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Chen YL, Lin YY, Chin PW, Chen CC, Cheng CG, Cheng CA. Analyzing COVID-19 and Air Pollution Effects on Pediatric Asthma Emergency Room Visits in Taiwan. Toxics 2024; 12:79. [PMID: 38251034 PMCID: PMC10818664 DOI: 10.3390/toxics12010079] [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] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/07/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024]
Abstract
(1) Background: An asthma exacerbation that is not relieved with medication typically requires an emergency room visit (ERV). The coronavirus disease 2019 (COVID-19) pandemic began in Taiwan in January of 2020. The influence of the COVID-19 pandemic on pediatric ERVs in Taiwan was limited. Our aim was to survey pediatric asthma ERVs in the COVID-19 era; (2) Methods: Data were collected from the health quality database of the Taiwanese National Health Insurance Administration from 2019 to 2021. Air pollution and climatic factors in Taipei were used to evaluate these relationships. Changes in the rates of pediatric asthma ERVs were assessed using logistic regression analysis. Poisson regression was used to evaluate the impact of air pollution and climate change; (3) Results: The rate of pediatric asthma ERVs declined in different areas and at different hospital levels including medical centers, regional and local hospitals. Some air pollutants (particulate matter ≤ 2.5 µm, particulate matter ≤ 10 µm, nitrogen dioxide, and carbon monoxide) reduced during the COVID-19 lockdown. Ozone increased the relative risk (RR) of pediatric asthma ERVs during the COVID-19 period by 1.094 (95% CI: 1.095-1.12) per 1 ppb increase; (4) Conclusions: The rate of pediatric asthma ERVs declined during the COVID-19 pandemic and ozone has harmful effects. Based on these results, the government could reduce the number of pediatric asthma ERVs through healthcare programs, thereby promoting children's health.
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Affiliation(s)
- Yan-Lin Chen
- School of Medicine, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Yen-Yue Lin
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Pi-Wei Chin
- Department of Nursing, Ministry of Health and Welfare, Hua-Lien Hospital, Hua-Lien 97061, Taiwan;
| | - Cheng-Chueh Chen
- Department of General Surgery, China Medical University Beigang Hospital, Yunlin 65152, Taiwan;
| | - Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Lien RY, Cheng CG, Hung SH, Wang CY, Lin HC, Lu SF, Chin SI, Kuo YW, Liu CW, Yung MC, Cheng CA. The Effect of the Knowledge, Skills, and Attitudes from Nurse Training Using In Situ Simulation in an Intensive Care Unit. Healthcare (Basel) 2023; 11:2851. [PMID: 37957996 PMCID: PMC10649282 DOI: 10.3390/healthcare11212851] [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] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND In situ simulation is the practice of using simulated scenarios to improve skill implementation, train critical thinking and problem-solving abilities, and enhance self-efficacy. This study aimed to enhance nursing knowledge, skills, and attitudes toward clinical work by applying in situ simulation training to improve the healthcare of critically ill patients. METHODS This study was conducted from a medical center in northern Taiwan and included 86 trainees who received intensive care training courses from 1 June 2017 to 31 May 2019. The self-report knowledge assessment, empathetic self-efficacy scale, skill assessment, and attitudes of instructors before and after training were collected. The statistical analysis used the Wilcoxon test for knowledge and attitudes, and chi-square tests were used for skills to evaluate the learning effect. RESULTS The results showed a statistically significant improvement in knowledge, skills, attitudes, and empathy in nursing care. CONCLUSIONS In situ simulation learning can be an accepted method for nursing skills in the intensive care unit. Through this study, we understood that the in situ simulation method was beneficial to nurses' care and care thinking processes. It is worth developing and evaluating integrated simulation education to enhance learning, change behavior, and promote holistic care in the nursing field.
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Affiliation(s)
- Ru-Yu Lien
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan
- School of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Emergency, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
- Department of Exercise and Health Sciences, University of Taipei, Taipei 111036, Taiwan
| | - Shih-Hsin Hung
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan
- School of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Department of Nursing, Chang Jung Christian University, Tainan 711301, Taiwan
| | - Chien-Ying Wang
- Department of Exercise and Health Sciences, University of Taipei, Taipei 111036, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan
- Division of Trauma, Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - Hui-Chen Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
| | - Shu-Fen Lu
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan
- School of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Shu-I Chin
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - Yi-Wen Kuo
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - Chia-Wen Liu
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - Ming-Chi Yung
- Department of Cardiovascular Surgery, Taiwan Adventist Hospital, Taipei 10556, Taiwan
| | - Chun-An Cheng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 111036, Taiwan
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Cheng CG, Chen YH, Chang YH, Lin HC, Chin PW, Lin YY, Yung MC, Cheng CA. Underestimated Subsequent Sensorineural Hearing Loss after Septicemia. Medicina (Kaunas) 2023; 59:1897. [PMID: 38003946 PMCID: PMC10673047 DOI: 10.3390/medicina59111897] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/18/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023]
Abstract
Background and Objectives: Hearing loss after septicemia has been found in mice; the long-term risk increased 50-fold in young adults in a previous study. Hearing loss after septicemia has not received much attention. The aim of this study was to assess the relationship between septicemia and subsequent hearing loss. Materials and Methods: Inpatient data were obtained from the Taiwan Insurance Database. We defined patients with sensorineural hearing loss and excluded patients under 18 years of age. Patients without hearing loss were selected as controls at a frequency of 1:5. The date of admission was defined as the date of diagnosis. Comorbidities in the 3 years preceding the date of diagnosis were retrieved retrospectively. Associations with hearing loss were established by multiple logistic regression and forward stepwise selection. Results: The odds ratio (OR) for the association between sepsis and hearing loss was 3.052 (95% CI: 1.583-5.884). Autoimmune disease (OR: 5.828 (95% CI: 1.906-17.816)), brain injury (OR: 2.264 (95% CI: 1.212-4.229)) and ischemic stroke (OR: 1.47 (95% CI: 1.087-1.988)) were associated with hearing loss. Conclusions: Our study shows that hearing loss occurred after septicemia. Apoptosis caused by sepsis and ischemia can lead to hair cell damage, leading to hearing loss. Clinicians should be aware of possible subsequent complications of septicemia and provide appropriate treatment and prevention strategies for complications.
