dwelling older men and women using the Healthy Aging Longitudinal Study in Taiwan (HALST). Community dwelling adults aged 65 and above were analyzed. Pulmonary function, depressive symptoms, and filial piety expectation (FPE) and receipt of filial piety (RFP) were collected. The interaction and mediation of filial piety between lung function and depression was analyzed. We found that in older men, forced expiratory volume in the first second (FEV1) was inversely correlated with depression (β = -0.1281, p = 0.004) with no mediation effect of FPE. In older women, FEV1 was negatively associated with FPE, but FPE did not increase the risk of depression (β = 0.0605, p = 0.12). In both older men and women, FEV1 was negatively associated with RFP, while RFP reduced the risk of depression (p< 0.001). In older women, the correlation between FEV1 was complete mediation of RFP. Results indicate that feelings of insufficient filial piety may increase the likelihood of depression, especially in elderly women with worse lung function. Although modest, the main mediation effect of filial piety was improvement of lung function in older subjects, which might decrease depression.
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Affiliation(s)
- Cheng-Chen Chang
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Kaichi Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Maoli, Taiwan
| | - Chun-Min Chen
- Big Data Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Si-Sheng Huang
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - I-Chien Wu
- Institute of Population Health Sciences, National Health Research Institutes, Maoli, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Maoli, Taiwan
| | - Agnes C. Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Maoli, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Maoli, Taiwan
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3
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Chang CC, Yang TC, Wang WF, Ju PC, Hsieh MH. Persistent hiccups related to long-acting aripiprazole injection: A case report. Psychiatry Clin Neurosci 2022; 76:678-680. [PMID: 36104301 DOI: 10.1111/pcn.13479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/07/2022] [Accepted: 09/11/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Cheng-Chen Chang
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Tzu Ching Yang
- Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan
| | - Wen-Fang Wang
- School of Nursing, China Medical University, Taichung, Taiwan
| | - Po-Chung Ju
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Hong Hsieh
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Hsieh MH, Ju PC, Chiou JY, Wang YH, Wang JY, Chang CC. Spousal Concordance and Cross-Disorder Concordance of Mental Disorders: A Nationwide Cohort Study. Psychiatry Investig 2022; 19:788-794. [PMID: 36327958 PMCID: PMC9633167 DOI: 10.30773/pi.2022.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/06/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Although both partners of a married couple can have mental disorders, the concordant and cross-concordant categories of disorders in couples remain unclear. Using national psychiatric population-based data only from patients with mental disorders, we examined married couples with mental disorders to examine spousal concordance and cross-disorder concordance across the full spectrum of mental disorders. METHODS Data from the 1997 to 2012 Taiwan Psychiatric Inpatient Medical Claims data set were used and a total of 662 married couples were obtained. Concordance of mental disorders was determined if both spouses were diagnosed with mental disorder of an identical category in the International Classification of Diseases, Ninth Revision, Clinical Modification; otherwise, cross-concordance was reported. RESULTS According to Cohen's kappa coefficient, the most concordant mental disorder in couples was substance use disorder, followed by bipolar disorder. Depressive and anxiety disorders were the most common cross-concordant mental disorders, followed by bipolar disorder. The prevalence of the spousal concordance of mental disorders differed by monthly income and the couple's age disparity. CONCLUSION Evidence of spousal concordance and cross-concordance for mental disorders may highlight the necessity of understanding the social context of marriage in the etiology of mental illness. Identifying the risk factors from a common environment attributable to mental disorders may enhance public health strategies to prevent and improve chronic mental illness of married couples.
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Affiliation(s)
- Ming-Hong Hsieh
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Po-Chung Ju
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Jeng-Yuan Chiou
- Department of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jong-Yi Wang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Cheng-Chen Chang
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Chen YJ, Wang WF, Jhang KM, Chang MC, Chang CC, Liao YC. Prediction of Institutionalization for Patients With Dementia in Taiwan According to Condition at Entry to Dementia Collaborative Care. J Appl Gerontol 2022; 41:1357-1364. [PMID: 35220779 DOI: 10.1177/07334648211073129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to examine the institutionalization rate in patients with dementia in Taiwan, identify the predictors of institutionalization, and conduct a mediation analysis of caregiver burden between neuropsychiatric symptoms and institutionalization. We analyzed data from a retrospective cohort registered in dementia collaborative care (N = 518). The analyses applied univariate and multivariate Cox proportional hazard regression with Firth's penalized likelihood to assess the relationship between each predictor at entry and institutionalization for survival analysis. Thirty (5.8%) patients were censored due to institutionalization after a median follow-up of one-and-a-half years. Neuropsychiatric symptoms, loss of walking ability, and living alone predicted institutionalization. Caregiver burden may partially mediate the effects of neuropsychiatric symptoms and institutionalization. High caregiver burden due to presence of neuropsychiatric symptoms may partially contribute to institutionalization among people living with dementia in Taiwan. However, proper management of neuropsychiatric symptoms and caregiver empowerment may ameliorate institutionalization risk.
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Affiliation(s)
- Yen-Jen Chen
- Department of Psychiatry, 36596Changhua Christian Hospital, Changhua, Taiwan.,Department of Psychiatry, Yuanlin Christian Hospital, Changhua, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, 36596Changhua Christian Hospital, Changhua, Taiwan.,Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan
| | - Kai-Ming Jhang
- Department of Neurology, 36596Changhua Christian Hospital, Changhua, Taiwan
| | - Ming-Che Chang
- Department of Nuclear Medicine, 36596Changhua Christian Hospital, Changhua, Taiwan
| | - Cheng-Chen Chang
- Department of Psychiatry, 36596Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, 34899Chung Shan Medical University, Taichung, Taiwan
| | - Yi-Cheng Liao
- Department of Psychiatry, 36596Changhua Christian Hospital, Changhua, Taiwan
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Chang CC, Chen PS, Lin JR, Chen YA, Liu CS, Lin TT, Chang HH. Mitochondrial DNA Copy Number Is Associated With Treatment Response and Cognitive Function in Euthymic Bipolar Patients Receiving Valproate. Int J Neuropsychopharmacol 2022; 25:525-533. [PMID: 34979555 PMCID: PMC9352174 DOI: 10.1093/ijnp/pyab095] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 12/20/2021] [Accepted: 01/02/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Bipolar disorder (BD) is associated with cognitive impairment and mitochondrial dysfunction. However, the associations among mitochondrial DNA copy number (MCN), treatment response, and cognitive function remain elusive in BD patients. METHODS Sixty euthymic BD patients receiving valproate (VPA) and 66 healthy controls from the community were recruited. The indices of metabolic syndrome (MetS) were measured. Quantitative polymerase chain reaction analysis of blood leukocytes was used to measure the MCN. Cognitive function was measured by calculating perseverative errors and completed categories on the Wisconsin Card Sorting Test (WCST). The VPA treatment response was measured using the Alda scale. RESULTS BD patients had significantly higher MCN, triglyceride, and C-reactive protein (CRP) levels, waist circumference, and worse performance on the WCST than the controls. Regression models showed that BD itself and the VPA concentration exerted significant effects on increased MCN levels. Moreover, the receiver operating characteristic curve analysis showed that an MCN of 2.05 distinguished VPA responders from nonresponders, with an area under the curve of 0.705 and a sensitivity and specificity of 0.529 and 0.816, respectively. An MCN level ≥2.05 was associated with 5.39 higher odds of being a VPA responder (P = .006). BD patients who were stratified into the high-MCN group had a higher VPA response rate, better WCST performance, lower CRP level, and less MetS. CONCLUSIONS The study suggests a link between the peripheral MCN and cognitive function in BD patients. As an inflammatory status, MetS might modulate this association.
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Affiliation(s)
| | | | - Jhih-Rong Lin
- Institute of Clinical Pharmacy and Pharmaceutical Sciences College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-An Chen
- Institute of Clinical Pharmacy and Pharmaceutical Sciences College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chin-San Liu
- Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua, Taiwan,Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Ta-Tsung Lin
- Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Hui Hua Chang
- Correspondence: Hui Hua Chang, PhD, Institute of Clinical Pharmacy and Pharmaceutical Sciences, National Cheng Kung University, No. 1, University Road, Tainan 701, Taiwan ()
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Chang CC, Chen YJ, Chen YA, Liao YC. Acute Hepatitis Due to Agomelatine Use in Elderly Women with Depression: Case Series. Clin Psychopharmacol Neurosci 2021; 19:789-792. [PMID: 34690134 PMCID: PMC8553533 DOI: 10.9758/cpn.2021.19.4.789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 12/24/2022]
Abstract
Although agomelatine may be associated with an increased risk of hepatotoxicity, the incidence rate of acute hepatitis seemed divergent between clinical trials and daily practice. Whether aging or gender is a risk factor in developing hepatotoxicity due to agomelatine is not clear. We present 3 older female cases with acute hepatitis occurring due to highly probable idiosyncratic drug-induced liver injury caused by agomelatine. From these cases, regular surveillance on liver function in the older women taking antidepressants would be of benefits.
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Affiliation(s)
- Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yen-Jen Chen
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Yu-An Chen
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Yi-Cheng Liao
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
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8
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Chang CC, Wang WF, Li YY, Chen YA, Chen YJ, Liao YC, Jhang KM, Wu HH. Using the Apriori Algorithm to Explore Caregivers' Depression by the Combination of the Patients with Dementia and Their Caregivers. Risk Manag Healthc Policy 2021; 14:2953-2963. [PMID: 34285609 PMCID: PMC8286245 DOI: 10.2147/rmhp.s316361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/16/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this study was to identify the caring scenarios that result in severe depression in caregivers caring for dementia patients. Patients and Methods A cross-sectional study with 1111 dementia patients and their caregivers in Taiwan from October 2015 to January 2020 was conducted. Gender, age, type of dementia, clinical dementia rating, walking ability, mood symptoms, behavioral symptoms, and psychological symptoms were the variables from the dementia patients. Age, relation to the patient, employment, type of primary care, frequency of care, mood symptoms, and the score from the Center for Epidemiologic Studies Depression Scale were the variables from the caregivers. A comprehensive viewpoint of both dementia patients and their caregivers was evaluated by the Apriori algorithm to find the attributes resulting in different caregiving depressions. Results Forty-seven rules were found with 18 rules of mild depressive symptomatology, 17 rules of moderate depressive symptomatology, and 12 rules of severe depressive symptomatology. A total of 7 general rules were summarized to be the severe depressive symptomatology. The results showed that an unemployed or retired caregiver with the mood symptoms such as helplessness, anger, emotional liability, or anxiety who took care of AD patients or AD patients with a moderate severity would have severe depression. Increased care frequencies (≥6 days per week) and multiple mood problems from caregivers result in severe depression. The composition of adult children, patients' aggression, and caregivers' helplessness as well as the combinations of male patients aged 75-84 years with the caregiver's mood of helplessness or nervousness and hopelessness were highly associated with severe depression. Conclusion For those caring for AD patients, severe depression was associated with the combination of different parameters to constitute each of these seven scenarios. Unlike previous studies which often evaluated one or two variables related to caregiver's depression, this study provided a more comprehensive viewpoint that enabled the collaborative team to efficiently identify and manage different scenarios by summarizing the rules of caregivers with severe depression from a systematic viewpoint.
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Affiliation(s)
- Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.,Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan
| | - Yi-Ying Li
- Department of Business Administration, National Changhua University of Education, Changhua, Taiwan
| | - Yu-An Chen
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Yen-Jen Chen
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Yi-Cheng Liao
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Kai-Ming Jhang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsin-Hung Wu
- Department of Business Administration, National Changhua University of Education, Changhua, Taiwan.,Department of M-Commerce and Multimedia Applications, Asia University, Taichung City, Taiwan.,Faculty of Education, State University of Malang, Malang, East Java, Indonesia
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9
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Chang CC, Hsieh MH, Chiou JY, Huang HH, Ju PC, Wang JY. Multiple Factors Associated With Child Abuse Perpetration: A Nationwide Population-Based Retrospective Study. J Interpers Violence 2021; 36:5360-5382. [PMID: 30311537 DOI: 10.1177/0886260518805100] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Differences in child abuse perpetration between individuals with and without mental disorders remain obscure. This study compared the risk difference and further investigated the association between the category of mental disorders and child abuse perpetration. A total of 681,970 adults from the 2002 to 2013 Taiwan National Health Insurance Research Database were analyzed, including 340,985 patients with psychiatric disorders (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD-9-CM] codes 290.x-319.x) and 340,985 sex- and age-matched individuals without psychiatric disorders. Child abuse perpetration (ICD-9-CM N-codes 995.5x and E-code E967) was the outcome variable. Matched analyses indicated that the risk of child abuse among patients with psychiatric disorders (0.25%) was significantly higher than that among those without psychiatric disorders (0.16%; odds ratio [OR] = 1.464, p < .0001). Among the six categories of mental disorders, the prevalence rates of committing child abuse were significantly higher for personality disorders, substance use, and affective disorders (0.56%, 0.45%, and 0.40%, respectively; p < .0001). Compared with anxiety disorders, substance use disorders were significantly associated with higher odds of child abuse perpetration (OR = 2.032, p < .05), especially physical abuse (OR = 2.018, p < .0001). Psychiatric morbidity was associated with higher odds of child abuse, with substance use determined as the major risk category. Screening high-risk families by using the associated factors is crucial.
