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Huang KW, Yin CH, Chang R, Chen JS, Chen YS. Price for waiting: the adverse outcomes of boarding critically ill elderly medical patients in the emergency department. Postgrad Med J 2024; 100:391-398. [PMID: 38308652 DOI: 10.1093/postmj/qgae006] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2024] [Revised: 12/12/2024] [Accepted: 12/28/2024] [Indexed: 02/05/2024]
Abstract
PURPOSE Boarding, the period in which a patient spends in the emergency department (ED) before admission, may be hazardous to critically ill patients, particularly the elderly. This study investigated the associations of boarding with hospital course, prognosis, and medical expenditure in older patients. METHODS From January 2019 to December 2021, the medical records of older patients (age ≥ 65) visiting the ED of a tertiary referral hospital who were admitted to the medical intensive care unit (ICU) were retrospectively reviewed. Eligible patients were categorized into two groups according to boarding time with a cutoff set at 6 h. Primary outcomes were in-hospital mortality, ICU/hospital length of stay, and total/average hospitalization cost. Subgroup analyses considered age and disease type. RESULTS Among 1318 ICU admissions from the ED, 36% were subjected to boarding for over 6 h. Prolonged boarding had a longer ICU (8.9 ± 8.8 vs. 11.2 ± 12.2 days, P < .001) and hospital (17.8 ± 20.1 vs. 22.8 ± 23.0 days, P < .001) stay, higher treatment cost (10.4 ± 13.9 vs. 13.2 ± 16.5 thousands of USD, P = .001), and hospital mortality (19% vs. 25% P = .020). Multivariate regression analysis showed a longer ICU stay in patients aged 65-79 (8.3 ± 8.4 vs. 11.8 ± 14.2 days, P < .001) and cardiology patients (6.9 ± 8.4 vs. 8.8 ± 9.7 days, P = .001). Besides, the treatment cost was also higher for both groups (10.4 ± 14.6 vs. 13.7 ± 17.7 thousands of USD, P = .004 and 8.4 ± 14.0 vs. 11.7 ± 16.6 thousands of USD, P < .001, respectively). CONCLUSION Extended ED boarding for critically ill medical patients over 65 years old was associated with negative outcomes, including longer ICU/hospital stays, higher treatment costs, and hospital mortality.
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Affiliation(s)
- Kuang-Wen Huang
- Department of Emergency Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung City 802301, Taiwan
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City 813414, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung City 813414, Taiwan
- Department of Health Care Management, National Sun Yat-sen University, Kaohsiung City 804201, Taiwan
- Department of Nursing, Meiho University, Pingtung County 912009, Taiwan
| | - Renin Chang
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City 813414, Taiwan
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung City 813414, Taiwan
- Department of Recreation and Sports Management, Tajen University, Pingtung County 907101, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung City 813414, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung City 813414, Taiwan
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Chen SC, Wu TT, Yin CH, Chen JS, Chen YS. Widespread Adoption of Microincision Vitrectomy Surgery Improves Visual Outcomes in Endogenous Endophthalmitis with Poor Initial Vision: A 21-Year Experience in Taiwan. Ocul Immunol Inflamm 2024:1-6. [PMID: 38691837 DOI: 10.1080/09273948.2024.2338272] [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: 11/13/2023] [Accepted: 03/28/2024] [Indexed: 05/03/2024]
Abstract
PURPOSE To review the presentation and visual prognostic factors of patients with endogenous endophthalmitis before and after the introduction of microincision vitrectomy surgery (MIVS), at a tertiary referral hospital in Taiwan, over a 21-year period. METHODS We retrospectively analyzed medical records of patients diagnosed with endogenous endophthalmitis before and after the introduction of MIVS between January 2002 and December 2022. RESULTS Data were collected from 147 patients. Diabetes mellitus was the most common comorbidity (59.9%). Liver abscess (32.7%) was the leading source of infection, followed by urinary tract infection (15.0%), and infective endocarditis (5.4%). Klebsiella pneumoniae (50.4%) was the most common pathogen, followed by Staphylococcus aureus (13.5%), and Candida albicans (8.3%). Poor initial visual acuity worse than counting fingers (CF) (p < 0.001) and diabetes mellitus (p = 0.008) were significantly associated with poor visual outcomes. In the treatment of 98 patients with poor initial visual acuity worse than CF, the proportion of vitrectomy surgeries performed increased from 13/56 (23.2%) to 24/42 (57.1%) (p = 0.001) after the introduction of MIVS. Final visual acuity of CF or better increased from 7/56 (12.5%) to 12/42 (28.6%) after the introduction of MIVS (p = 0.046). Vitrectomy was a better prognostic factor for final visual outcome in patients with poor initial visual acuity of worse than CF (p = 0.011) than other factors. CONCLUSION In endogenous endophthalmitis patients presenting with poor initial visual acuity, vitrectomy was a better visual prognostic factor. MIVS has allowed more patients to undergo vitrectomy and improved visual outcomes.
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Affiliation(s)
- Shih-Chou Chen
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Optometry, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Tsung-Tien Wu
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Institute of Health Care Management, National Sun Yat-Sen University, Kaohsiung, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Chung TL, Chen NC, Yin CH, Lee CC, Chen CL. The association of socioeconomic status on kidney transplant access and outcomes: a nationwide cohort study in Taiwan. J Nephrol 2024:10.1007/s40620-024-01928-5. [PMID: 38635122 DOI: 10.1007/s40620-024-01928-5] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 03/08/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Conflicting evidence exists regarding the relationship between socioeconomic status and access to or outcomes after kidney transplantation. This study analyzed the effects of individual and neighborhood socioeconomic status on kidney transplant access and outcomes in Taiwan. METHODS We used a retrospective cohort study design and performed comparisons using the Cox proportional hazards model after adjusting for risk factors. Data were collected from the National Health Insurance Bureau of Taiwan data (2003-2012). RESULTS Patients with high individual and neighborhood socioeconomic status had higher chances of receiving kidney transplants than those with low individual and neighborhood socioeconomic status [adjusted hazard ratio (aHR) = 2.04; 95% CI: (1.81-2.31), p < 0.001]. However, there were no significant differences in post-transplant graft failure or patient mortality in Taiwan between individuals of varying socioeconomic status after five years. When we stratified kidney transplants by domestic and overseas transplantation, there were no significant differences in post-transplant mortality and graft failure, but individuals who received a kidney graft in Taiwan with high individual and neighborhood socioeconomic status experienced lower risks of graft failure (aHR = 0.55; [95% CI 0.33-0.89], p = 0.017). CONCLUSION A relevant disparity exists in accessing kidney transplantation in Taiwan, depending on individual and neighborhood socioeconomic status. However, results post transplantation were not different after five years. Improved access to waitlisting, education, and welfare support may reduce disparities.