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Affiliation(s)
- Chun-Gu Cheng
- Department of Emergency, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan; (C.-G.C.)
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yu-Hsuan Chen
- Division of Chest Medicine, Department of Internal Medicine, Cheng Hsin General Hospital, Taipei 11220, Taiwan;
| | - Yin-Han Chang
- Department of Psychology, National Taiwan University, Taipei 10621, Taiwan
| | - Hui-Chen Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan;
| | - Pi-Wei Chin
- Department of Nursing, Ministry of Health and Welfare, Hua-Lien Hospital, Hualien 97061, Taiwan
| | - Yen-Yue Lin
- Department of Emergency, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan; (C.-G.C.)
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Ming-Chi Yung
- Department of Cardiovascular Surgery, Taiwan Adventist Hospital, Taipei 10540, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Lien RY, Wang CY, Hung SH, Lu SF, Yang WJ, Chin SI, Chiang DH, Lin HC, Cheng CG, Cheng CA. Reduction in the Incidence Density of Pressure Injuries in Intensive Care Units after Advance Preventive Protocols. Healthcare (Basel) 2023; 11:2116. [PMID: 37570356 PMCID: PMC10418660 DOI: 10.3390/healthcare11152116] [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] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 07/08/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023] Open
Abstract
(1) Background: Patients who are critically ill or undergo major surgery are admitted to intensive care units (ICUs). Prolonged immobilization is the most likely cause of pressure injuries (PrIs) in the ICU. Previous studies of Western populations found that effective protocols could reduce the incidence of PrIs, and the efficacy of systemic targeted intervention protocols in preventing PrIs in the Chinese population needs to be surveyed. (2) Methods: We reviewed cases of PrIs in the ICUs of Taipei Veterans General Hospital from 2014 to 2019. The ICU nurses at the hospital began to implement targeted interventions in January 2017. The incidence density of PrIs was calculated by dividing the number of PrIs by person days of hospitalizations in the pre-bundle (2014-2016) and post-bundle (2017-2019) stages. Poisson regression was performed to compare the trend of incidence densities. (3) Results: The incidence density of PrIs was 9.37/1000 person days during the pre-bundle stage and 1.85/1000 person days during the post-bundle stage (p < 0.001). The relative risk (RR) was 0.197 (95% confidence interval: 0.149-0.26). The incidence densities of iatrogenic PrIs and non-iatrogenic PrIs decreased as the RRs decreased. (4) Conclusions: Targeted interventions could significantly reduce the incidence of PrIs. Healthcare providers must follow the bundle care protocol for PrI prevention to improve the quality of healthcare and promote patient health.
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Affiliation(s)
- Ru-Yu Lien
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan; (R.-Y.L.); (S.-H.H.); (S.-F.L.); (W.-J.Y.); (S.-I.C.)
- School of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Chien-Ying Wang
- Department of Exercise and Health Sciences, University of Taipei, Taipei 111036, Taiwan;
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan
- Division of Trauma, Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - Shih-Hsin Hung
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan; (R.-Y.L.); (S.-H.H.); (S.-F.L.); (W.-J.Y.); (S.-I.C.)
- School of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Department of Nursing, Chang Jung Christian University, Tainan 711301, Taiwan
| | - Shu-Fen Lu
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan; (R.-Y.L.); (S.-H.H.); (S.-F.L.); (W.-J.Y.); (S.-I.C.)