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Affiliation(s)
- Cheng-Chen Chang
- Changhua Christian Hospital, Taiwan
- Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Hong Hsieh
- Chung Shan Medical University, Taichung, Taiwan
- Chung Shan Medical University Hospital, Taichung, Taiwan
| | | | | | - Po-Chung Ju
- Chung Shan Medical University Hospital, Taichung, Taiwan
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10
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Chen YA, Chang CC, Wang WF, Lin YS, Jhang KM, Lo TY, Wu HH. Association Between Caregivers' Burden and Neuropsychiatric Symptoms in Female Patients with Alzheimer's Disease with Varying Dementia Severity. J Multidiscip Healthc 2021; 14:929-940. [PMID: 33953562 PMCID: PMC8090980 DOI: 10.2147/jmdh.s298196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/11/2021] [Indexed: 01/14/2023] Open
Abstract
Purpose This study examined the attributes causing higher burdens for caregivers caring for female patients with Alzheimer’s disease by analyzing a combination of various variables, including demographic data, dementia severity, and neuropsychiatric symptoms. Patients and Methods This study included 99 female patients with Alzheimer’s disease who were cared for by the dementia collaborative care team at Changhua Christian Hospital, Taiwan. Neuropsychiatric symptoms used in this study included affections (9 types), behavior symptoms (9 symptoms), and psychological symptoms (3 symptoms). The Apriori algorithm was employed to identify association rules that reveal the relationships among demographic data, dementia severity, neuropsychiatric symptoms, and caregivers’ burden. Results A total of 185 rules were determined, including 51 rules with little or no burden, 108 rules with mild to moderate burden, and 26 rules with moderate to severe burden. The major findings are as follows. Neuropsychiatric symptoms were associated with varying degrees of caregivers’ burden among female patients aged 75 to 84 years with mild dementia. Crying spells and aggression were specifically associated with a moderate to severe burden. Delusion was associated with a mild to moderate and moderate to severe burden. Dysthymia and depression were associated with little or no burden to moderate to severe burden. Conclusion Clinicians can provide early interventions to reduce the burden of caregivers caring for female patients with Alzheimer’s disease and can refer caregivers for timely assistance to reduce their burden.
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Affiliation(s)
- Yu-An Chen
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.,Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan
| | - Ya-Sian Lin
- Department of Business Administration, National Changhua University of Education, Changhua, Taiwan
| | - Kai-Ming Jhang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Tzu-Ying Lo
- Department of Business Administration, National Changhua University of Education, Changhua, Taiwan
| | - Hsin-Hung Wu
- Department of Business Administration, National Changhua University of Education, Changhua, Taiwan.,Department of M-Commerce and Multimedia Applications, Asia University, Taichung City, Taiwan.,Faculty of Education, State University of Malang, Malang, East Java, Indonesia
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11
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Chen YC, Chang CC, Hsu WL, Chuang ST. Dairy cattle with bovine leukaemia virus RNA show significantly increased leukocyte counts. Vet J 2020; 257:105449. [PMID: 32546356 DOI: 10.1016/j.tvjl.2020.105449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 03/25/2020] [Accepted: 12/31/2019] [Indexed: 12/26/2022]
Abstract
Infection with bovine leukaemia virus (BLV), a retrovirus, causes dysfunction of the immune system and can have a marked economic impact on dairy industries due to decreased milk production and reduced lifespan in affected dairy cattle. The presence of proviral DNA has been the major diagnostic indicator of BLV infection. However in the course of BLV infection, the viral genome can be dormant, without detectable gene expression, resulting in limited impact on infected animals. At present, there is limited knowledge regarding haematological indices in dairy cattle that could indicate activation of the BLV genome and suggest reactivated BLV infection. In this study, BLV infection and BLV genome reactivation were evaluated based on the presence of BLV DNA and BLV env gene transcripts, respectively. BLV RNA transcription was confirmed. Among 93 whole blood samples obtained from asymptomatic dairy cattle, the prevalence of BLV proviral DNA and transcripts was 93.5% (n = 87/93) and 83.9% (n = 78/93), respectively. Between groups with and without BLV, the mean counts of white blood cells and lymphocytes in whole blood were significantly associated with the presence of BLV RNA (P < 0.05), but not with BLV proviral DNA. These results shed light on the activation status of the BLV genome and should be taken into account when evaluating the possible impact of BLV on cattle.
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Affiliation(s)
- Y C Chen
- Graduate Institute of Veterinary Pathobiology, College of Veterinary Medicine, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung 402, Taiwan
| | - C C Chang
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung 402, Taiwan
| | - W L Hsu
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung 402, Taiwan.
| | - S T Chuang
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung 402, Taiwan.
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12
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Wang JY, Chang CC, Lee MC, Li YJ. Identification of psychiatric patients with high mortality and low medical utilization: a population-based propensity score-matched analysis. BMC Health Serv Res 2020; 20:230. [PMID: 32188440 PMCID: PMC7081626 DOI: 10.1186/s12913-020-05089-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/09/2020] [Indexed: 12/25/2022] Open
Abstract
Background The decreased life expectancy and care costs of mental disorders could be enormous. However, research that compares mortality and utilization concurrently across the major category of mental disorders is absent. This study investigated all-cause mortality and medical utilization among patients with and without mental disorders, with an emphasis on identifying the psychiatric category of high mortality and low medical utilization. Methods A total of 570,250 individuals identified from the 2002–2013 Taiwan National Health Insurance Reearch Database consistuted 285,125 psychiatric patients and 285,125 non-psychiatric peers through 1:1 dual propensity score matching (PSM). The expenditure survival ratio (ESR) was proposed to indicate potential utilization shortage. The category of mental disorders and 13 covariates were analyzed using the Cox proportional hazard model and general linear model (GLM) through SAS 9.4. Results PSM analyses indicated that mortality and total medical expenditures per capita were both significantly higher in psychiatric patients than those in non-psychiatric patients (all P <.0.0001). Patients with substance use disorders were reported having the youngest ages at diagnosis and at death, with the highest 25.64 of potential years of life loss (YPLL) and relevant 2904.89 of ESR. Adjusted Cox model and GLM results indicated that, compared with anxiety disorders, affective disorders and substance use disorders were significantly associated with higher mortality (HR = 1.246 and 1.064, respectively; all P < 0.05); schizophrenia was significantly associated with higher total medical expenditures per capita (P < 0.0001). Thirteen additional factors were significantly associated with mortality or utilization (all P < 0.05). Conclusion Substance use disorders are the category of highest YPLL but notably in insufficient utilization. Health care utilization in patients with substance use disorders should be augmented timely after the diagnosis, especially toward home and community care. The factors related to mortality and utilization identified by this study merit clinical attention.
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Affiliation(s)
- Jong-Yi Wang
- Department of Health Services Administration, China Medical University, No. 91, Xueshi Rd., North Dist, Taichung City, 40402, Taiwan
| | - Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, 135 Nanxiao St., Changhua City, Changhua County, 50006, Taiwan
| | - Meng-Chen Lee
- Department of Medical Affairs, Landseed International Hospital, No. 77, Guangtai Rd., Pingzhen Dist, Taoyuan City, 32449, Taiwan
| | - Yi-Jhen Li
- Department of Health Services Policy and Management, University of South Carolina, 915 Greene St, Columbia, SC, 29208, USA.
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13
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Chiu WC, Lu ML, Chang CC. Mental Disorders and Interferon Nontreatment in Hepatitis C Virus Infection-a Population Based Cohort Study. Psychiatry Investig 2020; 17:268-274. [PMID: 32151125 PMCID: PMC7113179 DOI: 10.30773/pi.2019.0254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/08/2020] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study investigates the association between mental disorders and interferon nontreatment in patients with chronic hepatitis C virus (HCV) infection in a large national sample. METHODS Using the National Health Insurance Research Database of Taiwan, we conducted a nationwide population-based study. Each case was matched to five controls by age, sex, urbanization, and income. Conditional logistic regression was used to assess odds of HCV nontreatment in different mental disorders. RESULTS From 1999 to 2013, we identified 92,970 subjects with HCV infection and 15,495 HCV cases (16.7%) had received IFN therapy. Other than chronic obstructive pulmonary disease, the medical diseases and mental disorders were significantly different between IFN and non-IFN treated HCV patients. After adjusting for medical diseases, depressive disorder and anxiety disorder was positively associated with receiving IFN therapy. Patients with schizophrenia, bipolar disorders and alcohol use disorders were significantly less likely to receive interferon. Antidepressant exposure (cumulative daily exposure or cumulative daily dose) was associated with lower odds of IFN treatment. CONCLUSION Our nationwide cohort study demonstrated that INF nontreatment rate was lower in certain mental disorders. Antidepressant exposure might lower the chance of receiving IFN treatment. Our results may help to identify and to overcome the obstacles for HCV treatment and further apply to DAAs regimen.
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Affiliation(s)
- Wei-Che Chiu
- Department of Psychiatry, Cathay General Hospital, Taipei, Taiwan.,School of Medicine, Fu Jen Catholic University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan-Fang Hospital, Taipei, Taiwan.,School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Center of General Education, Tunghai University, Taichung, Taiwan
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14
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Ma SB, Griffin D, Boyd SC, Chang CC, Wong J, Guy SD. Cryptococcus neoformans var grubii meningoencephalitis in a patient on fingolimod for relapsing-remitting multiple sclerosis: Case report and review of published cases. Mult Scler Relat Disord 2020; 39:101923. [PMID: 31986367 DOI: 10.1016/j.msard.2019.101923] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/27/2019] [Accepted: 12/31/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Fingolimod, a sphingosine-1-phosphate modulator used in the treatment of relapsing-remitting multiple sclerosis, has been associated with several cases of cryptococcosis. CASE REPORT We present a case of Cryptococcal meningoencephalitis attributable to Cryptococcus neoformans var. grubii, in a 58-year-old bird-keeper from Australia, after 7 years of fingolimod therapy. We discuss this in the context of previously reported cases, our understanding of fingolimod immune modulation, and known Cryptococcus pathobiology. CONCLUSION We suggest consideration of harm minimisation behaviours in patients requiring fingolimod, particularly in those with profound CD4 lymphopenia. Furthermore, we echo the call for improved post-marketing surveillance systems to determine the epidemiology of atypical infections with novel immunomodulatory treatments.
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Affiliation(s)
- S B Ma
- Western Health, Melbourne, Victoria, Australia.
| | - Dwj Griffin
- Western Health, Melbourne, Victoria, Australia; Alfred Health, Melbourne, Victoria, Australia
| | - S C Boyd
- Western Health, Melbourne, Victoria, Australia
| | - C C Chang
- Alfred Health, Melbourne, Victoria, Australia
| | - Jsj Wong
- Dorevitch Pathology, Heidelberg, Victoria, Australia
| | - S D Guy
- Western Health, Melbourne, Victoria, Australia
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15
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Li WB, Huber GM, Blok HP, Gaskell D, Horn T, Semenov-Tian-Shansky K, Pire B, Szymanowski L, Laget JM, Aniol K, Arrington J, Beise EJ, Boeglin W, Brash EJ, Breuer H, Chang CC, Christy ME, Ent R, Gibson EF, Holt RJ, Jin S, Jones MK, Keppel CE, Kim W, King PM, Kovaltchouk V, Liu J, Lolos GJ, Mack DJ, Margaziotis DJ, Markowitz P, Matsumura A, Meekins D, Miyoshi T, Mkrtchyan H, Niculescu I, Okayasu Y, Pentchev L, Perdrisat C, Potterveld D, Punjabi V, Reimer PE, Reinhold J, Roche J, Roos PG, Sarty A, Smith GR, Tadevosyan V, Tang LG, Tvaskis V, Volmer J, Vulcan W, Warren G, Wood SA, Xu C, Zheng X. Unique Access to u-Channel Physics: Exclusive Backward-Angle Omega Meson Electroproduction. Phys Rev Lett 2019; 123:182501. [PMID: 31763910 DOI: 10.1103/physrevlett.123.182501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 10/01/2019] [Indexed: 06/10/2023]
Abstract
Backward-angle meson electroproduction above the resonance region, which was previously ignored, is anticipated to offer unique access to the three quark plus sea component of the nucleon wave function. In this Letter, we present the first complete separation of the four electromagnetic structure functions above the resonance region in exclusive ω electroproduction off the proton, ep→e^{'}pω, at central Q^{2} values of 1.60, 2.45 GeV^{2}, at W=2.21 GeV. The results of our pioneering -u≈-u_{min} study demonstrate the existence of a unanticipated backward-angle cross section peak and the feasibility of full L/T/LT/TT separations in this never explored kinematic territory. At Q^{2}=2.45 GeV^{2}, the observed dominance of σ_{T} over σ_{L}, is qualitatively consistent with the collinear QCD description in the near-backward regime, in which the scattering amplitude factorizes into a hard subprocess amplitude and baryon to meson transition distribution amplitudes: universal nonperturbative objects only accessible through backward-angle kinematics.