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Affiliation(s)
- Tung-Ling Chung
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Nai-Ching Chen
- Departments of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ching-Chih Lee
- Division of Otolaryngology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Chien-Liang Chen
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
- National Yang Ming Chiao Tung University, Hsinchu, Taiwan.
- Faculty of Medicine, National Sun Yat-sen University, No. 70 Lien-hai Road, Kaohsiung, 804201, Taiwan.
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Chen CS, Yu HC, Yin CH, Chen JS, Chen YS, Chen IS. A Retrospective Analysis: Investigating Factors Linked to High Lung-RADS Scores in a Nonsmoking, Non-Family History Population. Diagnostics (Basel) 2024; 14:784. [PMID: 38667430 PMCID: PMC11048957 DOI: 10.3390/diagnostics14080784] [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: 03/03/2024] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Low-dose computed tomography screening for lung cancer is currently targeted at heavy smokers or those with a family history of lung cancer. This study aimed to identify risk factors for lung cancer in individuals who do not meet the current lung cancer screening criteria as stipulated by the Taiwan Health Promotion Agency's low-dose computed tomography (LDCT) screening policy. A cohort analysis was conducted on 12,542 asymptomatic healthy subjects aged 20-80 years old who voluntarily underwent LDCT scans from January 2016 to December 2021. Logistic regression demonstrated that several factors, including age over 55 years, female gender, a body mass index (BMI) less than 23, a previous history of respiratory diseases such as tuberculosis or obstructive respiratory diseases (chronic obstructive pulmonary disease [COPD], asthma), and previous respiratory symptoms such as cough or dyspnea, were associated with high-risk lung radiology scores according to LDCT scans. These findings indicate that risk-based assessments using primary data and questionnaires to identify risk factors other than heavy smoking and a family history of lung cancer may improve the efficiency of lung cancer screening.
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Affiliation(s)
- Chi-Shen Chen
- Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan or (C.-S.C.); (H.-C.Y.)
- Department of Nursing, Mei-ho University, Pingtung 91202, Taiwan
| | - Hsien-Chung Yu
- Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan or (C.-S.C.); (H.-C.Y.)
- Department of Nursing, Mei-ho University, Pingtung 91202, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan;
- Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung 80421, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan; (J.-S.C.); (Y.-S.C.)
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan; (J.-S.C.); (Y.-S.C.)
| | - I-Shu Chen
- Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan or (C.-S.C.); (H.-C.Y.)
- Division of General Surgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
- Department of Physical Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan
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Tsai YC, Yin CH, Chen JS, Chen YS, Huang SC, Chen JK. Early enteral nutrition in patients with out-of-hospital cardiac arrest under target temperature management was associated with a lower 7-day bacteremia rate: A post-hoc analysis of a retrospective cohort study. J Microbiol Immunol Infect 2024; 57:309-319. [PMID: 38199822 DOI: 10.1016/j.jmii.2023.12.007] [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: 04/08/2023] [Revised: 10/26/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION Early enteral nutrition (EN) is a nutritional strategy for reducing the incidence of in-hospital infections. However, the benefits of early EN, under targeted temperature management (TTM) in patients with out-of-hospital cardiac arrest (OHCA), remain unclear. We aimed to evaluate the effect of early EN on the infective complications of OHCA patients who underwent TTM. METHODS We retrospectively searched the clinical databases of two adult emergency tertiary referral hospitals in southern Taiwan and identified patients admitted for OHCA who underwent TTM between 2017 and 2022. The 85 enrolled patients were divided into two groups based on timing: early EN (EN within 48 h of admission) and delayed EN (EN > 48 h after admission). Clinical outcomes of 7-day infective complications between the two groups were analyzed. RESULTS Early EN was provided to 57 (67 %) of 85 patients and delayed EN was provided to the remaining 28 (33 %) patients. No significant differences in baseline patient characteristics were observed between the two groups. In addition, no differences in clinical outcomes were observed, except that the early EN group had a lower 7-day bacteremia rate (5.3 % vs. 26.9 %, p = 0.013). Gram-negative bacteria were the major pathogen among the 7-day infective complications. CONCLUSION In OHCA patients treated with TTM, early EN was associated with a lower 7-day bacteremia rate. Furthermore, the application of early EN in this population was well tolerated without significant adverse events.
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Affiliation(s)
- Yu-Chi Tsai
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan; Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Hao Yin
- Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Chung Huang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan; Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Jui-Kuang Chen
- Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Nursing, Fooyin University, Kaohsiung, Taiwan; National Defense Medical Center, Taipei, Taiwan; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
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Hsu PH, Chang R, Yin CH, Chen YS, Chen JS. Association between blood culture turnaround time and clinical prognosis in emergency department patients with community acquired bloodstream infection: A retrospective study based on electronic medical records. Heliyon 2024; 10:e27957. [PMID: 38532997 PMCID: PMC10963333 DOI: 10.1016/j.heliyon.2024.e27957] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 02/16/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
Importance Previous investigations have found that time to positive blood culture (TTP) is a prognostic factor for clinical outcomes. In fact, what the emergency physician sees from the medical information system is TAT (turnaround time) defined as time required to post a bacterial culture report. We propose a definition of blood culture TAT that more closely aligns with clinical considerations by measuring the time from starting specimen culture to the release of an official blood culture report.We were curious to know whether the duration of TAT is as intricately linked to the prognosis of bacteremia as TTP. Objectives To examine the association between TAT and outcomes of adult patients who present to the ED with community acquired bacteremia. Design Setting, and Participants: This retrospective study utilized electronic medical records from Kaohsiung Veterans General Hospital (KVGH), a 1000-bed tertiary medical center in Taiwan. Patients were adults aged 18 years and older who presented to ED (Emergency department) for initial diagnosis of community acquired bacteremia from January 1, 2016 to March 31, 2021. Data analysis was performed from December 2022 to January 2023.Main outcomes and measures.The primary outcomes included mortality in the ED, all-cause in-hospital mortality, length of hospital stay, and all-cause 30-day mortality in relation to the individual first report of positive blood culture TAT. Results A total of 4011 eligible patients with bacteremia were evaluated, of which 207 patients had a blood culture TAT of ≤48 h. The overall 30-day all-cause mortality rate was 13%. Contrary to expectation, no statistically significant differences were observed in clinical prognosis between the TAT groups (≤48 versus >48 h). Subgroup analyses indicated that the length of TAT did not have a significant effect on clinical prognosis in patients who underwent lactate level assessment. Furthermore, no difference in clinical outcome was noted between TAT groups (≤48 versus >48 h) in terms of Gram-negative bacilli or Gram-positive cocci bacteremia. However, in patients with delayed antibiotic treatment (>3 h), a shorter TAT was significantly associated with a fatal outcome. Conclusion In adults with community-acquired bacteremia, this study did not observe a significant association between blood culture TAT and clinical prognosis, except in cases of delayed antibiotic treatment.
