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Lee YC, Yeh HT, Lu SW, Tsai YC, Tsai YC, Yen CC. Diagnostic accuracy of procalcitonin in adult non-neutropenic cancer patients with suspected infection: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:278. [PMID: 38438974 PMCID: PMC10910706 DOI: 10.1186/s12879-024-09174-7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/25/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Procalcitonin (PCT) has garnered attention as a potential diagnostic biomarker for infection in cancer patients. We performed a systematic review and meta-analysis to evaluate the diagnostic accuracy of procalcitonin (PCT) and to compare it with C-reactive protein (CRP) in adult non-neutropenic cancer patients with suspected infection. METHODS A systematic literature search was performed in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials to identify all relevant diagnostic accuracy studies. Original articles reporting the diagnostic accuracy of PCT for infection detection in adult patients with solid or hematological malignancies were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, area under the hierarchical summary receiver operator characteristic (HSROC) curve, and corresponding 95% confidence interval (CI) were calculated. RESULTS Seven studies were included in the meta-analysis. The pooled sensitivity and specificity of PCT were 60% (95% CI [45-74%]) and 78% (95% CI [69-86%]). The diagnostic odds ratio was estimated at 5.47 (95% CI [2.86-10.46]). Three studies compared the diagnostic accuracies of PCT and CRP. The pooled sensitivity and specificity values for PCT were 57% (95% CI [26-83%]) and 75% (95% CI [68-82%]), and those for CRP were 67% (95% CI [35-88%]) and 73% (95% CI [69-77%]). The pooled sensitivity and specificity of PCT and CRP did not differ significantly (p = 0.61 and p = 0.63). The diagnostic accuracy of PCT was similar to that of CRP as measured by the area under the HSROC curve (0.73, CI = 0.61-0.91 vs. 0.74, CI = 0.61-0.95, p = 0.93). CONCLUSION While elevated PCT levels can be indicative of potential infection, they should not be solely relied upon to exclude infection. We recommend not using the PCT test in isolation; Instead, it should be carefully interpreted in the context of clinical findings.
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Affiliation(s)
- Yi-Chih Lee
- Department of Emergency Medicine, Linkou Branch, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
| | - Hsin-Tzu Yeh
- Department of Emergency Medicine, Linkou Branch, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
| | - Sz-Wei Lu
- Department of Emergency Medicine, Tri-Service General Hospital SongShan Branch, National Defense Medical Center, Taipei, Taiwan
| | - Yi-Chun Tsai
- Department of Medicine, Critical Care, Queen Mary University of London, London, UK
| | - Yu-Chen Tsai
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Chieh-Ching Yen
- Department of Emergency Medicine, Linkou Branch, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan.
- Department of Emergency Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City, Taiwan.
- Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Tsai TY, Yeh HT, Liu YC, Lee CH, Chen KF, Chou E, Sun JT, Chen KC, Lee YK, Chau SW. Trends of Regional Anesthesia Studies in Emergency Medicine: An Observational Study of Published Articles. West J Emerg Med 2022; 23:878-885. [DOI: 10.5811/westjem.2022.8.57552] [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: 05/29/2022] [Accepted: 08/27/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction: Regional anesthesia (RA) has become a prominent component of multimodal pain management in emergency medicine (EM), and its use has increased rapidly in recent decades. Nevertheless, there is a paucity of data on how RA practice has evolved in the specialty. In this study we sought to investigate how RA has been implemented in EM by analyzing trends of published articles and to describe the characteristics of the published research.
Methods: We retrieved RA-related publications from the SciVerse Scopus database from inception to January 13, 2022, focusing on studies associated with the use of RA in EM. The primary outcome was an analysis of trend based on the number of annual publications. Other outcomes included reports of technique diversity by year, trends in the use of individual techniques, and characteristics of published articles. We used linear regression analysis to analyze trends.