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Affiliation(s)
- W B Li
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
- College of William and Mary, Williamsburg, Virginia 23185, USA
| | - G M Huber
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - H P Blok
- VU University, NL-1081 HV Amsterdam, Netherlands
- NIKHEF, Postbus 41882, NL-1009 DB Amsterdam, Netherlands
| | - D Gaskell
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Horn
- Catholic University of America, Washington, D.C. 20064, USA
| | - K Semenov-Tian-Shansky
- National Research Centre Kurchatov Institute: Petersburg Nuclear Physics Institute, RU-188300 Gatchina, Russia
- Saint Petersburg National Research Academic University of the Russian Academy of Sciences, RU-194021 St. Petersburg, Russia
| | - B Pire
- CPHT, CNRS, École Polytechnique, IP Paris, 91128-Palaiseau, France
| | - L Szymanowski
- National Centre for Nuclear Research (NCBJ), 02-093 Warsaw, Poland
| | - J-M Laget
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - K Aniol
- California State University Los Angeles, Los Angeles, California 90032, USA
| | - J Arrington
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - E J Beise
- University of Maryland, College Park, Maryland 20742, USA
| | - W Boeglin
- Florida International University, Miami, Florida 33119, USA
| | - E J Brash
- Christopher Newport University, Newport News, Virginia 23606, USA
| | - H Breuer
- University of Maryland, College Park, Maryland 20742, USA
| | - C C Chang
- University of Maryland, College Park, Maryland 20742, USA
| | - M E Christy
- Hampton University, Hampton, Virginia 23668, USA
| | - R Ent
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - E F Gibson
- California State University, Sacramento, California 95819, USA
| | - R J Holt
- Caltech, Pasadena, California 91125, USA
| | - S Jin
- Kyungpook National University, Daegu, 702-701, Republic of Korea
| | - M K Jones
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C E Keppel
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Hampton University, Hampton, Virginia 23668, USA
| | - W Kim
- Kyungpook National University, Daegu, 702-701, Republic of Korea
| | - P M King
- Ohio University, Athens, Ohio 45701, USA
| | - V Kovaltchouk
- Ontario Tech University, Oshawa, Ontario L1G 0C5, Canada
| | - J Liu
- Shanghai Jiao Tong University, Shanghai 200240, China
| | - G J Lolos
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - D J Mack
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - D J Margaziotis
- California State University Los Angeles, Los Angeles, California 90032, USA
| | - P Markowitz
- Florida International University, Miami, Florida 33119, USA
| | - A Matsumura
- Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - D Meekins
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Miyoshi
- Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - H Mkrtchyan
- A.I. Alikhanyan National Science Laboratory, Yerevan 0036, Armenia
| | - I Niculescu
- James Madison University, Harrisonburg, Virginia 22807, USA
| | - Y Okayasu
- Tohoku University, Sendai, Miyagi 980-8578, Japan
| | - L Pentchev
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Perdrisat
- College of William and Mary, Williamsburg, Virginia 23187, USA
| | - D Potterveld
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - V Punjabi
- Norfolk State University, Norfolk, Virginia 23504, USA
| | - P E Reimer
- Physics Division, Argonne National Laboratory, Argonne, Illinois 60439, USA
| | - J Reinhold
- Florida International University, Miami, Florida 33119, USA
| | - J Roche
- Ohio University, Athens, Ohio 45701, USA
| | - P G Roos
- University of Maryland, College Park, Maryland 20742, USA
| | - A Sarty
- Saint Mary's University, Halifax, Nova Scotia B3H 3C3, Canada
| | - G R Smith
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - V Tadevosyan
- A.I. Alikhanyan National Science Laboratory, Yerevan 0036, Armenia
| | - L G Tang
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
- Hampton University, Hampton, Virginia 23668, USA
| | - V Tvaskis
- NIKHEF, Postbus 41882, NL-1009 DB Amsterdam, Netherlands
- VU University, NL-1081 HV Amsterdam, Netherlands
| | - J Volmer
- VU University, NL-1081 HV Amsterdam, Netherlands
- DESY, Hamburg 22607, Germany
| | - W Vulcan
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - G Warren
- Pacific Northwest National Laboratory, Richland, Washington 99352, USA
| | - S A Wood
- Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - C Xu
- University of Regina, Regina, Saskatchewan S4S 0A2, Canada
| | - X Zheng
- University of Virginia, Charlottesville, Virginia 22904, USA
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16
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Serruys PW, Takahashi K, Kogame N, Chichareon P, Modolo R, Chang CC, Tomaniak M, Komiyama H, Hamm C, Steg PG, Stoll HP, Onuma Y, Valgimigli M, Windecker S, Vranckx P. P2817Efficacy and safety of ticagrelor monotherapy in patients with complex percutaneous coronary intervention: insights from the Global Leaders trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background/Introduction
Optimal dual antiplatelet therapy (DAPT) in patients with complex percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has not been fully investigated.
Purpose
To evaluate the efficacy and safety of 1-month DAPT followed by 23-month ticagrelor monotherapy in patients who underwent complex PCI.
Methods
The Global Leaders trial recruited 15,991 patients treated by default with a biolimus A9-eluting stent, and randomised in a 1:1 ratio either to the experimental strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) or to the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy). Complex PCI includes at least one of the following characteristics; left main and/or multivessel PCI, long stenting (defined as total stent length≥46mm), and bifurcation treatment with two stents. The present sub-analysis of the trial evaluated at two years the primary endpoint (composite of all-cause death and new Q-wave myocardial infarction [MI] centrally adjudicated with the Minnesota code). In addition, the patient-oriented composite endpoint (POCE) (composite of all-cause death, any stroke, any MI, and any revascularization) and the net adverse clinical events (NACE) (composite of POCE and Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) were also evaluated at two years.
Results
Of 15,450 patients included in the present analysis, 5,188 (26.7%) patients underwent complex PCI. The experimental strategy, when compared with the reference one, had a significantly lower risk of the primary endpoint (3.56% vs. 5.33%, HR: 0.66; 95% CI: 0.51–0.86; p-value= 0.002; p-value for interaction= 0.019) in patients with complex PCI. Similarly, the experimental treatment was associated with a significantly reduced risk of POCE (14.41% vs. 16.88%, HR: 0.84; 95% CI: 0.74–0.97; p=0.016, p-value for interaction= 0.099) and NACE (15.77% vs. 18.37%, HR: 0.85; 95% CI: 0.74–0.97; p=0.014; p-value for interaction= 0.096). The reduction in ischemic events was predominantly observed in patients with 2 or more characteristics of complex PCI (Figure). In contrast, there was no significant difference in the risk of BARC type 3 or 5 bleeding between the two regimens (2.40% vs. 2.38%, HR: 1.01; 95% CI: 0.71–1.44; p-value=0.956; p-value for interaction= 0.935).
Central illustration
Conclusion
Together with other well-established clinical risk factors, the extent and complexity of stenting should be taken into account in tailoring antiplatelet regimens for secondary prevention. The 1-month DAPT followed by 23-month ticagrelor monotherapy reduced the ischemic events without increasing the risk of bleeding in patients who underwent complex PCI, when compared with the conventional DAPT.
Acknowledgement/Funding
The Global Leaders trial was supported by the resource from AstraZeneca, Biosensors, and The Medicines Company.
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Affiliation(s)
- P W Serruys
- Imperial College London, London, United Kingdom
| | - K Takahashi
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - N Kogame
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - P Chichareon
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - R Modolo
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - C C Chang
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Tomaniak
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - H Komiyama
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - C Hamm
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - P G Steg
- University Paris Diderot, Paris, France
| | - H P Stoll
- Biosensors Clinical Research, Morges, Switzerland
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Valgimigli
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - S Windecker
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - P Vranckx
- Heart Centre Hasselt, Hasselt, Belgium
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17
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Van Geuns RJ, Smits PC, Chang CC, Wlodarczyk A, Chevalier B, West N, Gori T, Barbato E, Tarantini G, Kocka V, Achenbach S, Dudek D, Escaned J, Tijssen J, Onuma Y. P2695ABSORB bioresorbable scaffold versus Xience metallic stent in acute coronary syndromes with treated with percutaneous coronary intervention. A subanalysis of the COMPARE-ABSORB trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The safety and efficacy of the ABSORB scaffold in ACS patients remain unclear. The COMPARE-ABSORB trial compares the ABSORB to the Xience stent in lesions and patients at high risk for restenosis Patients with STEMI and urgent PCI for non-STEMI were not excluded.
Methods
Patients included in the COMPARE-ABSORB trial undergoing PCI for ACS were eligible. Predefined implantation techniques for ABSORB was mandatory. Primary endpoint is target lesion failure (TLF) at 1 year, defined as a composite of cardiac death, target vessel myocardial infarction and clinically indicated target lesion revascularization.
Results
Of 1670 patients, 842 were treated for ACS. At 1-year, TLF occurred in 22 patients (5.0%) of the ABSORB group and in 14 patients (3.5%) of the Xience group (HR 1.44%; 95% CI 0.74%-2.82%, P=0.284). Definite device thrombosis occurred in 9 patients (2.0%) of the ABSORB group and in 2 patients (0.5%) of the Xience group (HR 4.10%; 95% CI 0.89%-18.9%, P=0.071).
Baseline characteristics ABSORB (n=442) XIENCE (n=400) Age, years (SD) 60.7 (9.6) 61.3 (9.1) Male 350/442 (79.2%) 313/400 (78.3%) Current smoker 159/439 (36.2%) 126/397 (31.7%) Diabetes mellitus 152/440 (34.5%) 138/399 (34.6%) Hypertension 298/442 (67.4%) 266/400 (66.5%) Hypercholesterolemia 255/442 (57.7%) 232/400 (58.0%) Family history of coronary artery disease 147/442 (33.3%) 103/400 (25.8%) Previous MI 61/442 (13.8%) 67/400 (16.8%) Established Peripheral Vascular Disease 27/442 (6.1%) 15/400 (3.8%) Previous PCI 83/442 (18.8%) 86/400 (21.5%) Previous CABG 1/442 (0.2%) 4/400 (1.0%) Previous stroke 15/442 (3.4%) 21/400 (5.3%) Renal Insufficiency 9/442 (2.0%) 13/400 (3.3%) Clinical presentation Unstable angina 149/442 (33.7%) 141/400 (35.3%) Non-ST elevation myocardial infarction 183/442 (41.4%) 156/400 (39.0%) ST elevation myocardial infarction 110/442 (24.9%) 103/400 (25.7%)
KM plot for target lesion failure
Conclusion
The COMPARE-ABSORB trial showed no difference in the primary endpoint at one year for the ACS subgroup. The signal for increased thrombosis remained, even with the optimized implantation protocol
Acknowledgement/Funding
Maasstad Hospital, Rotterdam, the Netherlands
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Affiliation(s)
- R J Van Geuns
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - P C Smits
- Maasstad Hospital, Cardiology department, Rotterdam, Netherlands (The)
| | - C C Chang
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - A Wlodarczyk
- Miedziowe Centrum Zdrowia, Department of Cardiology, Lubin, Poland
| | - B Chevalier
- Cardiovascular Institute Paris-Sud (ICPS), Massy, France
| | - N West
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, United Kingdom
| | - T Gori
- Johannes Gutenberg University Mainz (JGU), Mainz, Germany
| | - E Barbato
- Cardiovascular Center Aalst, Aalst, Belgium
| | | | - V Kocka
- Charles University of Prague, Prague, Czechia
| | - S Achenbach
- Friedrich Alexander University, Erlangen, Germany
| | - D Dudek
- Jagiellonian University Medical College, 2nd Department of Cardiology, Krakow, Poland
| | - J Escaned
- Hospital Clinic San Carlos, Madrid, Spain
| | - J Tijssen
- Academic Medical Center of Amsterdam, Amsterdam, Netherlands (The)
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
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18
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Takahashi K, Chichareon P, Modolo R, Kogame N, Chang CC, Tomaniak M, Hamm C, Steg PG, Stoll HP, Onuma Y, Valgimigli M, Vranckx P, Windecker S, Serruys PW. P2811Impact of ticagrelor monotherapy on two-year clinical outcomes in patients with long stenting: insights from the Global Leaders trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Data on the efficacy and safety of different antiplatelet regimens are limited in patients with increasing total stent length (TSL).