- School of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| | - Wen-Ju Yang
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan; (R.-Y.L.); (S.-H.H.); (S.-F.L.); (W.-J.Y.); (S.-I.C.)
| | - Shu-I Chin
- Department of Nursing, Taipei Veterans General Hospital, Taipei 112201, Taiwan; (R.-Y.L.); (S.-H.H.); (S.-F.L.); (W.-J.Y.); (S.-I.C.)
| | - Dung-Hung Chiang
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan;
- Department of Critical Care Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan
| | - Hui-Chen Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan;
| | - Chun-Gu Cheng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 111036, Taiwan;
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Emergency, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Chun-An Cheng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 111036, Taiwan;
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Hsiao CC, Cheng CG, Chen CC, Chiu HW, Lin HC, Cheng CA. Semantic Visualization in Functional Recovery Prediction of Intravenous Thrombolysis following Acute Ischemic Stroke in Patients by Using Biostatistics: An Exploratory Study. J Pers Med 2023; 13:jpm13040624. [PMID: 37109009 PMCID: PMC10143597 DOI: 10.3390/jpm13040624] [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] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/16/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
(1) Background: Intravenous thrombolysis following acute ischemic stroke (AIS) can reduce disability and increase the survival rate. We designed a functional recovery analysis by using semantic visualization to predict the recovery probability in AIS patients receiving intravenous thrombolysis; (2) Methods: We enrolled 131 AIS patients undergoing intravenous thrombolysis from 2011 to 2015 at the Medical Center in northern Taiwan. An additional 54 AIS patients were enrolled from another community hospital. A modified Rankin Score ≤2 after 3 months of follow-up was defined as favorable recovery. We used multivariable logistic regression with forward selection to construct a nomogram; (3) Results: The model included age and the National Institutes of Health Stroke Scale (NIHSS) score as immediate pretreatment parameters. A 5.23% increase in the functional recovery probability occurred for every 1-year reduction in age, and a 13.57% increase in the functional recovery probability occurred for every NIHSS score reduction. The sensitivity, specificity, and accuracy of the model in the validation dataset were 71.79%, 86.67%, and 75.93%, respectively, and the area under the receiver operating characteristic curve (AUC) was 0.867; (4) Conclusions: Semantic visualization-based functional recovery prediction models may help physicians assess the recovery probability before patients undergo emergency intravenous thrombolysis.
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Affiliation(s)
- Chih-Chun Hsiao
- Department of Nursing, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
| | - Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Cheng-Chueh Chen
- Department of General Surgery, China Medical University Beigang Hospital, Yunlin 65152, Taiwan
| | - Hung-Wen Chiu
- Graduate Institute of Medical Informatics, College of Medical Science and Technology, Taipei Medical University, Taipei 11031, Taiwan
| | - Hui-Chen Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Cheng CG, Yen SY, Hsiao CC, Lin YY, Chang YH, Chen YH, Cheng CA. Short-Term Exposure Effect of Ambient Fine Particulate Matter, Ozone and Cold Temperature on Emergency Room Visits for Asthma Patients. Toxics 2023; 11:94. [PMID: 36850970 PMCID: PMC9964231 DOI: 10.3390/toxics11020094] [Citation(s) in RCA: 1] [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] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: The acute effects of ozone, cold temperature and particulate matter less than 2.5 μm (PM2.5) in size related to asthma attacks are well known worldwide. The adverse effects of ozone and cold temperature on asthma morbidity in Taiwan are still inconclusive. (2) Methods: This retrospective study included patients who had asthma emergency room visits (ERVs) from 1 January 2016 to 31 December 2019 in a regional hospital in Taiwan. The short-term negative effects were estimated using Distributed Lag Non-Linear Models (DLNMs) for the relative risks (RRs) of asthma ERVs associated with PM2.5, ozone and cold temperature exposures within 5 days. (3) Results: There was a significant association between a 10 ppm increase in PM2.5 exposure and asthma ERVs at a 2-day lag (RR 1.166, 95% confidence interval (C.I.): 1.051-1.294). There was a significant association between ozone and asthma ERVs at a 1-day lag (RR 1.179, 95% C.I.: 1.034-1.345). The ambient temperature in cold weather compared with the temperature of minimum asthma ERV showed an RR of 1.214, 95% C.I.: 1.009-1.252 at a 1-day lag. (4) Conclusions: This study provides evidence that short-term exposure to fine suspended particulates, ozone and inverse temperature is associated with asthma exacerbation.
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Affiliation(s)
- Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Shang-Yih Yen
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chih-Chun Hsiao
- Department of Nursing, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
| | - Yen-Yue Lin
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yin-Han Chang
- Department of Psychology, National Taiwan University, Taipei 10621, Taiwan
| | - Yu-Hsuan Chen
- Division of Chest Medicine, Department of Internal Medicine, Cheng Hsin General Hospital, Taipei 11220, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Hsiao CC, Lin CC, Cheng CG, Chang YH, Lin HC, Wu HC, Cheng CA. Self-Reported Beneficial Effects of Chinese Calligraphy Handwriting Training for Individuals with Mild Cognitive Impairment: An Exploratory Study. Int J Environ Res Public Health 2023; 20:1031. [PMID: 36673790 PMCID: PMC9859373 DOI: 10.3390/ijerph20021031] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 01/01/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Dementia is a common disease in aging populations. The treatment has mainly focused on memory decline prevention and behavior control. Nonpharmacological treatments, such as cognition training, physical exercise, and music therapy have been effective in slowing memory decline. Chinese calligraphy handwriting (CCH) through breath regulation and fine hand control involves high concentration levels, emotion regulation, and self-awareness. CCH is a mind and body activity that is culturally relevant to older Chinese adults. This study evaluated the beneficial effects of CCH on mild cognitive impairment. METHODS In 2018, we conducted 8 weeks of CCH training at the Tri-Service General Hospital. The participants were asked to copy a regular script. At the end of the course, they gave oral presentations and showed their work. Self-report questionnaires on emotion, memory, upper limb coordination, attention, and language were collected before and after training. RESULTS The five questionnaires showed significantly positive feelings after CCH training. The conditions of emotional stability, concentration, hand movement, memory, and speech improved. CONCLUSIONS CCH training stimulated the brain and improved cognition, psychological symptoms, and hand stability. It is inexpensive and worthwhile for elderly Chinese individuals with mild cognitive impairment to take time daily to practice calligraphy.