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Affiliation(s)
- Po-Hsiang Hsu
- Department of Emergency, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Renin Chang
- Department of Emergency, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Institute of Health Care Management, National Sun Yat-sen University, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Taiwan
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Taiwan
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Taiwan
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Wu HY, Lin CY, Tzeng YD, Hung CC, Liu SI, Yin CH, Chen JS, Chen YS, Yang JR. Preoperative systemic inflammation response index: Clinicopathologic predictor of pathological complete response in HER2-positive breast cancer patients receiving neoadjuvant systemic therapy. J Chin Med Assoc 2024; 87:226-235. [PMID: 38095571 DOI: 10.1097/jcma.0000000000001034] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Multiple pretreatment systemic inflammatory markers (SIMs) have been reported as predictors of pathological complete response (pCR) after neoadjuvant systemic therapy (NST) in patients with breast cancer (BC). However, the most significant SIM remains to be conclusively identified, and variations among different molecular subtypes remain unknown. The objective of the study was to identify the most significant SIM in patients with human epidermal growth factor receptor 2 (HER2) positive BC, to construct a pCR-predictive nomogram combining it with other clinicopathologic factors, and to evaluate its prognostic value on survival. METHODS We retrospectively reviewed the findings for 240 patients with stage I-III HER2-positive BC who underwent NST and subsequent surgery at Kaohsiung and Taichung Veterans General Hospital from 2011 to 2021. Clinicopathologic factors were analyzed by stepwise logistic regression with backward selection. The data were used to construct a nomogram plot for determining the pCR probability. Kaplan-Meier curves and log-rank test were used to evaluate disease-free survival (DFS) and overall survival (OS). RESULTS Among the pretreatment SIMs, only the systemic inflammation response index (SIRI) was significantly related to pCR, with an optimal cutoff value of 1.27 × 10 9 /L. Stepwise logistic analyses indicated that clinical N stage, HER2 immunohistochemistry score, hormone receptor status, targeted therapy regimen, and SIRI were independent predictors of pCR, with an area under the curve of 0.722. The Hosmer-Lemeshow test and calibration curve revealed that the predictive ability was a good fit to actual observations. A nomogram was constructed based on the logistic model. The external validation of the model also revealed satisfactory discrimination and calibration. Kaplan-Meier analysis showed that patients with SIRI <1.27 had longer DFS and OS. CONCLUSION Pretreatment SIRI <1.27 is predictive of pCR, DFS, and OS in HER2-positive BC. Our nomogram could efficiently predict pCR and facilitate clinical decision-making before neoadjuvant treatment.
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Affiliation(s)
- Hong-Yu Wu
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Chin-Yao Lin
- Department of Surgery, Breast Medical Center, Taichung Tzu Chi Hospital, Taichung, Taiwan, ROC
| | - Yen-Dun Tzeng
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan, ROC
| | - Chih-Chiang Hung
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
- Department of Applied Cosmetology, College of Human Science and Social Innovation, Hungkuang University, Taichung, Taiwan, ROC
| | - Shiuh-Inn Liu
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung, Taiwan, ROC
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Jie-Ru Yang
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
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Hsu CL, Wu PC, Yin CH, Chen CH, Lee KT, Lin CL, Shi HY. Clinical Outcomes and Cost-Effectiveness of Osteoporosis Screening With Dual-Energy X-ray Absorptiometry. Korean J Radiol 2023; 24:1249-1259. [PMID: 38016684 DOI: 10.3348/kjr.2023.0555] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/12/2023] [Accepted: 09/15/2023] [Indexed: 11/30/2023] Open
Abstract
OBJECTIVE This study aimed to evaluate the clinical outcomes and cost-effectiveness of dual-energy X-ray absorptiometry (DXA) for osteoporosis screening. MATERIALS AND METHODS Eligible patients who had and had not undergone DXA screening were identified from among those aged 50 years or older at Kaohsiung Veterans General Hospital, Taiwan. Age, sex, screening year (index year), and Charlson comorbidity index of the DXA and non-DXA groups were matched using inverse probability of treatment weighting (IPTW) for propensity score analysis. For cost-effectiveness analysis, a societal perspective, 1-year cycle length, 20-year time horizon, and discount rate of 2% per year for both effectiveness and costs were adopted in the incremental cost-effectiveness (ICER) model. RESULTS The outcome analysis included 10337 patients (female:male, 63.8%:36.2%) who were screened for osteoporosis in southern Taiwan between January 1, 2012, and December 31, 2021. The DXA group had significantly better outcomes than the non-DXA group in terms of fragility fractures (7.6% vs. 12.5%, P < 0.001) and mortality (0.6% vs. 4.3%, P < 0.001). The DXA screening strategy gained an ICER of US$ -2794 per quality-adjusted life year (QALY) relative to the non-DXA at the willingness-to-pay threshold of US$ 33004 (Taiwan's per capita gross domestic product). The ICER after stratifying by ages of 50-59, 60-69, 70-79, and ≥ 80 years were US$ -17815, US$ -26862, US$ -28981, and US$ -34816 per QALY, respectively. CONCLUSION Using DXA to screen adults aged 50 years or older for osteoporosis resulted in a reduced incidence of fragility fractures, lower mortality rate, and reduced total costs. Screening for osteoporosis is a cost-saving strategy and its effectiveness increases with age. However, caution is needed when generalizing these cost-effectiveness results to all older populations because the study population consisted mainly of women.