Purpose
To evaluate the impact of the experimental strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) vs. the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy) in patients with increasing TSL.
Methods
The present post-hoc analysis of the Global Leaders trial evaluated the primary endpoint (the composite of the all-cause death and new Q-wave myocardial infarction [MI]) at two years in patients with increasing TSL. In addition, the patient-oriented composite endpoint (POCE) (the composite of all-cause death, any stroke, any MI, and any revascularization) and the net adverse clinical events (NACE) (the composite of POCE and Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) were also assessed.
Results
The cohort of 15,450 patients treated with a biolimus-eluting biodegradable polymer stents were included in this analysis. In the longer TSL group (≥46mm), the experimental strategy significantly reduced the risk of the primary endpoint (3.78% vs. 5.68%, hazard ratio (HR): 0.67, 95% confidence interval (CI): 0.49–0.90, p=0.008, P interaction=0.042) as well as POCE (14.57% vs. 18.11%, HR: 0.79, 95% CI: 0.67–0.92, p=0.003, P interaction=0.010) and NACE (16.07% vs. 19.64%, HR: 0.80, 95% CI: 0.69–0.93, p=0.004, P interaction=0.012) at two years. The risk of BARC type 3 or 5 bleeding at two years was similar between the two antiplatelet regimens.
KM in patients with long stenting
Conclusion
Ticagrelor monotherapy significantly reduced the risk of the primary endpoint, POCE and NACE with a similar risk of BARC type 3 or 5 bleeding at two years in patients with the longer TSL.
Acknowledgement/Funding
The Global Leaders trial was supported by unrestricted grants from AstraZeneca, Biosensors, and The Medicines Company. ECRI (European Cardiovascular R
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Affiliation(s)
- K Takahashi
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - P Chichareon
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - R Modolo
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - N Kogame
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - C C Chang
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Tomaniak
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - C Hamm
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - P G Steg
- University Paris Diderot, Paris, France
| | - H P Stoll
- Biosensors Clinical Research, Morges, Switzerland
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Valgimigli
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - P Vranckx
- Heart Centre Hasselt, Hasselt, Belgium
| | - S Windecker
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - P W Serruys
- Imperial College London, London, United Kingdom
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19
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Takahashi K, Chichareon P, Chang CC, Tomaniak M, Modolo R, Kogame N, Stoll HP, Hamm C, Steg PG, Onuma Y, Valgimigli M, Vranckx P, Windecker S, Carrie D, Serruys PW. P2812Ischemic efficacy and bleeding safety of ticagrelor monotherapy in patients with multivessel percutaneous coronary intervention: insights from the Global Leaders trial. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
The optimal duration of DAPT after coronary stent implantation remains a matter of debate and a novel antiplatelet regimen without an increased risk of bleeding while maintaining an anti-ischemic efficacy is of paramount importance in patients at higher risk of ischemia.
Purpose
The aim of the present sub-study of the Global Leaders trial is to evaluate the efficacy and safety of the experimental antiplatelet strategy (1-month dual antiplatelet therapy [DAPT] followed by 23-month ticagrelor monotherapy) vs. the reference regimen (12-month DAPT followed by 12-month aspirin monotherapy) in patients with multivessel percutaneous coronary intervention (PCI).
Methods
The Global Leaders trial enrolled 15,991 patients treated by default with a biolimus A-9 eluting stent. The present sub-study of the trial sought to evaluate the impact of the long-term ticagrelor monotherapy on the primary endpoint (composite of all-cause death and new Q-wave myocardial infarction [MI] centrally adjudicated with the Minnesota code) at two years. In addition, the patient-oriented composite endpoint (POCE) (composite of all-cause death, any stroke, any MI, and any revascularization) and the net adverse clinical events (NACE) (composite of POCE and Bleeding Academic Research Consortium [BARC] type 3 or 5 bleeding) were also evaluated at two years.
Results
A total of 15,845 patients was included in this analysis, of whom 3,576 patients received multivessel PCI. At two years, the experimental strategy significantly reduced a risk of the primary endpoint (the composite of all-cause death and new Q-wave myocardial infarction [MI]) (3.05% vs. 4.85%, HR: 0.62, 95% CI: 0.44–0.88, p=0.006, Pinteraction=0.031) in patients with multivessel PCI. Similarly, the experimental treatment had a significant risk reduction in the patient-oriented composite endpoint (POCE), defined as the composite of all-cause death, any stroke, any MI, and any revascularization (13.37% vs. 16.74%, HR: 0.78, 95% CI: 0.66–0.93, p=0.005, Pinteraction=0.020) and the net adverse clinical events (NACE), defined as the composite of POCE and Bleeding Academic Research Consortium [BARC] defined bleeding type 3 or 5 (14.65% vs. 18.38%, HR: 0.78, 95% CI: 0.66–0.92, p=0.003, Pinteraction=0.014) at two years. There was no significant difference in BARC type 3 or 5 bleeding (2.44% vs. 2.65%, HR: 0.92, 95% CI: 0.61–1.39, p=0.685, Pinteraction=0.754) at two years between the two regimens.
KM in patients with multivessel PCI
Conclusion
The present study has demonstrated the experimental antiplatelet strategy, when compared with the reference regimen, could potentially have a favourable balance between ischemic efficacy and bleeding safety in patients who underwent multivessel PCI.
Acknowledgement/Funding
The Global Leaders trial was supported by unrestricted grants from AstraZeneca, Biosensors, and The Medicines Company. ECRI (European Cardiovascular R
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Affiliation(s)
- K Takahashi
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - P Chichareon
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - C C Chang
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Tomaniak
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - R Modolo
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - N Kogame
- University of Amsterdam, Amsterdam, Netherlands (The)
| | - H P Stoll
- Biosensors Clinical Research, Morges, Switzerland
| | - C Hamm
- Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany
| | - P G Steg
- University Paris Diderot, Paris, France
| | - Y Onuma
- Erasmus Medical Centre, Rotterdam, Netherlands (The)
| | - M Valgimigli
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - P Vranckx
- Heart Centre Hasselt, Hasselt, Belgium
| | - S Windecker
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - D Carrie
- Toulouse Rangueil University Hospital (CHU), Toulouse, France
| | - P W Serruys
- Imperial College London, London, United Kingdom
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20
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Chu CY, Cho YT, Jiang JH, Chang CC, Liao SC, Tang CH. Patients with chronic urticaria have a higher risk of psychiatric disorders: a population-based study. Br J Dermatol 2019; 182:335-341. [PMID: 31220338 DOI: 10.1111/bjd.18240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND The prevalence of psychiatric comorbidities in patients with chronic urticaria (CU) in a national population is largely unknown. OBJECTIVES To investigate the prevalence of psychiatric disorders and psychiatric medication use in patients with CU in Taiwan. METHODS Data were sourced from Taiwan's National Health Insurance Research Database for 2011. Patients who had a primary/secondary International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code of 708·1, 708·8 or 708·9 during 2011 with at least two outpatient visits and an antihistamine prescription were identified as CU cases. Patients with CU were classified into three disease severity groups according to their medication types. Psychiatric disorders were identified by patients having three outpatient visits with a primary or secondary diagnosis of a given psychiatric disease. Psychiatric medication use was defined by having at least four outpatient visits with prescriptions for anxiolytics, antidepressants or sleeping pills in 2010 or 2011. RESULTS Of the 167 132 patients with CU, 82·5% had mild CU, 17·0% had moderate CU and 0·4% had severe CU. Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication prescription than control groups. The relative risk (RR) of psychiatric disorders was 1·43 for patients with mild, 1·50 for patients with moderate and 2·32 for patients with severe CU vs. the controls (P < 0·001). For psychiatric medication prescription, the RRs were 1·95, 2·70 and 2·09, respectively, vs. controls (P < 0·001). CONCLUSIONS Patients with CU had a higher prevalence and risk of psychiatric disorders and psychiatric medication prescription than control groups. What's already known about this topic? Previous studies have shown a high prevalence of psychiatric comorbidities in patients with chronic urticaria (CU), with rates ranging from 35% to 60%. Anxiety, depression and somatoform disorders have been reported as the most prevalent mental disorders in patients with CU. What does this study add? Patients with CU had a higher prevalence of psychiatric disorders and psychiatric medication use than control groups in the general population. The relative risk (RR) of psychiatric disorders was 1·43 for those with mild CU, 1·50 for those with moderate CU and 2·32 for those with severe CU vs. controls. The RR for psychiatric medication use was 1·95 for those with mild CU, 2·70 for those with moderate CU and 2·09 for those with severe CU vs. controls. Mental health evaluations and management are important elements in CU management.
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Affiliation(s)
- C Y Chu
- Departments of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, 10002, Taiwan
| | - Y T Cho
- Departments of Dermatology, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, 10002, Taiwan
| | - J H Jiang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - C C Chang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
| | - S C Liao
- Departments of Psychiatry, National Taiwan University Hospital and National Taiwan University College of Medicine, 7 Chung-Shan South Road, Taipei, 10002, Taiwan
| | - C H Tang
- School of Health Care Administration, Taipei Medical University, Taipei, Taiwan
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21
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Chen VCH, Lu ML, Yang YH, Weng JC, Chang CC. Antidepressant use and hepatocellular carcinoma in patients with hepatitis C who had received interferon therapy: A population-based cohort study. J Affect Disord 2019; 253:147-153. [PMID: 31035215 DOI: 10.1016/j.jad.2019.04.093] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 03/24/2019] [Accepted: 04/21/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Using data from the National Health Insurance (NHI) of Taiwan, we conducted a nationwide population-based cohort study to investigate the association between antidepressant (ATD) use and the risk of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV) who had received interferon (IFN) therapy. METHODS This study included a total of 274,952 HCV-infected patients without hepatitis B virus infection who were enrolled in the NHI program between January 1, 1997 and December 31, 2013. Among these patients, only 10,713 (age ≥18 years) had received IFN therapy between 2004 and 2008. Among the patients who had received IFN therapy, 2014 had received ATDs, and 8684 had not. A Cox proportional hazards regression model was applied after adjusting for age, sex, income, urbanization, medical comorbidity, and medication use. RESULTS Compared with non-ATD-treated patients, ATD-treated patients were more likely to receive a diagnosis of alcohol-related disease, diabetes mellitus (DM), hypertension, and hyperlipidemia. ATD-treated patients had a significantly lower incidence of HCC than non-ATD-treated patients (P = 0.0019). Female, older (age ≥50 years), and non-DM patients who had received cumulative high doses of ATDs had a significantly lower risk of HCC than non-ATD-treated patients. After adjustment, only high-dose selective serotonin reuptake inhibitor (SSRI) use was inversely associated with HCC risk (adjusted hazard ratio 0.37, 95% confidence interval 0.19-0.71, P = 0.0027). CONCLUSIONS Our study showed that ATD use, especially a relatively high cumulative dose of SSRIs, in HCV-infected patients who had received IFN was associated with reduced HCC risk. Future clinical studies are warranted to explore the underlying mechanisms and to apply them to newer direct-acting antiviral agent treatments.
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Affiliation(s)
- Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital & School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yao-Hsu Yang
- Center of Excellence for Chang Gung Research Datalink, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Jun-Cheng Weng
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, No.135, Nanxiao Street, Changhua 50006, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Center of General Education, Tunghai University, Taichung, Taiwan.