Results: In total, 133 eligible publications were included. We found that overall 23 techniques have been described and results published in the EM literature. Articles related to RA increased from one article in 1982 to 18 in 2021, and the rate of publication has increased more rapidly since 2016. Reports of lower extremity blocks (60.90%) were published most frequently in ranked-first aggregated citations. The use of thoracic nerve blocks, such as the erector spinae plane block, has increased exponentially in the past three years. The United States (41.35%) has published the most RA-related articles. Regional anesthesia administered by emergency physicians (52.63%) comprised the leading field in published articles related to RA. Most publications discussed single-shot (88.72%) and ultrasound-guided methods (55.64%).
Conclusion: This study highlights that the number of published articles related to regional anesthesia in EM has increased. Although RA research has primarily focused on lower extremity blocks, clinical researchers continue to broaden the field of study to encompass a wide spectrum of techniques and indications.
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Affiliation(s)
- Tou-Yuan Tsai
- Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Department of Emergency Medicine, Chiayi, Taiwan; Tzu Chi University, School of Medicine, Hualien, Taiwan
| | - Hsin-Tzu Yeh
- Chang Gung Memorial Hospital, Linkou Branch, Department of Emergency Medicine, Taoyuan, Taiwan
| | - Yu-Chang Liu
- Chi Mei Medical Center, Department of Emergency Medicine, Tainan, Taiwan
| | - Ching-Hsing Lee
- Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Department of Emergency Medicine, Keelung, Taiwan
| | - Kuan-Fu Chen
- Chang Gung University, Clinical Informatics and Medical Statistics Research Center, Taoyuan, Taiwan; Chang Gung Memorial Hospital, Community Medicine Research Center, Keelung, Taiwan; Chang Gung Memorial Hospital, Department of Emergency Medicine, Keelung, Taiwan
| | - Eric Chou
- Baylor Scott & White All Saints Medical Center, Department of Emergency Medicine, Fort Worth, Texas; Baylor University Medical Center, Department of Emergency Medicine, Dallas, Texas
| | - Jen-Tang Sun
- Tzu Chi University, School of Medicine, Hualien, Taiwan; Far Eastern Memorial Hospital, Department of Emergency Medicine, New Taipei City, Taiwan
| | - Kuo-Chih Chen
- Taipei Medical University, Shuang Ho Hospital, Department of Emergency Medicine, New Taipei City, Taiwan
| | - Yi-Kung Lee
- Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Department of Emergency Medicine, Chiayi, Taiwan; Tzu Chi University, School of Medicine, Hualien, Taiwan
| | - Su Weng Chau
- Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Department of Emergency Medicine, Chiayi, Taiwan; Tzu Chi University, School of Medicine, Hualien, Taiwan
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Yeh HT, Chen HY, Liu SW, Weng TI, Fang CC, Yu JH, Chen YC, Su YJ, Gao SY, Lin CC. Clinical Presentations and Predictors of In-Hospital Mortality in Illicit Drug Users in the New Psychoactive Substances (NPS) Endemic Era in Taiwan. Toxics 2022; 10:toxics10070386. [PMID: 35878292 PMCID: PMC9317329 DOI: 10.3390/toxics10070386] [Citation(s) in RCA: 1] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 02/04/2023]
Abstract
Predictors of mortality in illicit drug users involving Novel Psychoactive Substances (NPS) and multiple substances have not been elucidated. We aimed to define predictors of mortality in the NPS endemic era’s illicit drug users to strengthen patient care in emergency treatment. This was a retrospective study. LC-MS/MS-confirmed positive illicit drug users who visited the emergency departments (ED) of six medical systems were enrolled. Demographic information, physical examinations, and laboratory data were abstracted for mortality analysis. There were 16 fatalities in 355 enrolled patients. The most frequently used illicit drugs were amphetamines, followed by opioids, cathinones, and ketamine. The most frequently detected cathinones among the 16 synthetic cathinones were eutylone, followed by mephedrone. The combined use of cathinones and ketamine was most commonly observed in our results. Univariate analysis revealed that the mortality patients were older, with deep coma, faster heart rate and respiratory rate, lower blood pressures and O2 room air saturation, more seizures, abnormal breath sounds, and had urine incontinence compared to the survivor patients. The mortality patients also had acute kidney injury, higher potassium, blood sugar, liver function test, and lactate level. The results of multiple logistic regression demonstrated that SBP < 90 mmHg, dyspnea, blood sugar > 140 mg/dl, and HCO3 < 20.6 mmHg were independent predictors of in-hospital mortality. Regardless of the pattern of the use of illicit drugs, the predictors allow for risk stratification and determining the optimal treatment.