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Affiliation(s)
- Chiao-Lin Hsu
- Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Healthcare Administration and Medical Informatics, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pin-Chieh Wu
- Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Institute of Health Care Management, College of Management, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Chung-Hwan Chen
- Department of Orthopaedics and Orthopaedic Research Center, Kaohsiung Medical University Hospital, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Orthopaedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan
| | - King-Teh Lee
- Department of Healthcare Administration and Medical Informatics, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Surgery, Park One International Hospital, Kaohsiung, Taiwan
- Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chih-Lung Lin
- Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Surgery, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Business Management, College of Management, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
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Yang YC, Chen YS, Liao WC, Yin CH, Lin YS, Chen MW, Chen JS. Significant perioperative parameters affecting postoperative complications within 30 days following craniotomy for primary malignant brain tumors. Perioper Med (Lond) 2023; 12:54. [PMID: 37872604 PMCID: PMC10594926 DOI: 10.1186/s13741-023-00343-x] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 10/02/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND The occurrence of postoperative complications within 30 days (PC1M) of a craniotomy for the removal of a primary malignant brain tumor has been associated with a poor prognosis. However, it is still unclear to early predict the occurrence of PC1M. This study aimed to identify the potential perioperative predictors of PC1M from its preoperative, intraoperative, and 24-h postoperative parameters. METHODS Patients who had undergone craniotomy for primary malignant brain tumor (World Health Organization grades III and IV) from January 2011 to December 2020 were enrolled from a databank of Kaohsiung Veterans General Hospital, Taiwan. The patients were classified into PC1M and nonPC1M groups. PC1M was defined according to the classification by Landriel et al. as any deviation from an uneventful 30-day postoperative course. In both groups, data regarding the baseline characteristics and perioperative parameters of the patients, including a new marker-kinetic estimated glomerular filtration rate, were collected. Logistic regression was used to analyze the predictability of the perioperative parameters. RESULTS The PC1M group included 41 of 95 patients. An American Society of Anesthesiologists score of > 2 (aOR, 3.17; 95% confidence interval [CI], 1.19-8.45; p = 0.021), longer anesthesia duration (aOR, 1.16; 95% CI, 0.69-0.88; p < 0.001), 24-h postoperative change in hematocrit by > - 4.8% (aOR, 3.45; 95% CI, 1.22-9.73; p = 0.0019), and 24-h postoperative change in kinetic estimated glomerular filtration rate of < 0 mL/min (aOR, 3.99; 95% CI, 1.52-10.53; p = 0.005) were identified as independent risk factors for PC1M via stepwise logistic regression analysis. When stratified according to the age of ≥ 65 years (OR, 11.55; 95% CI, 1.30-102.79; p = 0.028), the reduction of kinetic estimated glomerular filtration rate was more robustly associated with a higher risk of PC1M. CONCLUSIONS Four parameters were demonstrated to significantly influence the risk of PC1M in patients undergoing primary malignant brain tumor removal. Measuring and verifying these markers, especially kinetic estimated glomerular filtration rate, would help early recognition of PC1M risk in clinical care.
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Affiliation(s)
- Yao-Chung Yang
- Division of Neurosurgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung City, 81362, Taiwan
| | - Wei-Chuan Liao
- Division of Neurosurgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Institute of Health Care Management, National Sun Yat-Sen University, Kaohsiung, Taiwan
| | - Yung-Shang Lin
- Division of Neurosurgery, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Meng-Wei Chen
- Department of Surgery, Kaohsiung Armed Force General Hospital, Kaohsiung, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung City, 81362, Taiwan.
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Chen HG, Chen JS, Chen YS, Yin CH, Chen HC, Chiou YH. Comparison of mycophenolic acid with cyclophosphamide for the treatment of pediatric lupus nephritis: A retrospective study from a tertiary center hospital in Taiwan. J Microbiol Immunol Infect 2023; 56:1105-1113. [PMID: 37586916 DOI: 10.1016/j.jmii.2023.08.003] [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: 11/16/2022] [Revised: 07/23/2023] [Accepted: 08/04/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND This study aimed to compare the efficacy of mycophenolic acid (MPA) and cyclophosphamide (CYC) for treating pediatric lupus nephritis (pLN). METHODS Data on patients with pLN class III, IV, and V, diagnosed by renal biopsy, were collected from the Databank of Kaohsiung Veterans General Hospital between February 2005 and December 2020. The study included 31 pLN patients. Of these, 15 received MPA (MPA group) and 16 received CYC (CYC group). Systemic lupus erythematosus disease activity index score, laboratory findings, complete remission (CR), and partial remission (PR) were assessed at 6, 12, and 24 months. RESULTS In the MPA group, CR occurred in 7/15 (47%) patients at month 6 and in 11/15 (73%) at months 12 and 24. In the CYC group, CR was reached in 5/16 (31%) patients at month 6, in 8/16 (50%) at month 12, and in 9/16 (56%) at month 24. PR was seen in 3/15 (20%) patients in the MPA group and in 3/16 (19%) in the CYC group at month 24. The cumulative probability of CR and PR showed no statistically significant difference between the two groups. However, the estimated glomerular filtration rate (eGFR) improved significantly in the MPA group at months 6, 12 and 24 compared to that in the CYC group (p < 0.05). CONCLUSION The efficacy of MPA is similar to that of CYC for pLN treatment, with MPA providing a significant improvement in eGFR after pLN induction therapy at months 6,12 and 24.
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Affiliation(s)
- Huei-Geng Chen
- Division of Pediatric Allergy Immunology and Rheumatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Pediatrics, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), Tainan, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Institute of Health Care Management, National Sun Yat-sen University, Taiwan
| | - Hsiao-Ching Chen
- Division of Pediatric Allergy Immunology and Rheumatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yee-Hsuan Chiou
- Division of Pediatric Allergy Immunology and Rheumatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung, Taiwan.
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11
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Cui TY, Liu RX, Chen YJ, Yin CH. [Expression of Mas1 receptor in human placenta and its effect on the function of trophoblast cells in pre-eclampsia patients]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:1426-1433. [PMID: 37743304 DOI: 10.3760/cma.j.cn112150-20221008-00972] [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] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Objective: To investigate the expression change of the Mas1 receptor in the placenta of healthy pregnant women during different gestation periods, analyze the expression level of the Mas1 receptor in the placenta of pre-eclampsia (PE) patients, and its biological function in trophoblast cells. Methods: Placental villous tissues were collected from normal pregnant women in early, mid and late pregnancy. Human trophoblast stem cells were isolated and cultured from early pregnancy villous tissues. The expression of the Mas1 receptor was detected by fluorescence immunoassay and real-time fluorescence quantitative PCR. In a case-control study, patients with full-term PE were selected as the case group and healthy women with full-term pregnancy were selected as the control group. Placental villus tissues were collected from both groups. Immunofluorescence chemistry and immunoprotein blotting were used to study the changes in Mas1 receptor expression in PE. Mas1 receptor agonists and blockers induced HTR8/Svneo cells and BeWo cells, and the effects of the Mas1 receptor on the proliferation and migration of trophoblast cells were detected by the CCK8 proliferation test and scratch test. Results: Eight cases were included in early pregnancy, seven cases in mid-pregnancy and six cases in late pregnancy. Mas1 receptors in normal placental villi tissue were mainly expressed in human trophoblast stem cell membranes and cytoplasm, and the expression of Mas1 receptor mRNA in villi tissue was significantly higher in late pregnancy than in mid-pregnancy. There were 24 cases included in the case group and 12 cases in the control group. Mas1 receptor expression in placental villi was significantly lower in the case group compared to the control group; Activation/inhibition of the Mas1 receptor had no significant effect on the proliferation of HTR8/Svneo cells and BeWo cells. Activated Mas1 receptor had no significant effect on the migration ability of HTR8/Svneo cells. Conclusion: Mas1 receptors are expressed in placental villous tissue and their expression varies with gestation. Mas1 receptor expression is reduced in PE patients, but it does not affect the value-added or migratory function of trophoblast cells.