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Affiliation(s)
- Chih-Chun Hsiao
- Department of Nursing, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan
| | - Chun-Chieh Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, National Defense Medical Center, Taoyuan 32549, Taiwan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Yin-Han Chang
- Department of Psychology, National Taiwan University, Taipei 10621, Taiwan
| | - Hui-Chen Lin
- School of Nursing, Taipei Medical University, Taipei 11031, Taiwan
| | - Hsing-Chen Wu
- Graduate Institute of Vocational and Technological Education, National Pingtung University of Science and Technology, Pingtung 91201, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
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Huang YM, Chien WC, Cheng CG, Chang YH, Chung CH, Cheng CA. Females with Diabetes Mellitus Increased the Incidence of Premenstrual Syndrome. Life (Basel) 2022; 12:life12060777. [PMID: 35743808 PMCID: PMC9224876 DOI: 10.3390/life12060777] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 05/10/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Premenstrual syndrome (PMS) is a multifactorial disorder caused by hormone and autonomic imbalance. In our study, hyperglycemia-induced insulin secretion increased progesterone secretion and progressive autonomic imbalance. The young patients with diabetes mellitus (DM) revealed hypo-parasympathetic function and hypersympathetic function compared with nondiabetic controls. Young female patients with DM with higher blood sugar and autonomic malfunction may be associated with PMS. However, there is a lack of evidence about DM in females related to PMS. We evaluated female patients with DM who subsequently followed PMS in a retrospective cohort study. Methods: We retrieved data from the National Health Insurance Research Database in Taiwan. Female patients with DM between 20 and 50 years old were assessed by the International Classification of Disease, 9 Revision, Clinical Modification (ICD-9-CM) disease code of 250. Patients who were DM-free females were fourfold matched to the control group by age and disease index date. The ICD-9-CM disease code of 625.4 identified the incidence of PMS followed by the index date as events. The possible risk factors associated with PMS were detected with a Cox proportional regression. Results: DM was a significant risk factor for PMS incidence with an adjusted hazard ratio of 1.683 (95% confidence interval: 1.104−2.124, p < 0.001) in females after adjusting for age, other comorbidities, season, urbanization status of patients and the hospital status of visiting. Conclusions: This study noted an association between DM and PMS in female patients. Healthcare providers and female patients with DM must be aware of possible complications of PMS, aggressive glycemic control, decreased hyperglycemia and autonomic dysfunction to prevent this bothersome disorder.
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Affiliation(s)
- Yao-Ming Huang
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, National Defense Medical Center, Taoyuan 32549, Taiwan; (Y.-M.H.); (C.-G.C.)
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (W.-C.C.); (C.-H.C.)
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, National Defense Medical Center, Taoyuan 32549, Taiwan; (Y.-M.H.); (C.-G.C.)
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Emergency Department, Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yin-Han Chang
- Department of Psychology, National Taiwan University, Taipei 10621, Taiwan;
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (W.-C.C.); (C.-H.C.)
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: ; Tel.: +886-2-87927173
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Cheng CG, Chen YH, Yen SY, Lin HC, Lin HC, Chou KR, Cheng CA. Air Pollution Exposure and the Relative Risk of Sudden Sensorineural Hearing Loss in Taipei. Int J Environ Res Public Health 2022; 19:6144. [PMID: 35627680 PMCID: PMC9141287 DOI: 10.3390/ijerph19106144] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 12/04/2022]
Abstract
(1) Background: The etiologies of sudden sensorineural hearing loss (SSHL) remain unclear. The level of mean particulate matter with a diameter of 2.5 μm or less (PM2.5) was not associated with SSHL, but the maximum PM2.5 level exhibited a negative association with SSHL in Korea. Exposure to nitrogen dioxide (NO2) for 2 weeks increased the risk of SSHL. The lag effects of SSHL after air pollution exposure were limited. We aimed to evaluate the association of SSHL with air pollution exposure to determine whether air pollution exposure caused delayed effects. (2) Methods: This observational study used inpatient data obtained from electronic health records at the Tri-Service General Hospital from 2011 to 2019. The data of all SSHL patients were retrieved. The air quality dataset from Songshan station from 2011 to 2019 was used. The main outcomes were the relative risks (RRs) of SSHL associated with PM2.5, O3, and NO2 exposures within 1 month. The relationships between these factors were examined using distributed lag nonlinear time series models. (3) Results: The RR of SSHL associated with PM2.5 exposure was 1.195 (95% confidence interval (C.I.: 1.047-1.363) for a 10 unit increase at a lag of 7 days. The RR of SSHL associated with O3 exposure was 1.14 (95% C.I.: 1.003-1.3) for a 10 unit increase at a lag of 9 days. The RR of SSHL associated with NO2 exposure was 1.284 (95% C.I.: 1.05-1.57) for a 10 unit increase at a lag of 23 days. (4) Conclusions: In our study, SSHL was confirmed to be associated with air pollution exposure with a lag effect. We discussed possible mechanisms to explore possible biological hypotheses and support further research. Large-scale studies including participants with other ethnicities and causal relationships are needed to confirm our findings.