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22
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Goh SW, Adawiyah J, Md Nor N, Yap F, Ch'ng P, Chang CC. Skin eruption induced by dieting - an underdiagnosed skin disease in Malaysia. Malays Fam Physician 2019; 14:42-46. [PMID: 31289632 PMCID: PMC6612274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Prurigo pigmentosa is an inflammatory dermatosis characterized by a pruritic, symmetrically distributed erythematous papular or papulo-vesicular eruption on the trunk arranged in a reticulated pattern that resolves with hyperpigmentation. It is typically non-responsive to topical or systemic steroid therapy. The exact etiology is unknown, but it is more commonly described in the Far East countries. Dietary change is one of the predisposing factors. We report on nine young adult patients with prurigo pigmentosa, among whom five were on ketogenic diets prior to the onset of the eruptions. All cases resolved with oral doxycycline with no recurrence. We hope to improve the awareness of this uncommon skin condition among general practitioners and physicians so that disfiguring hyperpigmentation due to delayed diagnosis and treatment can be avoided.
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Affiliation(s)
- S W Goh
- MB BCh (Soton), MRCP (UK) Medical Department, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur Malaysia.,
| | - J Adawiyah
- MB BCh BAO, MMed (UKM) AdvMDerm (UKM), University Kebangsaan Malaysia Medical Centre, Kuala Lumpur Malaysia.,
| | - N Md Nor
- MBBCH (Cardiff), MRCP (UK), AdvMDerm (UKM), Medical Department, University Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.
| | - Fbb Yap
- MD (UNIMAS), MRCP (UK), AdvMDerm (UKM), Universiti Tunku Abdul Rahman, Selangor, Malaysia,
| | - Pwb Ch'ng
- MD (UKM), MRCP (UK), AdvMDerm (UKM), Gleneagles Kuala Lumpur Kuala Lumpur, Malaysia,
| | - C C Chang
- MBBS (Malaya), MRCP (UK), AdvMDerm (UKM), Gleneagles Kuala Lumpur, Kuala Lumpur, Malaysia
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23
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Hsu WY, Chiu NY, Chang CC, Chang TG, Lane HY. The association between cigarette smoking and obstructive sleep apnea. Tob Induc Dis 2019; 17:27. [PMID: 31582938 PMCID: PMC6751985 DOI: 10.18332/tid/105893] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Obstructive sleep apnea (OSA) is a serious sleep disorder characterized by repetitive episodes of paused or shallow breathing during sleep. Patients with OSA often have excessive daytime sleepiness. The role of cigarette smoking in OSA remains controversial. The aim of this study was to examine the relationship between cigarette smoking and OSA. METHODS In this retrospective chart review, we reviewed 18-month sleep laboratory charts in central Taiwan. We collected data regarding sleep, current cigarette smoking status, sex, age, body mass index (BMI), neck circumference, Epworth Sleepiness Scale score, and polysomnographic sleep parameters. In total, 733 subjects were recruited; among these, 151 were smokers and 582 were non-smokers. RESULTS Smokers had significantly higher apnea–hypopnea index (p<0.001) for non-rapid eye movement sleep stage, higher apnea–hypopnea index (p<0.001) for total sleep time, and higher snore frequency (p<0.001) in t-test analysis. They also demonstrated higher Epworth Sleepiness Scale scores, shorter sleep times, lower percentage of slow-wave (deep) sleep, and longer snore times. However, no significant association was found between cigarette smoking and OSA after adjusting for sex, age, and BMI (OR=1.02, 95% CI: 0.66–1.57). CONCLUSIONS We did not find any significant association between cigarette smoking and OSA after adjusting for age, sex, and BMI. Further well-designed prospective controlled cohort studies might clarify the relationship between cigarette smoking and OSA.
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Affiliation(s)
- Wen-Yu Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Nan-Ying Chiu
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ting-Gang Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsien-Yuan Lane
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan.,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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24
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Huang SS, Chang CC. Comparison of insight in patients with schizophrenia, bipolar I disorder, and major depressive disorder in a real-world setting. Taiwan J Psychiatry 2019. [DOI: 10.4103/tpsy.tpsy_17_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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25
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Chang CC, Hsieh MH, Wang JY, Chiu NY, Wang YH, Chiou JY, Huang HH, Ju PC. Association between Thioridazine Use and Cancer Risk in Adult Patients with Schizophrenia-A Population-Based Study. Psychiatry Investig 2018; 15:1064-1070. [PMID: 30481993 PMCID: PMC6259001 DOI: 10.30773/pi.2018.10.10.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 10/10/2018] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Several cell line studies have demonstrated thioridazine's anticancer, multidrug resistance-reversing and apoptosis-inducing properties in various tumors. We conducted this nationwide population-based study to investigate the association between thioridazine use and cancer risk among adult patients with schizophrenia. METHODS Based on the Psychiatric Inpatient Medical Claim of the National Health Insurance Research Database of Taiwan, a total of 185,689 insured psychiatric patients during 2000 to 2005 were identified. After excluding patients with prior history of schizophrenia, only 42,273 newly diagnosed patients were included. Among them, 1,631 patients ever receiving thioridazine for more than 30 days within 6 months were selected and paired with 6,256 randomly selected non-thioridazine controls. These patients were traced till 2012/12/31 to see if they have any malignancy. RESULTS The incidence rates of hypertension and cerebrovascular disease were higher among cases than among matched controls. The incidence of hyperlipidemia, coronary artery disease and chronic pulmonary disease did not differ between the two groups. By using Cox proportional hazard model for cancer incidence, the crude hazard ratio was significantly higher in age, hypertension, hyperlipidemia, cerebrovascular disease, coronary artery disease and chronic pulmornary disease. However, after adjusting for other covariates, only age and hypertension remained significant. Thioridazine use in adult patients with schizophrenia had no significant association with cancer. CONCLUSION Despite our finding that thioridazine use had no prevention in cancer in adult patients with schizophrenia. Based on the biological activity, thioridazine is a potential anticancer drug and further investigation in human with cancer is warranted.
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Affiliation(s)
- Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Hong Hsieh
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jong-Yi Wang
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
| | - Nan-Ying Chiu
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Psychiatry, LuKang Christian Hospital, Lukang, Taiwan
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jeng-Yuan Chiou
- Department of Health Policy and Management, Chung Shan Medical University, Taichung, Taiwan
| | - Hsiang-Hsiung Huang
- Department of Psychiatry, Tungs' Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Po-Chung Ju
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan.,Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
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26
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Nicholson A, Berkowitz E, Monge-Camacho H, Brantley D, Garron N, Chang CC, Rinaldi E, Clark MA, Joó B, Kurth T, Tiburzi BC, Vranas P, Walker-Loud A. Heavy Physics Contributions to Neutrinoless Double Beta Decay from QCD. Phys Rev Lett 2018; 121:172501. [PMID: 30411940 DOI: 10.1103/physrevlett.121.172501] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Indexed: 06/08/2023]
Abstract
Observation of neutrinoless double beta decay, a lepton number violating process that has been proposed to clarify the nature of neutrino masses, has spawned an enormous world-wide experimental effort. Relating nuclear decay rates to high-energy, beyond the standard model (BSM) physics requires detailed knowledge of nonperturbative QCD effects. Using lattice QCD, we compute the necessary matrix elements of short-range operators, which arise due to heavy BSM mediators, that contribute to this decay via the leading order π^{-}→π^{+} exchange diagrams. Utilizing our result and taking advantage of effective field theory methods will allow for model-independent calculations of the relevant two-nucleon decay, which may then be used as input for nuclear many-body calculations of the relevant experimental decays. Contributions from short-range operators may prove to be equally important to, or even more important than, those from long-range Majorana neutrino exchange.
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Affiliation(s)
- A Nicholson
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, North Carolina 27516-3255, USA
- Department of Physics, University of California, Berkeley, California 94720, USA
| | - E Berkowitz
- Institut für Kernphysik and Institute for Advanced Simulation, Forschungszentrum Jülich, 54245 Jülich, Germany
| | - H Monge-Camacho
- Department of Physics, The College of William & Mary, Williamsburg, Virginia 23187, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - D Brantley
- Department of Physics, The College of William & Mary, Williamsburg, Virginia 23187, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Physics Division, Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - N Garron
- Theoretical Physics Division, Department of Mathematical Sciences, University of Liverpool, Liverpool L69 3BX, United Kingdom
| | - C C Chang
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Interdisciplinary Theoretical and Mathematical Sciences Program (iTHEMS), RIKEN 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - E Rinaldi
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- RIKEN-BNL Research Center, Brookhaven National Laboratory, Upton, New York 11973, USA
| | - M A Clark
- NVIDIA Corporation, 2701 San Tomas Expressway, Santa Clara, California 95050, USA
| | - B Joó
- Scientific Computing Group, Thomas Jefferson National Accelerator Facility, Newport News, Virginia 23606, USA
| | - T Kurth
- NERSC Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - B C Tiburzi
- Department of Physics, The City College of New York, New York, New York 10031, USA
- Graduate School and University Center, The City University of New York, New York, New York 10016, USA
| | - P Vranas
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Physics Division, Lawrence Livermore National Laboratory, Livermore, California 94550, USA
| | - A Walker-Loud
- Department of Physics, University of California, Berkeley, California 94720, USA
- Nuclear Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
- Physics Division, Lawrence Livermore National Laboratory, Livermore, California 94550, USA
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27
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Dixon PC, Stirling L, Xu X, Chang CC, Dennerlein JT, Schiffman JM. Aging may negatively impact movement smoothness during stair negotiation. Hum Mov Sci 2018; 60:78-86. [PMID: 29843055 DOI: 10.1016/j.humov.2018.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 05/17/2018] [Accepted: 05/17/2018] [Indexed: 11/25/2022]
Abstract
Stairs represent a barrier to safe locomotion for some older adults, potentially leading to the adoption of a cautious gait strategy that may lack fluidity. This strategy may be characterized as unsmooth; however, stair negotiation smoothness has yet to be quantified. The aims of this study were to assess age- and task-related differences in head and body center of mass (COM) acceleration patterns and smoothness during stair negotiation and to determine if smoothness was associated with the timed "Up and Go" (TUG) test of functional movement. Motion data from nineteen older and twenty young adults performing stair ascent, stair descent, and overground straight walking trials were analyzed and used to compute smoothness based on the log-normalized dimensionless jerk (LDJ) and the velocity spectral arc length (SPARC) metrics. The associations between TUG and smoothness measures were evaluated using Pearson's correlation coefficient (r). Stair tasks increased head and body COM acceleration pattern differences across groups, compared to walking (p < 0.05). LDJ smoothness for the head and body COM decreased in older adults during stair descent, compared to young adults (p ≤ 0.015) and worsened with increasing TUG for all tasks (-0.60 ≤ r ≤ -0.43). SPARC smoothness of the head and body COM increased in older adults, regardless of task (p < 0.001), while correlations showed improved SPARC smoothness with increasing TUG for some tasks (0.33 ≤ r ≤ 0.40). The LDJ outperforms SPARC in identifying age-related stair negotiation adaptations and is associated with performance on a clinical test of gait.
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Affiliation(s)
- P C Dixon
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA; Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
| | - L Stirling
- Department of Aeronautics and Astronautics, Massachusetts Institute of Technology, Cambridge, USA; Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, USA
| | - X Xu
- Department of Industrial and Systems Engineering, North Carolina State University, Raleigh, NC, USA
| | - C C Chang
- Department of Industrial Engineering & Engineering Management, National Tsing Hua University, Taiwan, ROC
| | - J T Dennerlein
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, USA; Bouvé College of Health Sciences, Northeastern University Boston, USA Sciences, Northeastern University, Boston, USA.
| | - J M Schiffman
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
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28
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Naderi A, Koschella A, Heinze T, Shih KC, Nieh MP, Pfeifer A, Chang CC, Erlandsson J. Corrigendum to "Sulfoethylated nanofibrillated cellulose: Production and properties" [Carbohydr. Polym. 169 (2017) 515-523]. Carbohydr Polym 2018; 179:1. [PMID: 29111030 DOI: 10.1016/j.carbpol.2017.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- A Naderi
- Innventia AB, Box 5604, SE-11486 Stockholm, Sweden.
| | - A Koschella
- Friedrich Schiller University of Jena, Institute for Organic Chemistry and Macromolecular Chemistry, Center of Excellence for Polysaccharide Research, Humboldtstraße 10, D-07743, Jena, Germany.
| | - T Heinze
- Friedrich Schiller University of Jena, Institute for Organic Chemistry and Macromolecular Chemistry, Center of Excellence for Polysaccharide Research, Humboldtstraße 10, D-07743, Jena, Germany.
| | - K C Shih
- Department of Chemical & Biomolecular Engineering, 97 North Eagleville Road, Storrs, CT-06269-3136, United States; Department of Agricultural Chemistry, Taiwan.
| | - M P Nieh
- Department of Chemical & Biomolecular Engineering, 97 North Eagleville Road, Storrs, CT-06269-3136, United States.
| | - A Pfeifer
- Friedrich Schiller University of Jena, Institute for Organic Chemistry and Macromolecular Chemistry, Center of Excellence for Polysaccharide Research, Humboldtstraße 10, D-07743, Jena, Germany.
| | - C C Chang
- ThINC Facility at Advanced Energy Research & Technology Center, 1000 Innovation Road, Stony Brook, NY, 11794-6044, United States.
| | - J Erlandsson
- Department of Fibre and Polymer Technology, KTH - Royal Institute of Technology, Teknikringen 56, SE-100 44 Stockholm, Sweden.