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Affiliation(s)
- T Y Cui
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - R X Liu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Y J Chen
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - C H Yin
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
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12
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Fang NW, Huang YS, Yin CH, Chen JS, Chiou YH. Maternal risk factors in offspring with congenital anomalies of the kidney and urinary tract in Asian women. Pediatr Nephrol 2023; 38:3065-3070. [PMID: 37052690 DOI: 10.1007/s00467-023-05954-6] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/16/2023] [Accepted: 03/16/2023] [Indexed: 04/14/2023]
Abstract
BACKGROUND Congenital anomalies of the kidney and urinary tract (CAKUT) are the primary cause of pediatric chronic kidney disease. Maternal body mass index (BMI) before pregnancy, pregestational diabetic mellitus (DM), and gestational diabetic mellitus (GDM) are potential modifiable risk factors for CAKUT in offspring. METHODS In this case control study, 4619 neonates were enrolled during 2012-2020 from Kaohsiung Veterans General Hospital in Taiwan. Maternal risk factors before and during pregnancy were compared in children with and without CAKUT. The yearly incidence of CAKUT in offspring and maternal overweight were recorded. RESULTS In total, 73 (1.6%) cases of CAKUT in offspring were identified. Maternal overweight before pregnancy (BMI ≥ 24 kg/m2) was an independent risk factor for CAKUT in offspring. No associations of pregestational DM and GDM with CAKUT in offspring were observed. The incidence rates of CAKUT and maternal obesity have increased in the past 10 years. CONCLUSIONS Maternal obesity before pregnancy is associated with CAKUT in offspring and should be addressed to ensure better outcomes. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Nai-Wen Fang
- Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Pediatrics, Pingtung Veterans General Hospital, Pingtung, Taiwan
| | - Yu-Shan Huang
- Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yee-Hsuan Chiou
- Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
- Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung, Taiwan.
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13
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Liu XH, Wang C, Yan RH, Peng XX, Yin CH. [Selection of statistical methods for estimating the association between exposure factors and rare outcomes based on cohort studies]. Zhonghua Liu Xing Bing Xue Za Zhi 2023; 44:1126-1132. [PMID: 37482717 DOI: 10.3760/cma.j.cn112338-20230106-00011] [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] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Odds ratio (OR) and relative risk (RR) are the most commonly used statistical indicators for the estimation of the association between exposure and outcome. In the cohort study with rare outcomes, the estimated OR approximately equals RR, but RR seems more interpretable. The study aims to explore the difference between OR and RR estimated by different multivariate analyses to provide reference for the selection of more appropriate multivariate regression methods and reporting indicators for estimating the association between exposure and rare outcome in cohort studies. This case study used the data from China birth cohort study. Modes of conception and congenital disabilities were regarded as exposure and outcome, respectively. Maternal age, family history of congenital disabilities with clear evidence were included as covariates. Logistic regression, log-binomial regression, and Poisson regression were used to estimate the OR and RR, respectively. Then, OR, RR, and their 95%CI estimated by three regression models were compared. The OR estimated by logistic regression was approximately equal to the RR estimated by log-binomial regression or Poisson regression. However, the RR estimated by log-binomial regression or Poisson regression was closer to 1.00, with a narrower 95%CI. Log-binomial regression or Poisson regression might have non convergence or over dispersion problems. It is recommended to report the RR obtained by log-binomial regression or Poisson regression in the cohort study with rare outcomes if applicable.
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Affiliation(s)
- X H Liu
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing 100045, China
| | - C Wang
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing 100045, China
| | - R H Yan
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing 100045, China
| | - X X Peng
- Center for Clinical Epidemiology and Evidence-Based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children Health, Beijing 100045, China
| | - C H Yin
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
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14
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Hsieh MY, Chen JS, Yin CH. Investigation of the patients with recurrent acute transfusion reactions: A single tertiary medical centre experience. J Int Med Res 2023; 51:3000605231181733. [PMID: 37421139 DOI: 10.1177/03000605231181733] [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] [Indexed: 07/09/2023] Open
Abstract
OBJECTIVE To assess the spectrum of patients who developed recurrent acute transfusion reactions (TRs) and to characterize these recurrent TRs. METHODS This retrospective study included patients who developed ≥2 acute TRs between April 2017 and March 2020 in a tertiary medical centre. RESULTS Among 216 TRs that occurred after 2024 transfusions in 87 patients, 66 (75.9%) patients reported a history of transfusions before the first TR and 70 (80.5%) patients received further transfusions after the last TR; with the same type of TR and reaction to the same type of blood product observed in 59 (67.8%) patients and 56 (64.4%) patients, respectively. TRs were most commonly associated with packed red blood cell (PRBC) transfusions and a febrile non-haemolytic transfusion reaction (FNHTR) was the most common type of TR. However, leukocyte reduced (LR) PRBCs were less common than LR platelets among transfusions with TR (22.7% [27/119] versus 75.0% [57/76], respectively) and premedication was prescribed before 196 of 216 (90.7%) transfusions with TR. CONCLUSION Most patients with recurrent TRs received repeated transfusions in addition to transfusions with TR. Instead of considering premedication, an increase in the use of LR might be the strategy to reduce the recurrence of TR.
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Affiliation(s)
- Ming-Yun Hsieh
- Department of Paediatrics, Kaohsiung Veterans General Hospital, Kaohsiung
- Department of Biological Sciences, National Sun Yat-sen University, Kaohsiung
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung
- Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung
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15
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Zhang EJ, Su SF, Gao S, Liu RX, Yue WT, Liu JH, Xie SH, Zhang Y, Yin CH. [Association between coagulation function indicators and placental abruption among preeclampsia-eclampsia pregnant women]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:905-911. [PMID: 37357211 DOI: 10.3760/cma.j.cn112150-20221008-00969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objective: To explore the association between coagulation function indicators and placental abruption (PA) in different trimesters of pregnancy among preeclampsia-eclampsia pregnant women. Methods: From February 2018 to December 2020, pregnant women who participated in the China birth cohort study and were diagnosed with preeclampsia, eclampsia and chronic hypertension with superimposed preeclampsia in Beijing Obstetrics and Gynecology Hospital were enrolled in this study. The baseline and follow-up information were collected by questionnaire survey, and the coagulation function indicators in the first and third trimesters were obtained through medical records. The Cox proportional hazards model was used to analyze the association between the coagulation function indicators and PA. A restrictive cubic spline curve was used to draw the dose-response curve between the relevant coagulation function indicators and PA. Results: A total of 1 340 participants were included in this study. The age was (32.50±4.24) and the incidence of PA was 4.4% (59/1 340). After adjusting for relevant factors, Cox proportional hazards model showed that compared with the high-level classification of fibrinogen (FIB), participants within the middle-(HR=3.28, 95%CI: 1.27-8.48) and low-level (HR=3.84, 95%CI: 1.40-10.53) classification during the first trimester and within the low-level classification (HR=4.18, 95%CI: 1.68-10.39) during the third trimester were more likely to experience PA. Compared with the middle-level classification of pro-thrombin time (PT), the risk of PA in the participants within the low-level classification (HR=2.67, 95%CI: 1.48-4.82) was significantly higher in the third trimester. The restrictive cubic spline analysis showed a linear negative association between FIB and PA in the first and third trimesters, while PT and PA showed an approximately L-shaped association. Conclusion: Among pregnant women diagnosed with preeclampsia-eclampsia, the middle-and low-level classification of FIB in the first and third trimesters and the low-level classification of PT in the third trimester could increase the risk of PA.