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Affiliation(s)
- Hsin-Tzu Yeh
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (H.-T.Y.); (H.-Y.C.); (S.-Y.G.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Hsien-Yi Chen
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (H.-T.Y.); (H.-Y.C.); (S.-Y.G.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Sung-Wei Liu
- Department of Emergency, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien 970, Taiwan;
- Institute of Medical Sciences, Tzu Chi University, Hualien 970, Taiwan
| | - Te-I Weng
- Department of Emergency Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan; (T.-I.W.); (C.-C.F.)
- Forensic and Clinical Toxicology Center, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan
- Institute of Forensic Medicine, College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Cheng-Chung Fang
- Department of Emergency Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan; (T.-I.W.); (C.-C.F.)
- Forensic and Clinical Toxicology Center, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei 100, Taiwan
| | - Jiun-Hao Yu
- Department of Emergency Medicine, China Medical University Hospital, Hsinchu 300, Taiwan;
| | - Yen-Chia Chen
- Emergency Department, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Department of Emergency Medicine, School of Medicine, National Yang-Ming Chiao Tung University, Taipei 11217, Taiwan
- Department of Emergency Medicine, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
| | - Yu-Jang Su
- Emergency Department, Mackay Memorial Hospital, Taipei 104, Taiwan;
- Poison Center, Mackay Memorial Hospital, Taipei 104, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City 251, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, New Taipei City 251, Taiwan
| | - Shi-Ying Gao
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (H.-T.Y.); (H.-Y.C.); (S.-Y.G.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
| | - Chih-Chuan Lin
- Department of Emergency Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan; (H.-T.Y.); (H.-Y.C.); (S.-Y.G.)
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence:
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Yeh HT, Liau SK, Niu KY, Hsiao CH, Yeh CC, Lu JX, Ng CJ, Yen CC. Clinical Characteristics and In-Hospital Outcomes in Dialysis Patients with Septic Arthritis. Medicina (Kaunas) 2022; 58:medicina58030401. [PMID: 35334577 PMCID: PMC8953317 DOI: 10.3390/medicina58030401] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 01/17/2022] [Revised: 03/04/2022] [Accepted: 03/06/2022] [Indexed: 11/17/2022]
Abstract
Background and Objectives: Septic arthritis is a medical emergency associated with high morbidity and mortality. The incidence rate of septic arthritis among dialysis patients is higher than the general population, and dialysis patients with bacteremia frequently experience adverse outcomes. The aim of this study was to identify the clinical features and risk factors for longer hospital length of stay (LOS), positive blood culture, and in-hospital mortality in dialysis patients with septic arthritis. Materials and Methods: The medical records of 52 septic arthritis dialysis patients admitted to our hospital from 1 January 2009 to 31 December 2020 were analyzed. The primary outcomes were bacteremia and in-hospital mortality. Variables were compared, and risk factors were evaluated using linear and logistic regression models. Results: Twelve (23.1%) patients had positive blood cultures. A tunneled cuffed catheter for dialysis access was used in eight (15.4%) patients, and its usage rate was significantly higher in patients with positive blood culture than in those with negative blood culture (41.7 vs. 7.5%, p = 0.011). Fever was present in 15 (28.8%) patients, and was significantly more frequent in patients with positive blood culture (58.3 vs. 20%, p = 0.025). The most frequently involved site was the hip (n = 21, 40.4%). The most common causative pathogen was Gram-positive cocci, with MRSA (n = 7, 58.3%) being dominant. The mean LOS was 29.9 ± 25.1 days. The tunneled cuffed catheter was a significant predictor of longer LOS (Coef = 0.49; Cl 0.25−0.74; p < 0.001). The predictors of positive blood culture were fever (OR = 4.91; Cl 1.10−21.83; p = 0.037) and tunneled cuffed catheter (OR = 7.60; Cl 1.31−44.02; p = 0.024). The predictor of mortality was tunneled cuffed catheter (OR = 14.33; Cl 1.12−183.18; p = 0.041). Conclusions: In the dialysis population, patients with tunneled cuffed catheter for dialysis access had a significantly longer hospital LOS. Tunneled cuffed catheter and fever were independent predictors of positive blood culture, and tunneled cuffed catheter was the predictor of in-hospital mortality. The recognition of the associated factors allows for risk stratification and determination of the optimal treatment plan in dialysis patients with septic arthritis.