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29
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Abstract
Tracheal bronchus is a congenital anatomical variant of patients with accessory bronchus in the right upper lobe deriving directly from the supracarinal trachea. Pre-operative consultation with the anesthesiologist is important for patient safety and can avoid adverse effects induced by endotracheal intubation. In this report, we described a case of tracheal bronchus in which general anesthesia was performed for video-assisted thoracoscopic surgery. We discussed some of the issues surrounding to complications in tracheal bronchus.
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Affiliation(s)
- K M Lai
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - M H Hsieh
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - F Lam
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan
| | - C Y Chen
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - T L Chen
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - C C Chang
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan; Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
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Faber GS, Koopman AS, Kingma I, Chang CC, Dennerlein JT, van Dieën JH. Continuous ambulatory hand force monitoring during manual materials handling using instrumented force shoes and an inertial motion capture suit. J Biomech 2017; 70:235-241. [PMID: 29157658 DOI: 10.1016/j.jbiomech.2017.10.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 09/20/2017] [Accepted: 10/15/2017] [Indexed: 11/17/2022]
Abstract
Hand forces (HFs) are commonly measured during biomechanical assessment of manual materials handling; however, it is often a challenge to directly measure HFs in field studies. Therefore, in a previous study we proposed a HF estimation method based on ground reaction forces (GRFs) and body segment accelerations and tested it with laboratory equipment: GFRs were measured with force plates (FPs) and segment accelerations were measured using optical motion capture (OMC). In the current study, we evaluated the HF estimation method based on an ambulatory measurement system, consisting of inertial motion capture (IMC) and instrumented force shoes (FSs). Sixteen participants lifted and carried a 10-kg crate from ground level while 3D full-body kinematics were measured using OMC and IMC, and 3D GRFs were measured using FPs and FSs. We estimated 3D hand force vectors based on: (1) FP+OMC, (2) FP+IMC and (3) FS+IMC. We calculated the root-mean-square differences (RMSDs) between the estimated HFs to reference HFs calculated based on crate kinematics and the GRFs of a FP that the crate was lifted from. Averaged over subjects and across 3D force directions, the HF RMSD ranged between 10-15N when using the laboratory equipment (FP + OMC), 11-18N when using the IMC instead of OMC data (FP+IMC), and 17-21N when using the FSs in combination with IMC (FS + IMC). This error is regarded acceptable for the assessment of spinal loading during manual lifting, as it would results in less than 5% error in peak moment estimates.
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Affiliation(s)
- G S Faber
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA.
| | - A S Koopman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - I Kingma
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - C C Chang
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA; Department of Industrial Engineering & Engineering Management, National Tsing Hua University, Taiwan, ROC
| | - J T Dennerlein
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - J H van Dieën
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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Ko HH, Chang CC, Lin CH, Kuo YH, Chen IS, Chang HS. Bioactive chemical constituents isolated from the root of Neolitsea acuminatissima. Am J Transl Res 2017. [DOI: 10.1055/s-0037-1608145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- HH Ko
- Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, Kaohsiung, Taiwan
- Research Center for Natural Products and Drug Development, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - CC Chang
- Department of Fragrance and Cosmetic Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - CH Lin
- Research Center for Natural Products and Drug Development, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - YH Kuo
- Department of Chinese Pharmaceutical Science and Chinese Medicine Resources, China Medical University, Taichung, Taiwan
- Department of Biotechnology, Asia University, Taichung, Taiwan
| | - IS Chen
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - HS Chang
- Research Center for Natural Products and Drug Development, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
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Åmellem I, Suresh S, Chang CC, Tok SSL, Tashiro A. A critical period for antidepressant-induced acceleration of neuronal maturation in adult dentate gyrus. Transl Psychiatry 2017; 7:e1235. [PMID: 28925998 PMCID: PMC5639251 DOI: 10.1038/tp.2017.208] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 06/21/2017] [Indexed: 11/15/2022] Open
Abstract
Selective serotonin reuptake inhibitors (SSRIs) are the most commonly used medications for mood and anxiety disorders, and adult neurogenesis in the dentate gyrus has been shown to be involved in the behavioral effects of SSRIs in mice. Studies have shown the varied effects of chronic treatment with SSRIs on adult neurogenesis. One such effect is the acceleration of neuronal maturation, which affects the functional integration of new neurons into existing neuronal circuitry. In this study, we labeled new neurons by using GFP-expressing retroviral vectors in mice and investigated the effect of an SSRI, fluoxetine, on these neurons at different time points after neuronal birth. Chronic treatment with fluoxetine accelerated the dendritic development of the newborn neurons and shifted the timing of the expression of the maturational marker proteins, doublecortin and calbindin. This accelerated maturation was observed even after sub-chronic treatment, only when fluoxetine was administered during the second week of neuronal birth. These results suggest the existence of a 'critical period' for the fluoxetine-induced maturation of new neurons. We propose that the modified functional integration of new neurons in the critical period may underlie the behavioral effects of fluoxetine by regulating anxiety-related decision-making processes.
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Affiliation(s)
- I Åmellem
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway,St Olavs Hospital, Trondheim, Norway,Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, Singapore,Warwick-NTU Neuroscience Programme, School of Life Sciences, University of Warwick, Coventry, UK,Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, 11 Mandalay Road #12-01B, Singapore 308232. E-mail: or
| | - S Suresh
- Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, Singapore,Warwick-NTU Neuroscience Programme, School of Life Sciences, University of Warwick, Coventry, UK
| | - C C Chang
- Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, Singapore,Warwick-NTU Neuroscience Programme, School of Life Sciences, University of Warwick, Coventry, UK
| | - S S L Tok
- Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, Singapore,Warwick-NTU Neuroscience Programme, School of Life Sciences, University of Warwick, Coventry, UK
| | - A Tashiro
- Kavli Institute for Systems Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway,St Olavs Hospital, Trondheim, Norway,Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, Singapore,Warwick-NTU Neuroscience Programme, School of Life Sciences, University of Warwick, Coventry, UK,Warwick-NTU Neuroscience Programme, School of Biological Sciences, Nanyang Technological University, 11 Mandalay Road #12-01B, Singapore 308232. E-mail: or
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Li HY, Duan Y, Yang BQ, Chang CC, Liu N, Zhang LX, Lin S. [Analysis of the correlation between deep medullary veins and clinical prognosis of middle cerebral artery stroke]. Zhonghua Yi Xue Za Zhi 2017; 97:1956-1959. [PMID: 28693074 DOI: 10.3760/cma.j.issn.0376-2491.2017.25.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the relativity between the distribution of deep medullary vein (DMV) in patients with middle cerebral artery stroke and clinical prognosis by using susceptibility-weighted imaging (SWI). Methods: A total of 144 cases of middle cerebral artery stroke patients and 55 healthy volunteers were retrospectively analyzed from January 2015 to October 2015 in order to investigate the symmetrical characteristic and the classification of DMV, then 30 cases were followed up. Kappa test was used to consider the consistency of judging DMV symmetry and type data by two radiologists. Results:Kappa value in DMV symmetry and DMV type were 0.875 and 0.852. Chi-square test analysis revealed a statistically significant difference of DMV symmetry between healthy control and stroke group(χ(2)=31.046, P=0.000). There was correlation between DMV type and NIHSS score in stroke group (r(s)=0.208, P=0.025). There was no statistically significant difference of DMV distribution in the different periods of stroke group (P=0.110). But there was statistically significant difference of DMV distribution between acute and chronic stroke (P=0.018). Among 30 follow-up cases, 18 cases with asymmetry DMV changed into symmetry after stroke therapy. In 8 cases with symmetry DMV, the diameter of DMV became smaller after treatment. In 4 cases, DMV had no changes. Conclusions: DMV in patients of MCA stroke are mostly asymmetry distribution. DMV classification can be used as an imaging standard to predict the prognosis of stroke patients.
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Affiliation(s)
- H Y Li
- Department of Radiology, the General Hospital of Shenyang Military Region, Shenyang 110016, China
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Duan Y, Yang BQ, Chang CC, Zhou J, Li HY, Xu ZH, Wang ZW, Li DY. [Preliminary study on assessment of lexiscan-induced blood-brain barrier opening and its level by CT perfusion imaging]. Zhonghua Yi Xue Za Zhi 2017; 96:2825-2829. [PMID: 27686551 DOI: 10.3760/cma.j.issn.0376-2491.2016.35.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the level of lexiscan-induced blood-brain barrier opening of healthy rabbits via CT perfusion weighted imaging (PWI) scan. Methods: Between November 2014 and May 2015, thirty New Zealand white rabbits were randomly assigned into three groups: the experimental group A1 which received one injection of lexiscan(1 ml/kg); the experimental group A2 which received three times injection of lexiscan(total dose: 1.5 ml/kg), finished within 15 minutes; the control group B which was injected the same volume normal saline(1 ml/kg), after 30 minutes, CT PWI scan was performed. Then cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT) and permeability surface(PS) of the region of interest of each group were acquired and compared statistically. Five cases of each group were injected with 2% Evans blue intravenously posterior to imaging. After one hour of infusion, all the animals were killed. Their brains were examined for the determination of Evans blue distribution. Results: Both the values of CBF and CBV and the staining with Evans blue of the group A1(CBF: (89.88±2.21), (81.42±4.28) ml·(100 g)-1·min-1; CBV: (3.97±0.43), (3.66±0.16) ml/g)and group A2 (CBF: (75.16±0.84), (63.66±7.21) ml·(100 g)-1·min-1; CBV: (4.07±0.01), (3.75±0.05) ml/g) were higher than those of the group B(CBF: (20.08±5.08), (14.58±8.62) ml·(100 g)-1·min-1; CBV: (0.85±0.04), (0.65±0.17) ml/g), the differences were all statistically significant (all P<0.01). While there was no statistically difference between group A1 and group A2(P>0.05). The value of PS of the group A2((22.43±8.09), (20.20±7.01)ml·(100 g)-1·min-1 )was higher than that of group A1((13.82±4.44), (10.12±2.44)ml·(100 g)-1·min-1) and group B(0.00, 0.00)(the lowest one), the differences were all statistically significant(all P<0.01). The value of MTT of the group A1((2.50±0.82, 2.47±0.10) s) had no statistical difference with group A2 and group B, while the value of group A2((4.50±0.17), (4.72±0.15) s) was higher than that of group B((1.88±0.09), (1.99±0.00) s), the differences were all statistically significant (P<0.05). Conclusion: Changes in hemodynamics of lexiscan-induced blood-brain barrier opening can be monitored by CT PWI scan. When the total dose of lexiscan increasing, the level of the BBB opening is higher with significantly increased CBF, CBV, PS and MTT.
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Affiliation(s)
- Y Duan
- *Department of Radiology, the General Hospital of Shenyang Military Region, Shenyang 110016, China
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Ma SP, Tsai CJ, Chang CC, Hsu WY. Delirium associated with concomitant use of duloxetine and bupropion in an elderly patient. Psychogeriatrics 2017; 17:130-132. [PMID: 27046219 DOI: 10.1111/psyg.12202] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 02/02/2016] [Accepted: 02/11/2016] [Indexed: 11/30/2022]
Abstract
Delirium is common in daily practice. Drug-induced delirium constitutes approximately one-third of all cases of delirium. In cases characterized by the limited efficacy of a single antidepressant, a combination of two antidepressants is required, which may induce a complex drug-drug interaction. We reviewed a case of duloxetine- and bupropion-related delirium in an elderly male patient in our clinical practice. The patient was diagnosed with major depressive disorder and was treated with duloxetine. However, he developed delirium 10 days after bupropion was added to his treatment regimen. Three days after the cessation of bupropion, his delirious condition gradually improved. Duloxetine and bupropion are both cytochrome P450 2D6 inhibitors that may result in a higher level of hydroxybupropion. An increased level of hydroxybupropion may cause the elevation of dopamine and a risk of subsequent delirium. We should be aware of the risk of delirium induced by drug-drug interactions.