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Affiliation(s)
- E J Zhang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - S F Su
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - S Gao
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - R X Liu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - W T Yue
- Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - J H Liu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - S H Xie
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Y Zhang
- Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - C H Yin
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
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16
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Gao S, Liu RX, Yue WT, Yin CH. [Progress in researches on cardiovascular health behaviors and factors in perinatal women]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:941-948. [PMID: 37357217 DOI: 10.3760/cma.j.cn112150-20221008-00970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
The cardiovascular health index (CVH) is a composite index consisting of 7 CVH metrics (CVHM) to evaluate the cardiovascular health status in the population. CVH has been proven to be closely related to a variety of health outcomes and widely used in the prevention of many diseases and the evaluation of intervention effectiveness. This review summarizes the recent distribution of CVH and CVHM in pregnant women and the relationship between CVH and CVHM with adverse health outcomes, which aims to explore the application of CVH and CVHM in preventing pregnancy-related diseases and improving the long-term health level of perinatal women and their offspring.
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Affiliation(s)
- S Gao
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - R X Liu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - W T Yue
- Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - C H Yin
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
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17
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Su SF, Gao S, Zhang EJ, Liu RX, Yue WT, Liu JH, Xie SH, Zhang Y, Yin CH. [Analysis of incidence and associated factors of preterm birth based on pre-pregnancy body mass index stratification]. Zhonghua Yu Fang Yi Xue Za Zhi 2023; 57:899-904. [PMID: 37357210 DOI: 10.3760/cma.j.cn112150-20221008-00968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objective: To analyze the incidence of preterm birth based on pre-pregnancy body mass index (BMI) stratification and explore the associated factors of preterm birth among pregnant women at different BMI stratifications. Methods: From February 2018 to December 2020, pregnant women who participated in China Birth Cohort Study (CBCS) and gave birth at Beijing Obstetrics and Gynecology Hospital were enrolled as the study subjects. Electronic Data Capture System and standard structured questionnaires were used to collect data related to pre-pregnancy, pregnancy, and delivery for pregnant women. Pregnant women were divided into the low-weight group, normal-weight group and overweight group based on their pre-pregnancy BMI. A Cox proportional hazards model was used to analyze the associated factors of preterm birth among pregnant women with different BMI before pregnancy. Results: A total of 27 195 singleton pregnant women were included, with a preterm birth rate of 5.08% (1 381/27 195). The preterm birth rates in the low-weight group, normal-weight group and overweight group were 4.29% (138/3 219), 4.63% (852/18 390) and 7.00% (391/5 586) respectively (P<0.001). After adjusting for relevant factors, the Cox proportional hazards model showed that the risk of preterm birth in the overweight group was 1.457 times higher than that in the normal-weight group (95%CI: 1.292-1.643). Preeclampsia-eclampsia (HR=2.701, 95%CI: 1.318-5.537) was the associated factor for preterm birth in the low-weight group. Advanced maternal age (HR=1.232, 95%CI: 1.054-1.441), history of preterm birth (HR=4.647, 95%CI: 3.314-6.515), vaginal bleeding in early pregnancy (HR=1.613, 95%CI: 1.380-1.884), and preeclampsia-eclampsia (HR=3.553, 95%CI: 2.866-4.404) were associated factors for preterm birth in the normal-weight group. Advanced maternal age (HR=1.473, 95%CI: 1.193-1.818), history of preterm birth (HR=3.209, 95%CI: 1.960-5.253), vaginal bleeding in early pregnancy (HR=1.636, 95%CI: 1.301-2.058), preeclampsia-eclampsia (HR=2.873, 95%CI:2.265-3.643), and pre-gestational diabetes mellitus (HR=1.867, 95%CI: 1.283-2.717) were associated factors for preterm birth in the overweight group. Conclusion: Pre-pregnancy overweight is an associated factor for preterm birth, and there are significant differences in the associated factors of preterm birth among pregnant women with different BMI before pregnancy.
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Affiliation(s)
- S F Su
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - S Gao
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - E J Zhang
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - R X Liu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - W T Yue
- Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - J H Liu
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - S H Xie
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - Y Zhang
- Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
| | - C H Yin
- Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China
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Lin YP, Ding RS, Yin CH, Chen YS, Chen JS, Chang ST. Effects of Intravascular Photobiomodulation on Insomnia, Muscle Soreness, and Biochemistry Profiles: An Eight-Year Retrospective Cohort. Medicina (Kaunas) 2023; 59:1006. [PMID: 37374210 PMCID: PMC10305368 DOI: 10.3390/medicina59061006] [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: 03/14/2023] [Revised: 05/03/2023] [Accepted: 05/18/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Although cognitive-behavioral therapy is the first-line treatment for insomnia, pharmacotherapy is often prescribed to treat insomnia and related symptoms. In addition, muscle relaxants are commonly prescribed to alleviate muscle soreness when the pain is unbearable. However, pharmacotherapy can lead to numerous side effects. The non-drug strategy intravascular laser irradiation of blood (iPBM) has been advocated to improve pain, wound healing, blood circulation, and blood cell function to relieve insomnia and muscle soreness symptoms. Therefore, we assessed whether iPBM improves blood parameters and compared drug use before and after iPBM therapy. METHODS Consecutive patients who received iPBM therapy between January 2013 and August 2021 were reviewed. The associations between laboratory data, pharmacotherapies, and iPBM therapy were retrospectively analyzed. We compared patient characteristics, blood parameters, and drug use within the three months before the first treatment and the three months after the last treatment. We also compared the changes before and after treatment in patients who received ≥10 or 1-9 iPBM treatments. RESULT We assessed 183 eligible patients who received iPBM treatment. Of them, 18 patients reported insomnia disturbance, and 128 patients reported pain in any part of their body. After the treatment, HGB and HCT significantly increased after treatment in both the ≥10 and 1-9 iPBM treatment groups (HGB p < 0.001 and p = 0.046; HCT p < 0.001 and p = 0.029, respectively). Pharmacotherapy analysis revealed no significant differences in drug use before and after treatment, though drug use tended to decrease after iPBM. CONCLUSIONS iPBM therapy is an efficient, beneficial, and feasible treatment that increases HGB and HCT. While the results of this study do not support the suggestion that iPBM reduces drug use, further larger studies using symptom scales are needed to confirm the changes in insomnia and muscle soreness after iPBM treatment.