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Affiliation(s)
- Hsin-Tzu Yeh
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (H.-T.Y.); (J.-X.L.); (C.-J.N.)
| | - Shuh-Kuan Liau
- Department of Nephrology, Kidney Research Center, Chang Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang Gung University, Taoyuan 33305, Taiwan;
| | - Kuang-Yu Niu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung Branch, Keelung 20401, Taiwan; (K.-Y.N.); (C.-C.Y.)
| | - Chien-Han Hsiao
- Department of Linguistics, Indiana University, Bloomington, IN 47405, USA;
| | - Chung-Cheng Yeh
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Keelung Branch, Keelung 20401, Taiwan; (K.-Y.N.); (C.-C.Y.)
| | - Jian-Xun Lu
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (H.-T.Y.); (J.-X.L.); (C.-J.N.)
| | - Chip-Jin Ng
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (H.-T.Y.); (J.-X.L.); (C.-J.N.)
| | - Chieh-Ching Yen
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 33305, Taiwan; (H.-T.Y.); (J.-X.L.); (C.-J.N.)
- Institute of Emergency and Critical Care Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
- Correspondence: ; Tel.: +886-033281200
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Yeh HT, Lee CH. Hyperbaric oxygen therapy research: an analysis of the 100 most-cited publications from 2011 to 2020. Undersea Hyperb Med 2022; 49:519-532. [PMID: 36446297 DOI: 10.22462/07.08.2022.11] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Hyperbaric oxygen (HBO2) is used in several clinical and research fields. This study aimed to analyze the 100 most-cited hyperbaric-related publications of the past 10 years to understand the trends in HBO2 research. METHODS This was a literature review. All publication and citation data were retrieved from the Scopus database. Publications with "hyperbaric oxygen," "hyperbaric oxygenation," "HBO," and "HBOT" in the title, abstract, or keywords published between January 01, 2011, and December 31, 2020, were enrolled. The 100 most-cited HBO2-focused publications were identified, and their publication title, authors' nationality, publication journal, year, type (original or review), and application field were recorded and analyzed using descriptive statistics. Linear regression was used to evaluate the trends in publication numbers. RESULTS A total of 6,517 publications were enrolled. The annual rate of increase was 4.56 per year (p-value = 0.13, 95% CI: -1.62 to 10.74). The total, average, median and mode of citations were 67,726, 10.4, 4, and 0, respectively. The 100 most-cited HBO2-focused publications accounted for 1.5% (100/6,517) of all publications and 8.1% (5509/67,726) of the total number of times cited. The most-cited publications originated from 17 countries and were published in 65 journals, led by the Cochrane Database of Systematic Reviews. CONCLUSIONS The annual number of HBO2 publications was stationary. The citation numbers showed a skewed distribution. The United States was the leading country in HBO2 research. Of 26 application fields, traumatic brain injury, stroke, and diabetic foot were the leading three fields.