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Affiliation(s)
- Szu-Pin Ma
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Chia-Jui Tsai
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Wen-Yu Hsu
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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Chang YS, Chang CC, Chen YH, Chen WS, Chen JH. Risk of infective endocarditis in patients with systemic lupus erythematosus in Taiwan: a nationwide population-based study. Lupus 2017; 26:1149-1156. [PMID: 28420053 DOI: 10.1177/0961203317694260] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objectives Patients with systemic lupus erythematosus are considered vulnerable to infective endocarditis and prophylactic antibiotics are recommended before an invasive dental procedure. However, the evidence is insufficient. This nationwide population-based study evaluated the risk and related factors of infective endocarditis in systemic lupus erythematosus. Methods We identified 12,102 systemic lupus erythematosus patients from the National Health Insurance research-oriented database, and compared the incidence rate of infective endocarditis with that among 48,408 non-systemic lupus erythematosus controls. A Cox multivariable proportional hazards model was employed to evaluate the risk of infective endocarditis in the systemic lupus erythematosus cohort. Results After a mean follow-up of more than six years, the systemic lupus erythematosus cohort had a significantly higher incidence rate of infective endocarditis (42.58 vs 4.32 per 100,000 person-years, incidence rate ratio = 9.86, p < 0.001) than that of the control cohort. By contrast, the older systemic lupus erythematosus cohort had lower risk (adjusted hazard ratio 11.64) than that of the younger-than-60-years systemic lupus erythematosus cohort (adjusted hazard ratio 15.82). Cox multivariate proportional hazards analysis revealed heart disease (hazard ratio = 5.71, p < 0.001), chronic kidney disease (hazard ratio = 2.98, p = 0.034), receiving a dental procedure within 30 days (hazard ratio = 36.80, p < 0.001), and intravenous steroid therapy within 30 days (hazard ratio = 39.59, p < 0.001) were independent risk factors for infective endocarditis in systemic lupus erythematosus patients. Conclusions A higher risk of infective endocarditis was observed in systemic lupus erythematosus patients. Risk factors for infective endocarditis in the systemic lupus erythematosus cohort included heart disease, chronic kidney disease, steroid pulse therapy within 30 days, and a recent invasive dental procedure within 30 days.
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Affiliation(s)
- Y S Chang
- 1 Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,2 Division of Allergy, Immunology, and Rheumatology, Shuang Ho Hospital, Taipei Medical University, Taiwan
| | - C C Chang
- 1 Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,3 Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Y H Chen
- 4 Biostatistics Center, College of Management, Taipei Medical University, Taiwan
| | - W S Chen
- 5 Division of Rheumatology, Immunology, and Allergy, Taipei Veterans General Hospital, Taiwan
| | - J H Chen
- 6 Biostatistics Center and Graduate Institute of Data Science, College of Management, Taipei Medical University, Taiwan
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Tuan PH, Chang CC, Chang FL, Lee CY, Sung CL, Cho CY, Chen YF, Su KW. Modelling end-pumped passively Q-switched Nd-doped crystal lasers: manifestation by a Nd:YVO 4/Cr 4+:YAG system with a concave-convex resonator. Opt Express 2017; 25:1710-1722. [PMID: 29519025 DOI: 10.1364/oe.25.001710] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
A theoretical model for the passively Q-switched (PQS) operation which includes the spatial overlapping between the pump and lasing modes under the thermal lensing effect is developed to give a transcendental equation that can directly determine the critical parameters such as pulse energy, pulse repetition rate, and pulse width for the PQS performance. More importantly, an analytical function which gives the approximate solution for the transcendental equation as well as a specific critical criterion for good PQS operation are derived for practical analyses and design. A Nd:YVO4/Cr4+:YAG system with a concave-convex resonator which can achieve fairly stable PQS pulse trains even at a high pump level is further exploited to manifest the proposed spatially dependent model. The good agreement between the experimental results and the theoretical predictions is verified to show the feasibility of the proposed model for designing high-power PQS lasers with high accuracy.
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Sung CL, Lee CY, Chang CC, Liang HC, Chen YF. Generation of terahertz optical beating from a simultaneously self-mode-locked Nd:YAG laser at 1064 and 1123 nm. Opt Lett 2017; 42:302-305. [PMID: 28081098 DOI: 10.1364/ol.42.000302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The reflectivity of the output coupler is designed to achieve the synchronously self-mode-locked operation at 1064 and 1123 nm in a diode-end-pumped Nd:YAG laser. Numerical analyses are performed to confirm that the designed output coupler can lead the emission lines to be predominant at 1064 and 1123 nm. Moreover, the crossover of the threshold pump powers for the 1064 and 1123 nm emission lines can be exploited to obtain the single central wavelength of 1064 nm or the single central wavelength of 1123 nm or, simultaneously, dual-central-wavelength self-mode-locked operation by finely adjusting the cavity alignment. For the dual-central-wavelength mode-locked emissions, the pulse repetition rate and the pulse duration are 4.5 GHz and 50.8 ps, respectively. The maximum output power can be up to 2.47 W at a pump power of 7.5 W. The synchronization of the 1064 and 1123 nm mode-locked pulses generates the optical beating pulse trains with repetition rates up to 14.7 THz.
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Tuan PH, Chang CC, Lee CY, Cho CY, Liang HC, Chen YF. Exploiting concave-convex linear resonators to design end-pumped solid-state lasers with flexible cavity lengths: Application for exploring the self-mode-locked operation. Opt Express 2016; 24:26024-26034. [PMID: 27857341 DOI: 10.1364/oe.24.026024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The characteristics of a convex-concave linear resonator under the thermal lensing effect are theoretically analyzed to find an analytical model for designing end-pumped solid-state lasers with flexible cavity lengths. By exploiting the design model, the power scaling for continuous-wave operation under strong thermal lensing can be easily achieved in the proposed resonator with different cavity lengths. Furthermore, the proposed resonator is applied to explore the exclusive influence of cavity length on the self-mode-locked (SML) operation. It is discovered that the lasing longitudinal modes will split into multiple groups in optical spectrum to lead to a multi-pulse mode-locked temporal state when the cavity length increases. Finally, a theoretical model is derived to reconstruct the experimental results of SML operation to deduce a simple relationship between the group number of lasing modes and the cavity length.
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Lee CT, Chiang YC, Huang JY, Tantoh DM, Nfor ON, Lee JF, Chang CC, Liaw YP. Incidence of Major Depressive Disorder: Variation by Age and Sex in Low-Income Individuals: A Population-Based 10-Year Follow-Up Study. Medicine (Baltimore) 2016; 95:e3110. [PMID: 27082549 PMCID: PMC4839793 DOI: 10.1097/md.0000000000003110] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Major depressive disorder (MDD), the most prevalent mental disorder is a global public health issue. The aim of this study was to assess the association between low income and major depressive disorder (MDD) by age and sex. The National Health Insurance Research Database (NHIRD) of Taiwan was used to retrieve data. A total of 1,743,948 participants were eligible for the study. Low-income individuals were identified from 2001 and 2003 (specifically, Group Insurance Applicants, ie, category"51" or "52") and followed from 2004 to 2010. MDD was identified using the ICD-9-CM 296.2 and 296.3 codes. Among non-low-income individuals, the MDD incidence rates increased with age in both males and females, that is, 0.35, 0.93, 0.97, 1.40 per 10,000 person-months for males and 0.41, 1.60, 1.89, 1.95 per 10,000 person-months for females aged 0 to 17, 18 to 44, 45 to 64, and ≥65 years, respectively. Low-income females (18-44 years) and males (45-64 years) had the highest incidence of MDD, which was 3.90 and 3.04, respectively, per 10,000 person-months. Among low and non-low-income individuals, the MDD incidence rates were higher in the females than males in all age groups. Males aged 45 to 64 and 0 to 17 years had highest hazard ratios (HR) of 2.789 (95% confidence interval [CI], 1.937-4.014) and 2.446 (95% CI, 1.603-3.732), respectively. The highest HRs for females were 2.663 (95% CI, 1.878-3.775) and 2.219 (CI, 1.821-2.705) in the 0 to 17 and 18- to 44-year age groups. Low income was not found to serve as a risk factor for the development of MDD in males and females aged ≥65 years. Among the non-low-income males and females, the incidence rates of MDD were found to increase with age. Low income was found to serve as a significant risk factor for MDD only in individuals under age 65.
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Affiliation(s)
- Chun-Te Lee
- From the Department of Psychiatry (C-TL); School of Medicine (C-TL); Department of Public Health and Institute of Public Health (Y-CC, J-YH, DMT, ONN, Y-PL); Department of Family and Community Medicine (Y-PL), Chung Shan Medical University Hospital, Taichung; Department of Psychiatry (J-FL), Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei; School of Medicine (J-FL), Tzu Chi University, Hualien; Institute of Medicine (C-CC), Chung Shan Medical University, Taichung; and Department of Psychiatry (C-CC), Changhua Christian Hospital, Changhua, Taiwan
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Li E, Chang CC, Zhang Z, Li Q. Characterization of tissue scaffolds for time-dependent biotransport criteria - a novel computational procedure. Comput Methods Biomech Biomed Engin 2015; 19:1210-24. [PMID: 26718135 DOI: 10.1080/10255842.2015.1124268] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study aims to establish a new computational framework that allows modeling transient oxygen diffusion in tissue scaffolds more efficiently. It has been well known that the survival of cells strongly relies on continuous oxygen/nutrient supply and metabolite removal. With optimal design in scaffold architecture, its ability to sustain long distance oxygen supply could be improved considerably. In this study, finite element based homogenization procedure is first used to characterize the initial effective biotransport properties in silico. These initial properties are proper indicators to prediction of the on-going performance of tissue scaffolds over time. The transient model by adopting an edge-based smoothed finite element method with combination of mass-redistributed method is then established to more efficiently simulate the transient oxygen transfer process in tissue scaffolds. The proposed new method allows large time steps to model the oxygen diffusion process without losing numerical accuracy, thereby enhancing the computational efficiency significantly, in particular for the design optimization problems which typically require numerous analysis iterations. A number of different scaffold designs are examined either under net diffusion without cell seeding, or under cellular oxygen/nutrient uptake with or without considering cell viability. The association between the homogenized effective diffusivity of net scaffold microstructures and corresponding transient diffusion and time-dependent cellular activities is divulged. This study provides some insights into scaffold design.
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Affiliation(s)
- Eric Li
- a School of Aerospace, Mechanical and Mechatronic Engineering , The University of Sydney , Sydney , Australia
| | - C C Chang
- a School of Aerospace, Mechanical and Mechatronic Engineering , The University of Sydney , Sydney , Australia
| | - Zhongpu Zhang
- a School of Aerospace, Mechanical and Mechatronic Engineering , The University of Sydney , Sydney , Australia
| | - Qing Li
- a School of Aerospace, Mechanical and Mechatronic Engineering , The University of Sydney , Sydney , Australia
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Chang CC, Lee CT, Lan TH, Ju PC, Hsieh YH, Lai TJ. Effects of antidepressant treatment on total antioxidant capacity and free radical levels in patients with major depressive disorder. Psychiatry Res 2015; 230:575-80. [PMID: 26476591 DOI: 10.1016/j.psychres.2015.10.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Revised: 09/15/2015] [Accepted: 10/03/2015] [Indexed: 11/30/2022]
Abstract
In this prospective study, we investigated the effects of antidepressant therapy on total antioxidant capacity and free radical levels in patients with major depressive disorder (MDD). We recruited thirty-five first-episode patients who met the criteria of the Fourth Edition of Diagnostic and Statistical Manual of Mental Disorders of MDD and 35 age- and sex-matched healthy controls. Superoxide and hydroxyl radicals were measured to investigate oxidative status and the total radical-trapping antioxidant parameter (TRAP) assay was performed to evaluate antioxidant capacity in healthy controls and in patients before and after receiving a 12-week regimen of sertraline. The severity of depression was evaluated using the 17-item Hamilton Depression Rating Scale (HDRS). Before treatment, the mean HDRS score in patients with MDD was 26.11±4.93. Of the 35 patients with MDD, 19 (54.29%) completed the 12-week treatment regimen and all achieved remission. Patients with MDD had significantly lower TRAP baseline values than healthy controls. After adjusting for age, sex, occupation, education and marital status, we found that HDRS score was negatively correlated with TRAP value and level of superoxide radicals. After treatment, the MDD group demonstrated significantly higher TRAP values and significantly lower levels of superoxide and hydroxyl radicals. In conclusion, MDD patients are accompanied by lowered antioxidant capacity than healthy individuals. Antidepressant treatment for 12 weeks results in increased antioxidant capacity and a decrease in circulating free radicals.