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Affiliation(s)
- Yen-Po Lin
- Department of Medical Education, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Department of Medical Education, National Cheng Kung University Hospital, Tainan 704, Taiwan
| | - Ruei-Sian Ding
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Chun-Hao Yin
- Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung 804, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Shin-Tsu Chang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114, Taiwan
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Lin CY, Huang SC, Tzou SJ, Yin CH, Chen JS, Chen YS, Chang ST. Tendon Disorders in Chronic Liver Disease: A Retrospective Cohort Study in Taiwan. Int J Environ Res Public Health 2023; 20:4983. [PMID: 36981892 PMCID: PMC10049230 DOI: 10.3390/ijerph20064983] [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: 02/02/2023] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 06/18/2023]
Abstract
To investigate the relationship between chronic liver disease and tendon disorder, a retrospective cohort study was conducted using the Kaohsiung Veterans General Hospital database. Patients >18 years with newly diagnosed liver disease and with at least a two-year follow-up in the hospital were included. An equal number of 20,479 cases were enrolled in both the liver-disease and non-liver-disease groups using a propensity score matching method. Disease was defined using ICD-9 or ICD-10 codes. The primary outcome was the development of tendon disorder. Demographic characteristics, comorbidities, use of tendon-toxic drugs, and status of HBV/HCV infection were included for analysis. The results showed 348 (1.7%) and 219 (1.1%) individuals developed tendon disorder in the chronic liver disease group and non-liver-disease group. Concomitant use of glucocorticoids and statins may have further raised the risk of tendon disorder in the liver disease group. The co-existence of HBV/HCV infection did not increase the risk of tendon disorder in the patients with liver disease. Considering these findings, physicians should be more aware of tendon issues in advance, and a prophylactic strategy should be adopted in patients with chronic liver disease.
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Affiliation(s)
- Ching-Yueh Lin
- Department of Physical Medicine and Rehabilitation, Kaohsiung Armed Forces General Hospital, Kaohsiung 802301, Taiwan
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114202, Taiwan
| | - Shih-Chung Huang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung 802301, Taiwan
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan
| | - Shiow-Jyu Tzou
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
- Teaching and Researching Center, Kaohsiung Armed Forces General Hospital, Kaohsiung 802301, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
- Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
| | - Shin-Tsu Chang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114202, Taiwan
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
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20
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Liu CH, Huang SC, Yin CH, Huang WC, Chen JS, Chen YS, Gan ST, Tzou SJ, Hsu CT, Wu HM, Wang WH. Atrial Fibrillation Risk and Urate-Lowering Therapy in Patients with Gout: A Cohort Study Using a Clinical Database. Biomedicines 2022; 11:biomedicines11010059. [PMID: 36672567 PMCID: PMC9855783 DOI: 10.3390/biomedicines11010059] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/19/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022] Open
Abstract
Individuals of Asian descent are at higher risk for developing hyperuricemia and gout as compared to Western populations. Urate-lowering therapy (ULT) is an effective treatment for hyperuricemia and gout. It was reported that febuxostat, one of the ULTs, raises the risk of atrial fibrillation (AF) in elderly populations. Nevertheless, this association has not been properly investigated in Asian populations. We aimed to investigate the development of AF after ULT with different drugs in an Asian population. We conducted a retrospective cohort study using the clinical database at Kaohsiung Veterans General Hospital. Patients newly diagnosed with gout between 1 January 2013 and 31 December 2020 and with a documented baseline serum uric acid (sUA) level but no prior diagnosis of AF were identified. Patients were divided into three groups-allopurinol, benzbromarone, and febuxostat users. During the follow-up period, the risks of incident AF following the initiation of ULT with different drugs were assessed. Development of incident AF was noted in 43 (6%) of the 713 eligible patients during the follow-up period (mean, 49.4 ± 26.6 months). Febuxostat-treated patients had a higher prevalence of certain comorbidities (diabetes mellitus, heart failure, and chronic kidney disease) and higher CHA2DS2-VASc scores. Compared with allopurinol, neither febuxostat nor benzbromarone was associated with increased adjusted hazard ratios (HR) for incident AF (HR: 1.20, 95% confidence interval [CI]: 0.43-3.34; HR: 0.68, 95% CI: 0.22-2.08). There was no difference in the risk of incident AF among Asian patients with gout who received febuxostat, allopurinol, or benzbromarone. Further studies are needed to evaluate long-term cardiovascular outcomes in patients receiving different ULT drugs.
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Affiliation(s)
- Ching-Han Liu
- Division of Cardiology, Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung 80284, Taiwan
- Division of Cardiology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Department of Marine Biotechnology and Resources, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
| | - Shih-Chung Huang
- Division of Cardiology, Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung 80284, Taiwan
- Division of Cardiology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- Institute of Health Care Management, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
| | - Wei-Chun Huang
- Department of Critical Care Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Su-Ting Gan
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Shiow-Jyu Tzou
- Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
| | - Ching-Tsai Hsu
- Division of Cardiology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Cardiology, Department of Internal Medicine, Taoyuan Armed Forces General Hospital, Taoyuan 32551, Taiwan
| | - Hao-Ming Wu
- Division of Cardiology, Department of Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung 80284, Taiwan
| | - Wen-Hwa Wang
- Department of Internal Medicine, Division of Cardiology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- Health Management Center, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- Institute of Management, I-Shou University, Kaohsiung 84001, Taiwan
- Department of Cardiology, Harefield Hospital, Royal Brompton and Harefield NHS Foundation Trust, London UB9 6JH, UK
- Correspondence:
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21
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Chen MY, Ou SH, Chen NC, Yin CH, Chen CL. Aluminum overload in the reverse osmosis dialysis era: does it exist? Ren Fail 2022; 44:1595-1603. [PMID: 36190833 PMCID: PMC9553183 DOI: 10.1080/0886022x.2022.2104165] [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] [Indexed: 11/28/2022] Open
Abstract
Background Aluminum accumulation is a well-described complication in dialysis patients. Improvements in hemodialysis technology have possibly eliminated the occurrence of aluminum overload. Limited evidence suggests that aluminum overload may decline in the era of aluminum removal from dialysis fluids, even with the use of aluminum binders. Methods We examined the data from January 2014 to June 1, 2020, identified through our electronic records, to evaluate the desferrioxamine (DFO) test results for aluminum overload. The presentation and treatment of aluminum overload were recorded. Results Ninety-nine dialysis patients were enrolled for the DFO test. Forty-seven patients (47.5%) were identified as DFO test positive for aluminum overload, of which 14 (14/47) patients had symptoms, including one patient with an unexplained fracture, eight patients with unexplained anemia despite high-dose erythropoiesis-stimulating agents, and five patients with hypercalcemia (serum calcium >11 mg dL-1). None of the patients with aluminum overload developed encephalopathy. Only four of the 47 patients had microcytic anemia. Patients requiring longer treatments (>10 months versus <10 months) had similar basal serum aluminum (p = 0.219) but had an increase in serum aluminum after DFO (p = 0.041). Furthermore, the treatments decreased erythropoietin doses in the aluminum overload group, with serum total alkaline phosphatase levels <60 U L-1 (p = 0.028). Conclusion We concluded that aluminum overload existed in the reverse osmosis dialysis era. In light of non-obvious symptoms, such as anemia and bone turnover change, serum aluminum in dialysis patients should be monitored in countries using aluminum-based phosphate binders, despite reverse osmosis dialysis.