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Affiliation(s)
- Chun-Gu Cheng
- Department of Emergency, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan;
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Emergency Department, Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
- Department of Emergency, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan
| | - Yu-Hsuan Chen
- Division of Chest Medicine, Department of Internal Medicine, Cheng Hsin General Hospital, Taipei 11220, Taiwan;
| | - Shang-Yih Yen
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Hui-Chen Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan; (H.-C.L.); (K.-R.C.)
| | - Hung-Che Lin
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan; (H.-C.L.); (K.-R.C.)
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei 116, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei 23561, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei 110301, Taiwan
- Neuroscience Research Center, Taipei Medical University, Taipei 11031, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
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Cheng CG, Wu DC, Lu JC, Yu CP, Lin HL, Wang MC, Cheng CA. Restricted use of copy and paste in electronic health records potentially improves healthcare quality. Medicine (Baltimore) 2022; 101:e28644. [PMID: 35089204 PMCID: PMC8797538 DOI: 10.1097/md.0000000000028644] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 12/13/2021] [Accepted: 12/24/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT The copy-and-paste feature is commonly used for clinical documentation, and a policy is needed to reduce overdocumentation. We aimed to determine if the restricted use of copy and paste by doctors could improve inpatient healthcare quality.Clinical documentation in an inpatient dataset compiled from 2016 to 2018 was used. Copied-and-pasted text was detected in word templates using natural language programming with a threshold of 70%. The prevalence of copying and pasting after the policy introduction was accessed by segmented regression for trend analysis. The rate of readmission for the same disease within 14 days was assessed to evaluate inpatient healthcare quality, and the completion of discharge summary notes within 3 days was assessed to determine the timeliness of note completion. The relationships between these factors were used cross-correlation to detect lag effect. Poisson regression was performed to identify the relative effect of the copy and paste restriction policy on the 14-day readmission rate or the discharge note completion rate within 3 days.The prevalence of copying and pasting initially decreased, then increased, and then flatly decreased. The cross-correlation results showed a significant correlation between the prevalence of copied-and-pasted text and the 14-day readmission rate (P < .001) and a relative risk of 1.105 (P < .005), with a one-month lag. The discharge note completion rate initially decreased and not affected long term after restriction policy.Appropriate policies to restrict the use of copying and pasting can lead to improvements in inpatient healthcare quality. Prospective research with cost analysis is needed.
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Affiliation(s)
- Chun-Gu Cheng
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
- Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ding-Chung Wu
- Department of Medical Records, Tri-Service General Hospital, Taipei, Taiwan
- School of Public Health, National Defense General Hospital, Taipei, Taiwan
- Graduate Institute of Life Science, National Defense Medical Center, Taipei, Taiwan
| | - Jui-Cheng Lu
- Department of Medical Records, Tri-Service General Hospital, Taipei, Taiwan
- Department of Business Administration, Kang Ning University, Taipei, Taiwan
| | - Chia-Peng Yu
- Department of Medical Records, Tri-Service General Hospital, Taipei, Taiwan
- School of Public Health, National Defense General Hospital, Taipei, Taiwan
| | - Hong-Ling Lin
- Department of Medical Records, Tri-Service General Hospital, Taipei, Taiwan
- School of Public Health, National Defense General Hospital, Taipei, Taiwan
| | - Mei-Chuen Wang
- Department of Medical Records, Tri-Service General Hospital, Taipei, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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11
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Lin YR, Lin YY, Yu CP, Yang YS, Cheng CG, Cheng CA. Increased Involvement of Klebsiellapneumoniae and Enterococcusfaecium in Healthcare-Associated Infections of Intensive Care Units in Taiwan. Healthcare (Basel) 2021; 9:healthcare9101349. [PMID: 34683029 PMCID: PMC8544546 DOI: 10.3390/healthcare9101349] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/02/2021] [Accepted: 10/07/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Healthcare-associated infections (HAIs) cause increases in length of stay, mortality, and healthcare costs. A previous study conducted in Taiwan obtained similar results to those reported in Korea and Japan in 2015. Changes in microorganisms have been noted in recent years. Understanding the recent condition of HAIs in intensive care units (ICUs) can enable healthcare providers to develop effective infection control protocols to reduce HAIs. Methods: We used the Taiwan Nosocomial Infection Surveillance System to evaluate the incidence densities of HAIs, the proportions of causative pathogens, and the proportions of antimicrobial resistance (AMR). The Poisson regression model was constructed to incidence density, and the chi-square test was used to assess proportion. Results: The incidence density of HAIs decreased 5.7 to 5.4 per 1000 person-days. However, the proportions of Klebsiella pneumoniae and Enterococcus faecium significantly increased. In addition, the proportions of carbapenem-resistant K. pneumoniae and vancomycin-resistant Enterococcus faecium significantly increased over time. Conclusion: Analysis of the microorganisms involved in HAIs in ICUs showed elevated proportions of K. pneumoniae and E. faecium with AMR. Infection control protocols have been implemented for several years and require improvements regarding environmental cleanliness and medical staff prevention.