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Affiliation(s)
- Hsin-Tzu Yeh
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Linkou, Taiwan
| | - Ching-Hsing Lee
- Department of Emergency Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Keelung, Taiwan
- Hyperbaric Oxygen Center, Chang Gung Memorial Hospital, Keelung, Taiwan
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Chen CJ, Yeoh SC, Yeh HT, Hsiao SM, Kuo HC. Surgical results in women with detrusor underactivity and stress urinary incontinence undergoing suburethral sling procedure-Predictive factors for successful outcome. Low Urin Tract Symptoms 2019; 12:143-149. [PMID: 31691485 DOI: 10.1111/luts.12293] [Citation(s) in RCA: 3] [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] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/23/2019] [Accepted: 10/03/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To elucidate the treatment results and predictors for successful outcome in women with detrusor underactivity (DU) and stress urinary incontinence (SUI) undergoing suburethral sling procedure. METHODS Medical records of women with coexistent SUI and DU treated with a suburethral sling were retrospectively reviewed and we analyzed the association between treatment outcome and baseline demographics including etiology of DU and urodynamic variables. Patients who were dry and could urinate spontaneously were considered successful. Treatment failure was considered in those who were dry but needing clean intermittent catheterization (CIC) and patients who were still wet. Urogenital Distress Inventory (UDI-6) and Incontinence Impact Questionnaire (IIQ-7) scores were used to assess the impact of surgery on the quality of life. RESULTS Among 71 patients, a successful outcome was noted in 39 (55%), failed outcome with CIC in 15 (21%), and totally treatment failure in 17 (24%). Treatment outcome did not differ among the etiology subgroups. Overall, UDI-6 and IIQ-7 scores significantly improved after surgery. Multivariable logistic regression analysis revealed that the IIQ-7 and maximum flow rate (Qmax) were two independent predictors for improvement after surgery. An IIQ-7 score ≤6, and Qmax ≥6 mL/s can predict improvement by receiver operating characteristic analysis. Qmax ≤6 mL/s can predict needing CIC after surgery. CONCLUSIONS For women with SUI and coexistent DU who underwent suburethral sling procedure, low IIQ-7 (≤6) scores and higher Qmax (≥6 mL/s) are predictors for improvement of surgical outcome. A Qmax of <6 mL/s was the only predictor for CIC after surgery.
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Affiliation(s)
| | | | - Hsin-Tzu Yeh
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Sheng-Mou Hsiao
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Hann-Chorng Kuo
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
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Abstract
BACKGROUND Studies suggest that both oxidized low and high density lipoprotein (LDL and HDL) play a role in the pathogenesis of atherosclerosis. Gemfibrozil is widely used and is reported to increase cholesterol of LDL and HDL in hypertriglyceridemic patients. The aim of this study was to investigate the effect of gemfibrozil treatment on the oxidative status of lipoprotein particles in Fredrickson phenotype IV hypertriglyceridemic patients. METHODS Twenty-two patients, aged 38-64 years, with fasting plasma triglyceride concentrations between 2.90 and 8.97 mmol L(-1), were recruited and were given gemfibrozil 300 mg three times daily for 12 weeks. Venous blood samples were collected before gemfibrozil treatment, after 4, 8, or 12 weeks of treatment, and 4 weeks after termination of treatment, and used to analyse the plasma lipid profile, isolate lipoproteins, and analyse the chemical composition and in vitro oxidation of lipoprotein particles. RESULTS Gemfibrozil treatment resulted in a decrease in plasma total triglyceride levels and the triglyceride content of all lipoproteins. Plasma total cholesterol levels were decreased as a result of a decrease in very low density lipoprotein (VLDL) cholesterol levels. A slight increase in LDL cholesterol levels was observed, whereas the thiobarbituric acid-reactive substances (TBARS) of LDL were decreased and the lag and peak time of LDL to oxidation were unchanged and maximal diene production was decreased. Plasma HDL cholesterol levels, the surface-to-core ratio of HDL particles, and the resistance of HDL to oxidation were increased. CONCLUSION The decreased TBARS and diene production of LDL, increased HDL cholesterol levels, and increased resistance of HDL to oxidation may, in part, explain why gemfibrozil treatment was found to be generally beneficial in terms of protection against coronary heart disease.