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Affiliation(s)
- Cheng-Chen Chang
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Chun-Te Lee
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Tsuo-Hung Lan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Chung Ju
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Yi-Hsien Hsieh
- Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Te-Jen Lai
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.
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Faber GS, Chang CC, Kingma I, Dennerlein JT, van Dieën JH. Estimating 3D L5/S1 moments and ground reaction forces during trunk bending using a full-body ambulatory inertial motion capture system. J Biomech 2015; 49:904-912. [PMID: 26795123 DOI: 10.1016/j.jbiomech.2015.11.042] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 10/25/2015] [Accepted: 11/20/2015] [Indexed: 12/22/2022]
Abstract
Inertial motion capture (IMC) systems have become increasingly popular for ambulatory movement analysis. However, few studies have attempted to use these measurement techniques to estimate kinetic variables, such as joint moments and ground reaction forces (GRFs). Therefore, we investigated the performance of a full-body ambulatory IMC system in estimating 3D L5/S1 moments and GRFs during symmetric, asymmetric and fast trunk bending, performed by nine male participants. Using an ambulatory IMC system (Xsens/MVN), L5/S1 moments were estimated based on the upper-body segment kinematics using a top-down inverse dynamics analysis, and GRFs were estimated based on full-body segment accelerations. As a reference, a laboratory measurement system was utilized: GRFs were measured with Kistler force plates (FPs), and L5/S1 moments were calculated using a bottom-up inverse dynamics model based on FP data and lower-body kinematics measured with an optical motion capture system (OMC). Correspondence between the OMC+FP and IMC systems was quantified by calculating root-mean-square errors (RMSerrors) of moment/force time series and the interclass correlation (ICC) of the absolute peak moments/forces. Averaged over subjects, L5/S1 moment RMSerrors remained below 10Nm (about 5% of the peak extension moment) and 3D GRF RMSerrors remained below 20N (about 2% of the peak vertical force). ICCs were high for the peak L5/S1 extension moment (0.971) and vertical GRF (0.998). Due to lower amplitudes, smaller ICCs were found for the peak asymmetric L5/S1 moments (0.690-0.781) and horizontal GRFs (0.559-0.948). In conclusion, close correspondence was found between the ambulatory IMC-based and laboratory-based estimates of back load.
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Affiliation(s)
- G S Faber
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA.
| | - C C Chang
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA; Department of Industrial Engineering & Engineering Management National Tsing Hua University, Taiwan, ROC
| | - I Kingma
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
| | - J T Dennerlein
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Physical Therapy, Movement, and Rehabilitation Sciences, Northeastern University, Boston, MA, USA
| | - J H van Dieën
- Department of Human Movement Sciences, Faculty of Behaviour and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
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Abstract
Inhalation of Cryptococcus into the respiratory system is the main route of acquisition of human infection, yet pulmonary cryptococcosis goes mostly unrecognized by many clinicians. This delay in diagnosis, or misdiagnosis, of lung infections is due in part to frequently subtle clinical manifestations such as a subacute or chronic cough, a broad differential of diagnostic possibilities for associated pulmonary masses (cryptococcomas) and, on occasion, negative respiratory tract cultures. Hematogenous dissemination from the lung can result in protean manifestations, the most severe of which is meningoencephalitis. There are few clinical studies of pulmonary cryptococcosis and its pathogenesis is poorly understood. The main purpose of this review is to describe the epidemiology, clinical presentation, diagnosis, and treatment of pulmonary cryptococcosis to increase clinician's awareness of this diagnostic possibility and to enhance clinical management. Useful pointers to the approach and management of pulmonary cryptococcosis and the implications of disseminated disease are included, together with recommendations for future research.
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Affiliation(s)
- C C Chang
- Lewin-Cameron Laboratory, The Doherty Institute, University of Melbourne, Melbourne, Australia
| | - T C Sorrell
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia
| | - S C-A Chen
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, NSW, Australia
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Slavin MA, Thursky KA, Worth LJ, Chang CC, Morrissey CO, Blyth CC, Chen SC, Szer J. Introduction to the updated Australian and New Zealand consensus guidelines for the use of antifungal agents in the haematology/oncology setting, 2014. Intern Med J 2015; 44:1267-76. [PMID: 25482739 DOI: 10.1111/imj.12593] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This article introduces the second revision of the Australian and New Zealand consensus guidelines for the use of antifungal agents in the haematology/oncology setting. The current update occurs within the context of a growing population at risk of invasive fungal disease, improved understanding of risk factors, availability of new diagnostic tests, a much-expanded evidence base and changing clinical paradigms. Here, we provide an overview of the history and purpose of the guidelines, including changes in scope since the last clinical update was published in 2008. The process for development, and for enabling review of draft recommendations by end-users and other relevant stakeholders, is described. The approach to assigning levels of evidence and grades of recommendation is also provided, along with a comparison to international grading systems.
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Affiliation(s)
- M A Slavin
- Department of Infectious Diseases and Infection Control, Peter MacCallum Cancer Centre, East Melbourne, Victoria; Victorian Infectious Diseases Service, The Doherty Institute for Infection and Immunity, Parkville, Victoria; School of Medicine, The University of Melbourne, Melbourne, Victoria
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Chen SC, Sorrell TC, Chang CC, Paige EK, Bryant PA, Slavin MA. Consensus guidelines for the treatment of yeast infections in the haematology, oncology and intensive care setting, 2014. Intern Med J 2015; 44:1315-32. [PMID: 25482743 DOI: 10.1111/imj.12597] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pathogenic yeast forms are commonly associated with invasive fungal disease in the immunocompromised host, including patients with haematological malignancies and patients of haemopoietic stem cell transplants. Yeasts include the Candida spp., Cryptococcus spp., Pneumocystis jirovecii and some lesser-known pathogens. Candida species remain the most common cause of invasive yeast infections (and the most common human pathogenic fungi). These guidelines present evidence-based recommendations for the antifungal management of established, invasive yeast infections in adult and paediatric patients in the haematology/oncology setting. Consideration is also given to the critically ill patient in intensive care units, including the neonatal intensive care unit. Evidence for 'pre-emptive' or 'diagnostic-driven antifungal therapy' is also discussed. For the purposes of this paper, invasive yeast diseases are categorised under the headings of invasive candidiasis, cryptococcosis and uncommon yeast infections. Specific recommendations for the management of Pneumocystis jirovecii are presented in an accompanying article (see consensus guidelines by Cooley et al. appearing elsewhere in this supplement).
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Affiliation(s)
- S C Chen
- Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR - Pathology West, Westmead, New South Wales; Department of Infectious Diseases, Westmead Hospital, Westmead, New South Wales; Sydney Medical School, The University of Sydney, Sydney, New South Wales
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Chang CC, Ananda-Rajah M, Belcastro A, McMullan B, Reid A, Dempsey K, Athan E, Cheng AC, Slavin MA. Consensus guidelines for implementation of quality processes to prevent invasive fungal disease and enhanced surveillance measures during hospital building works, 2014. Intern Med J 2015; 44:1389-97. [PMID: 25482747 DOI: 10.1111/imj.12601] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Healthcare-associated fungal outbreaks impose a substantial economic burden on the health system and typically result in high patient morbidity and mortality, particularly in the immunocompromised host. As the population at risk of invasive fungal infection continues to grow due to the increased burden of cancer and related factors, the need for hospitals to employ preventative measures has become increasingly important. These guidelines outline the standard quality processes hospitals need to accommodate into everyday practice and at times of healthcare-associated outbreak, including the role of antifungal stewardship programmes and best practice environmental sampling. Specific recommendations are also provided to help guide the planning and implementation of quality processes and enhanced surveillance before, during and after high-risk activities, such as hospital building works. Areas in which information is still lacking and further research is required are also highlighted.
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Affiliation(s)
- C C Chang
- Department of Infectious Diseases, Alfred Health and Monash University, Prahran, Victoria; Centre for Biomedical Research, Burnet Institute, Victoria; Lewin-Cameron Laboratory, The Doherty Institute for Infection and Immunity, Parkville, Victoria
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Lee CY, Chang CC, Sung CL, Chen YF. Intracavity continuous-wave multiple stimulated-Raman-scattering emissions in a KTP crystal pumped by a Nd:YVO(4) laser. Opt Express 2015; 23:22765-22770. [PMID: 26368245 DOI: 10.1364/oe.23.022765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Intracavity continuous-wave (CW) multiple stimulated-Raman-scattering emissions have been successfully demonstrated in a KTP crystal pumped by a Nd:YVO(4) 1064-nm laser for the first time. Three different output couplers (OCs) with high-reflection (HR) coating in the range of 1-1.1, 1-1.13, and 1-1.15 μm are employed in the experiment to generate lasing wavelengths at 1095 (the first-Stokes emission of the 266 cm(-1) Raman shift), 1095 + 1128 (the first- and second-Stokes emission of the 266 cm(-1) Raman shift), and 1095 + 1128 + 1149 nm (the first two Stokes emissions of the 266 cm(-1) Raman shift and the first-Stokes emission of the 694 cm(-1) Raman shift), separately. This Raman laser paves a way to produce more-closely spaced set of CW emission in the green-yellow region.
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Chang CC, Jou SH, Lin TT, Lai TJ, Liu CS. Mitochondria DNA change and oxidative damage in clinically stable patients with major depressive disorder. PLoS One 2015; 10:e0125855. [PMID: 25946463 PMCID: PMC4422713 DOI: 10.1371/journal.pone.0125855] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 03/26/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To compare alterations of mitochondria DNA (mtDNA) copy number, single nucleotide polymorphisms (SNPs), and oxidative damage of mtDNA in clinically stable patients with major depressive disorder (MDD). METHODS Patients met DSM-IV diagnostic criteria for MDD were recruited from the psychiatric outpatient clinic at Changhua Christian Hospital, Taiwan. They were clinically stable and their medications had not changed for at least the preceding two months. Exclusion criteria were substance-induced psychotic disorder, eating disorder, anxiety disorder or illicit substance abuse. Comparison subjects did not have any major psychiatric disorder and they were medically healthy. Peripheral blood leukocytes were analyzed to compare copy number, SNPs and oxidative damage of mtDNA between the two groups. RESULTS 40 MDD patients and 70 comparison subjects were collected. The median age of the subjects was 42 years and 38 years in MDD and comparison groups, respectively. Leukocyte mtDNA copy number of MDD patients was significantly lower than that of the comparison group (p = 0.037). MDD patients had significantly higher mitochondrial oxidative damage than the comparison group (6.44 vs. 3.90, p<0.001). After generalized linear model adjusted for age, sex, smoking, family history, and psychotropic use, mtDNA copy number was still significantly lower in the MDD group (p<0.001). MtDNA oxidative damage was positively correlated with age (p<0.001) and MDD (p<0.001). Antipsychotic use was negatively associated with mtDNA copy number (p = 0.036). LIMITATIONS The study is cross-sectional with no longitudinal follow up. The cohort is clinically stable and generalizability of our result to other cohort should be considered. CONCLUSIONS Our study suggests that oxidative stress and mitochondria may play a role in the pathophysiology of MDD. More large-scale studies are warranted to assess the interplay between oxidative stress, mitochondria dysfunction and MDD.
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Affiliation(s)
- Cheng-Chen Chang
- The Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Shaw-Hwa Jou
- Department of Psychiatry, Taichung Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation, Taichung, Taiwan
- Department of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
- Department of Life Sciences, National Chung Hsing University, Taichung, Taiwan
| | - Ta-Tsung Lin
- Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua, Taiwan
| | - Te-Jen Lai
- The Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
- * E-mail: (TJL); (CSL)
| | - Chin-San Liu
- Vascular and Genomic Research Center, Changhua Christian Hospital, Changhua, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- * E-mail: (TJL); (CSL)
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Lee CY, Chang CC, Tuan PH, Cho CY, Huang KF, Chen YF. Cryogenically monolithic self-Raman lasers: observation of single-longitudinal-mode operation. Opt Lett 2015; 40:1996-1999. [PMID: 25927767 DOI: 10.1364/ol.40.001996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A cryogenically monolithic Nd:YVO4 self-Raman laser is experimentally explored and theoretically analyzed. The variation of the stimulated Raman scattering (SRS) threshold on the temperature is found to be nonlinear because the reduction of thermal lensing enlarges the cavity mode size. In spite of the nonlinear variation of the SRS threshold on the temperature, the overall SRS output power can be efficiently increased from 0.78 to 1.36 W for temperature decreasing from 285 to 80 K at an absorbed power of 17.2 W. More interestingly, the single-longitudinal-mode operation is experimentally achieved when temperature is lower than 125 K.
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