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Affiliation(s)
- Yu-Ren Lin
- National Defense Medical Center, Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan; (Y.-R.L.); (Y.-Y.L.)
- National Defense Medical Center, Department of Emergency Medicine, Tri-Service General Hospital, Taipei 11490, Taiwan
| | - Yen-Yue Lin
- National Defense Medical Center, Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan; (Y.-R.L.); (Y.-Y.L.)
- National Defense Medical Center, Department of Emergency Medicine, Tri-Service General Hospital, Taipei 11490, Taiwan
| | - Chia-Peng Yu
- Department of Medical Research, Tri-Service General Hospital, Taipei 11490, Taiwan;
- National Defense Medical Center, School of Public Health, Taipei 11490, Taiwan
| | - Ya-Sung Yang
- National Defense Medical Center, Department of Infection Medicine, Tri-Service General Hospital, Taipei 11490, Taiwan;
| | - Chun-Gu Cheng
- National Defense Medical Center, Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32549, Taiwan; (Y.-R.L.); (Y.-Y.L.)
- National Defense Medical Center, Department of Emergency Medicine, Tri-Service General Hospital, Taipei 11490, Taiwan
- Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
- Correspondence: (C.-G.C.); (C.-A.C.); Tel.: +886-3-4801604 (C.-G.C.); +886-2-87927173 (C.-A.C.)
| | - Chun-An Cheng
- National Defense Medical Center, Department of Neurology, Tri-Service General Hospital, Taipei 11490, Taiwan
- Correspondence: (C.-G.C.); (C.-A.C.); Tel.: +886-3-4801604 (C.-G.C.); +886-2-87927173 (C.-A.C.)
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12
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Wu DC, Lin HL, Cheng CG, Yu CP, Cheng CA. Improvement the Healthcare Quality of Emergency Department after the Cloud-Based System of Medical Information-Exchange Implementation. Healthcare (Basel) 2021; 9:healthcare9081032. [PMID: 34442169 PMCID: PMC8392092 DOI: 10.3390/healthcare9081032] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/05/2021] [Accepted: 08/06/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The National Health Insurance has been implemented in Taiwan since 1995. The government established a medical information-exchange system to reduce duplicate medications and examinations, which have inhibited healthcare expenditures. The potential benefit of medical information exchange about healthcare quality in emergency departments (ED) was worthy of evaluating; Methods: The inquiry rate of cloud data for patients’ information in Taiwanese National Health Insurance Administration was defined as a factor, and the healthcare quality included the ratio of staying more than 48 h in the ED and the hospitalization rate within 8 h from ED by triage levels of 1, 2, and 3 in different levels of hospitals from 2013 to 2019. Poisson regression analysis was used to quantify time trends of the query rate of the MediCloud system, the rate of staying more than 48 h in ED, admission rate within 8 h in ED, and the effect of healthcare quality in ED after MediCloud system implementation; Results: The health information exchange decreased the rate of staying over 48 h in the ED of medical centers. It also improved the early hospitalization of urgent ED patients in regional hospitals; Conclusions: Through medical information exchange to understand patients’ current conditions, we can reduce crowding in the ED of medical centers and facilitate rapid hospitalization of urgent patients in regional hospitals. According to these findings, the government should establish medical information exchange to improve the healthcare quality of ED.
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Affiliation(s)
- Ding-Chung Wu
- Department of Medical Records, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (D.-C.W.); (H.-L.L.); (C.-P.Y.)
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- Institute of Life Science, National Defense Medical Center, Taipei 11490, Taiwan
| | - Hong-Ling Lin
- Department of Medical Records, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (D.-C.W.); (H.-L.L.); (C.-P.Y.)
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Force General Hospital, National Defense Medical Center, Taoyuan 32549, Taiwan;
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
| | - Chia-Peng Yu
- Department of Medical Records, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan; (D.-C.W.); (H.-L.L.); (C.-P.Y.)