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Affiliation(s)
- M F Chen
- Department of Internal Medicine (Cardiology), National Taiwan University Medical Center, Taipei, Taiwan
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Hsu HC, Lee YT, Yeh HT, Chen MF. Effect of gemfibrozil on the composition and oxidation properties of very-low-density lipoprotein and high-density lipoprotein in patients with hypertriglyceridemia. J Lab Clin Med 2001; 137:414-21. [PMID: 11385362 DOI: 10.1067/mlc.2001.114991] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Recent studies suggest that both oxidized very-low-density lipoprotein (VLDL) and oxidized high-density lipoprotein (HDL) may play a role in the pathogenesis of atherosclerosis. Gemfibrozil is widely used and is reported to decrease VLDL levels and increase HDL levels. The aim of this study was to investigate the effect of gemfibrozil on the chemical composition and oxidative susceptibility of VLDL and HDL and their relationship with atherosclerosis. Twenty patients with hypertriglyceridemia were treated with 300 mg gemfibrozil, 3 times daily, for 12 weeks. Venous blood samples were collected before treatment, at the end of treatment, and 4 weeks after the end of treatment. Gemfibrozil effectively lowered concentrations of plasma lipid, apolipoprotein (apo) B, and apo E. The lipid and protein content of VLDL were also decreased, but not by the same extent. The surface-to-core ratio and apo E/apo B ratio of VLDL particles were increased after gemfibrozil treatment. HDL(2) cholesteryl ester and HDL(3) apo A-II content were also increased. Gemfibrozil treatment lowered levels of lipid peroxides in both VLDL and HDL particles. The susceptibility of VLDL to oxidation was unchanged, whereas maximal peroxide production was decreased. The oxidative susceptibility of both HDL(2) and HDL(3) decreased with gemfibrozil treatment. These results indicate that after gemfibrozil treatment, VLDL and HDL particles in patients with hypertriglyceridemia are less atherogenic, which may explain why gemfibrozil treatment is beneficial in terms of coronary heart disease in hypertriglyceridemia.
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Affiliation(s)
- H C Hsu
- Department of Internal Medicine (Cardiology), National Taiwan University Medical Center
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Chen JH, Yeh HT. The seventh copy of IS1 in Escherichia coli W3110 belongs to the IS1 A (IS1E) type which is the only IS1 type that transposes from chromosome to plasmids. Proc Natl Sci Counc Repub China B 1997; 21:100-5. [PMID: 9309873] [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] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In the Escherichia coli K-12 chromosome, six copies of IS1 (IS1A - IS1F) have been identified and characterized. According to their nucleotide (nt) sequences, the six IS1 copies can be classified into four types, IS1A(IS1E), IS1B(IS1C), IS1D and IS1F type. Zuber and Schumann (1993) identified the seventh IS1 copy at 49.6 minutes on the E. coli W3110 genetic map. Unfortunately, only the end 21-bp sequence as well as the neighboring 120-bp E. coli sequence were reported. We therefore designed two oligonucleotide primers to specifically amplify the seventh IS1 copy by PCR. One primer is homologous to the first sixteen bases of the IRL sequence of IS1A(IS1E), IS1B(IS1C) and IS1D. The other primer is complementary to the eighteen bases of E. coli sequence adjacent to IRR of the seventh IS1 copy. An 800-bp PCR fragment was obtained and its nt sequence determined, revealing an identical nucleotide sequence to that of IS1A(IS1E). A plasmid system was then used to isolate insertion mutations caused by insertions of the chromosomal insertion sequences. Of the 142 plasmid insertion mutants isolated, thirty-eight were insertions of chromosomal IS5, ten were IS30, and ninety-four were IS1. Detailed restriction mapping indicates that all ninety-four plasmid IS1 insertions were insertions of IS1 of the IS1A(IS1E) type.
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Affiliation(s)
- J H Chen
- Institute of Molecular Biology, National Chung Hsing University Taichung, Taiwan, R.O.C
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Ko YC, Hsu CS, Yeh HT, Chen CH. [A survey on the prevalence of reading disabled children in southern Taiwan]. Gaoxiong Yi Xue Ke Xue Za Zhi 1985; 1:515-20. [PMID: 3871052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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