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence:
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13
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Yu CP, Chou YC, Wu DC, Cheng CG, Cheng CA. Surveillance of foodborne diseases in Taiwan: A retrospective study. Medicine (Baltimore) 2021; 100:e24424. [PMID: 33592891 PMCID: PMC7870181 DOI: 10.1097/md.0000000000024424] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 12/22/2020] [Accepted: 01/02/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Foodborne pathogens cause diseases and death, increasing the economic burden. It needs to identify incident places, media food and pathgens. Our aim is to survey empirical data that provide a retrospective historical perspective on foodborne diseases and explore the causes and trends of outbreaks.We examined publicly available annual summary data on reported foodborne disease outbreaks in Taiwan from 2014 to 2018. We calculated the percentage of places, media food, bacteria and natural toxin sources in foodborne diseases and performed a chi-square test for difference evaluation. The higher risk of places and causes in 2018 compared with 2014 was empolyzed with univariate logistic regression.There were 26847 patients with foodborne diseases during the period from 2014 to 2018. The top 2 primary source locations of the foodborne diseases were schools and restaurants. The top 2 primary food media classifications of the foodborne diseases were boxed meals and compounded foods. The top 2 primary incident bacterial classifications of the observed foodborne diseases were Bacillus cereus and Staphylococcus aureus. The top 2 primary natural toxin classifications of the foodborne diseases were plants and histamines. The incidence of foodborne disease in military facilities, fruits and vegetables, and Staphylococcus aureus was increased in our study.Our study confirmed the high risk and increased incidence of foodborne diseases, food media classifications, bacterial classifications, and natural toxins in Taiwan. It is worthy of attention for the government health department-designed policy to promote disease prevention.
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Affiliation(s)
- Chia-Peng Yu
- Department of Medical Records, Tri-Service General Hospital, National Defense Medical Center
- School of Public Health, National Defense Medical Center, Taipei
| | - Yu-Ching Chou
- School of Public Health, National Defense Medical Center, Taipei
| | - Ding-Chung Wu
- Department of Medical Records, Tri-Service General Hospital, National Defense Medical Center
- School of Public Health, National Defense Medical Center, Taipei
| | - Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, National Defense Medical Center, Taoyuan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center
- Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Abstract
The ability of sepsis to induce acute phase hearing impairment has been evaluated in septic and sepsis-surviving mice. The relationship between septicemia and long-term hearing impairment remains unknown in humans.The data were obtained from the Taiwan Longitudinal National Health Insurance Database from 2000 to 2013. We identified patients suffering from septicemia after discharge, excluding those younger than 18 years old and older than 65 years old. The comparison group was matched based on age, sex, and comorbidities. The outcome was hearing impairment occurring after septicemia. The risk factors associated with hearing impairment were established using multivariate Cox proportional hazard regression.Our study found that septicemia associated with hearing impairment had an adjusted hazard ratio (HR) of 53.11 (95% confidence interval [CI]: 41.74-67.59). The other factors related to hearing impairment in young and middle-aged septicemia survivors included male sex (adjusted HR 1.31 [95% CI: 1.14-1.5]), chronic kidney disease (adjusted HR 1.63 [95% CI: 1.38-1.94]), and otoscleroisis (adjusted HR 231.54 [95% CI: 31.61-1695.8]).Our study revealed that septicemia was associated with increased development of hearing impairment in young and middle-aged humans in the long term. Clinicians should be aware of long-term septicemia-related hearing impairment and provide prevention strategies for otopathy in septicemia survivors.
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Affiliation(s)
- Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, National Defense Medical Center, Taoyuan
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei
- Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital
- School of Public Health
- Graduate Institute of Life and Medical Sciences
| | - Hung-Che Lin
- Graduate Institute of Life and Medical Sciences
- Department of Otolaryngology-Head and Neck Surgery
| | - Hui-Chen Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital
- School of Public Health
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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15
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Cheng CG, Chien WC, Yu CP, Chung CH, Cheng CA. Association between Reflux Esophagitis Incidence and Palmar Hyperhidrosis. Int J Environ Res Public Health 2020; 17:ijerph17124502. [PMID: 32585882 PMCID: PMC7345012 DOI: 10.3390/ijerph17124502] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 06/18/2020] [Accepted: 06/21/2020] [Indexed: 12/13/2022]
Abstract
The autonomic dysfunction in palmar hyperhidrosis (PH) includes not only sympathetic overactivity but also parasympathetic impairment. A decrease of parasympathetic tone has been noted in gastroesophageal reflux disease of neonates and adults. Patients with reflux esophagitis have a defective anti-reflux barrier. The association between reflux esophagitis and PH is deliberated in this article. The National Health Insurance Database in Taiwan was used. At first-time visits, PH patients were identified by the International Classification of Disease, 9th Revision, Clinical Modification disease code of 780.8 without endoscopic thoracic sympathectomy. Patients were matched by age and gender as control groups. The reflux esophagitis incidence was assessed using disease codes 530.11, 530.81, and 530.85. The factors related to reflux esophagitis were established by the Cox proportional regression model. The risk of reflux esophagitis in PH patients had a hazard ratio of 3.457 (95% confidence interval: 3.043-3.928) after adjustment of the other factors. We confirmed the association between reflux esophagitis and PH. Health care providers must be alerted to this relationship and other risk factors of reflux esophagitis to support suitable treatments to improve the quality of life of patients.
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Affiliation(s)
- Chun-Gu Cheng
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, National Defense Medical Center, Taoyuan 32549, Taiwan;
- Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei 11696, Taiwan
- Department of Emergency Medicine, Xin Tai General Hospital, New Taipei 24262, Taiwan
| | - Wu-Chien Chien
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei 11490, Taiwan;
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Chia-Peng Yu
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan;
- School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan;
| | - Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence: ; Tel.: +886-2-87927173
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16
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Cheng CA, Cheng CG, Chu H, Lin HC, Chung CH, Chiu HW, Chien WC. Correction to: Risk reduction of long-term major adverse cardiovascular events after endoscopic thoracic sympathectomy in palmar hyperhidrosis. Clin Auton Res 2018; 28:439. [PMID: 29860564 DOI: 10.1007/s10286-018-0536-9] [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] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
There is a typographical error in the International Classification of Disease Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic code used for palmar hyperhidrosis. The published manuscript wrongly reports that the ICD-9-CM code used for palmar hyperhidrosis was 708.8 (which indicates a diagnosis of "Other specified urticaria"), when, in actuality, the correct code 780.8 ("Hyperhidrosis") was applied. The authors regret this typographical error.
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Affiliation(s)
- Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Biomedical Informatics, Taipei Medical University, No. 250, Wu-Hsing Street, 110, Taipei, Taiwan
| | - Chun-Gu Cheng
- Department of Emergency, Armed Taoyuan General Hospital, Taoyuan, Taiwan.,Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsin Chu
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan.,Aviation Physiology Research Laboratory, Gangshan Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Hung-Che Lin
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei, 11490, Taiwan, ROC.,School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Hung-Wen Chiu
- Graduate Institute of Biomedical Informatics, Taipei Medical University, No. 250, Wu-Hsing Street, 110, Taipei, Taiwan.
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei, 11490, Taiwan, ROC. .,School of Public Health, National Defense Medical Center, Taipei, Taiwan.
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17
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Cheng CA, Cheng CG, Chu H, Lin HC, Chung CH, Chiu HW, Chien WC. Risk reduction of long-term major adverse cardiovascular events after endoscopic thoracic sympathectomy in palmar hyperhidrosis. Clin Auton Res 2017; 27:393-400. [PMID: 28929251 DOI: 10.1007/s10286-017-0464-0] [Citation(s) in RCA: 5] [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] [Received: 05/29/2017] [Accepted: 08/31/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE Palmar hyperhidrosis (PH) is excessive sweating of the palms resulting from sympathetic overactivity, and patients who undergo endoscopic thoracic sympathectomy (ETS) show reduced cardiac demand after 1 year and improved cerebral perfusion within 2-4 weeks. However, the long-term risks of major adverse cardiovascular events (MACE) following ETS remain unclear. METHODS We searched the Longitudinal National Health Insurance Database in Taiwan and identified PH patients (International Classification of Disease, Ninth Revision, Clinical Modification diagnostic code 708.8) from the outpatient database and patients who underwent ETS (procedure code 05.29) from the inpatient database between 2000 and 2010; furthermore, we excluded patients younger than 18 years of age or older than 65 years of age. We defined MACE as stroke (diagnostic codes 430-437), myocardial infarction (diagnostic code 410), or death. Patients followed until the first cardiac event or December 31, 2010. Risk factors were identified using a multivariable Cox proportional hazards regression. RESULTS The incidence of MACE was significantly lower in patients with ETS (0.76%) than without (1.67%). In PH patients, ETS significantly reduced the risk of MACE (adjusted hazard ratio 0.473; 95% confidence interval 0.277-0.808). CONCLUSION PH patients who underwent ETS showed a reduced risk of MACE over a long-term follow-up period. This result could provide support for patients with PH who are considering undergoing ETS because of its additional cardiovascular benefits.
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Affiliation(s)
- Chun-An Cheng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Biomedical Informatics, Taipei Medical University, No. 250, Wu-Hsing Street, 110, Taipei, Taiwan
| | - Chun-Gu Cheng
- Department of Emergency, Armed Taoyuan General Hospital, Taoyuan, Taiwan.,Department of Emergency and Critical Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hsin Chu
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Aerospace and Undersea Medicine, National Defense Medical Center, Taipei, Taiwan.,Aviation Physiology Research Laboratory, Gangshan Branch of Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Hung-Che Lin
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan, ROC.,School of Public Health, National Defense Medical Center, Taipei, Taiwan
| | - Hung-Wen Chiu
- Graduate Institute of Biomedical Informatics, Taipei Medical University, No. 250, Wu-Hsing Street, 110, Taipei, Taiwan.
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, 7115R, No.325, Section 2, Cheng-Kung Road, Neihu District, Taipei City, 11490, Taiwan, ROC. .,School of Public Health, National Defense Medical Center, Taipei, Taiwan.
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18
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Huang CH, Cheng CG, Su RY. Total knee replacement with minimally constrained prostheses in spontaneous bony ankylosis. Int Orthop 1996; 20:100-2. [PMID: 8739702 DOI: 10.1007/s002640050039] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Total knee replacement has been carried out in the 4 knees of 2 patients for spontaneous bony ankylosis. Minimally constrained prostheses were used because the ligaments were usually intact and the patellofemoral and tibiofemoral joint lines could be re-established. The approach and repair was by a V-Y quadricepsplasty. Satisfactory results were obtained.
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Affiliation(s)
- C H Huang
- Department of Orthopaedic Surgery, Mackay Memorial Hospital, Taipei, Taiwan, Republic of China
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