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Affiliation(s)
- Mei-Yin Chen
- Department of Nutrition and Food Service, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Shih-Hsiang Ou
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taiwan
| | - Nai-Ching Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Division of Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chien-Liang Chen
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taiwan.,Division of Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Institutes of Clinical Medicine, National Yang Ming Chiao Tung University, Taiwan.,Institution of Precision Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
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22
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Chu YT, Chen JS, Chen YS, Yang CC, Yin CH, Wang HP, Chiou YH. Effects of early aminophylline therapy on clinical outcomes in premature infants. Pediatr Neonatol 2022; 64:288-296. [PMID: 36564309 DOI: 10.1016/j.pedneo.2022.10.004] [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: 01/26/2022] [Revised: 09/29/2022] [Accepted: 10/19/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Aminophylline use and the association between clinical outcomes and therapy timing have been less investigated. The objective of this study was to determine the efficacy of early aminophylline use (within the first two days of life) in premature infants. METHOD A retrospective observational cohort of infants weighing <1500 g and <30 weeks of gestational age at Kaohsiung Veterans General Hospital received aminophylline either within the first two days of life (EA, early aminophylline group), after the third day of life (LA, late aminophylline group), or without aminophylline during the first month of life (WA, without aminophylline group). Demographic data and neonatal clinical outcomes were compared among the three groups. RESULTS This study included 89 preterm infants (EA = 33, LA = 38, WA = 18). The EA group had a lower incidence of bronchopulmonary dysplasia (BPD) than the WA group (adjusted odds ratio [aOR] = 8.86(1.56-59.32); P = 0.024). Although there was no significant difference in BPD incidence between the EA and LA groups (aOR = 2.66(0.51-13.81), P = 0.244), a trend remained. Birth body weight less than 1000 g was also a significant risk factor for BPD (aOR = 8.86(1.32-47.41), P = 0.014). The duration of mechanical ventilation was shorter in the infants in the EA group compared to the WA group (estimated beta = -11.344(-19.57-3.12); P = 0.008). CONCLUSION Early aminophylline administration may be associated with a decreased incidence of BPD in preterm infants. However, the clinical benefits of aminophylline treatment require further investigation. In addition, a birth body weight of less than 1000 g was a crucial risk factor for BPD.
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Affiliation(s)
- Yi-Ting Chu
- Division of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chih-Chieh Yang
- Division of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Taiwan; Institute of Health Care Management, National Sun Yat-Sen University, Taiwan
| | - Hsiao-Ping Wang
- Division of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yee-Hsuan Chiou
- Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Medical Laboratory Sciences and Biotechnology, Fooyin University, Kaohsiung, Taiwan.
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23
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Li SY, Yin CH, Chen JS, Chen YS, Yang CC, Fang NW, Wang HP, Chiou YH. A nomogram for predicting the development of serious bacterial infections in febrile term neonates: A single medical center experience in Southern Taiwan. Pediatr Neonatol 2022; 63:605-612. [PMID: 36008242 DOI: 10.1016/j.pedneo.2022.07.002] [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: 03/07/2022] [Revised: 07/04/2022] [Accepted: 07/07/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Serious bacterial infections (SBIs) could lead to mortality or severe long-term sequelae in neonates and infants aged <3 months. Accordingly, the aim of this study was to develop a quantitative and accurate assessment tool for predicting the risk of SBIs in febrile neonates. METHODS This retrospective study enrolled 131 febrile term neonates (aged <30 days) who were hospitalized at Kaohsiung Veterans General Hospital between January 2005 and December 2020. These neonates were classified into SBI and nonbacterial infection (NBI) groups on the basis of microbiological laboratory reports. The clinical characteristics and routine blood tests of both groups at the time of admission were analyzed. Stepwise logistic regression was applied to create and validate the nomogram for SBI prediction. RESULTS Among the 131 febrile neonates, 38 and 93 developed SBIs and NBIs, respectively. At the time of admission, ill clinical appearance, serum myelocyte/metamyelocyte presence, C-reactive protein (CRP) > 2.5 mg/dL, and pyuria were associated with an increased risk of SBIs. Accordingly, these four factors were used to develop a nomogram for SBI prediction, which exhibited significantly high performance (area under curve = 0.848, p < 0.001) in predicting SBI risk. CONCLUSION We developed a nomogram combining clinical appearance, serum myelocyte/metamyelocyte presence, CRP, and pyuria for predicting SBI risk in febrile neonates. This tool can assist clinicians in making early diagnoses and delivering the appropriate treatment.
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Affiliation(s)
- Shin-Ying Li
- Division of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Taiwan; Institute of Health Care Management, National Sun Yat-sen University, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Taiwan
| | - Chih-Chieh Yang
- Division of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Nai-Wen Fang
- Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Hsiao-Ping Wang
- Division of Pediatric Neonatology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yee-Hsuan Chiou
- Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Medical Laboratory Science and Biotechnology, Fooyin University, Kaohsiung, Taiwan.
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24
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Ou SH, Yin CH, Chung TL, Chen HY, Chen CL, Chen JS, Lee PT. Intravitreal Vascular Endothelial Growth Factor Inhibitor Use and Renal Function Decline in Patients with Diabetic Retinopathy. Int J Environ Res Public Health 2022; 19:14298. [PMID: 36361175 PMCID: PMC9657653 DOI: 10.3390/ijerph192114298] [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] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/24/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
Adverse renal effects of systemic vascular endothelial growth factor (VEGF) inhibitor treatment are well documented. We aimed to identify associations between intravitreal VEGF inhibitor use and renal function decline in patients with diabetic retinopathy. We included 625 patients with diabetic retinopathy for regular renal function follow-ups and grouped them according to intravitreal therapy (67 with and 558 without treatment). We used a generalized estimating equation model to identify renal function decline risk factors. Increased age (p = 0.02), insulin use (p = 0.01), hypertension (p < 0.01), and ischemic heart disease (p < 0.01) were associated with significantly decreased estimated glomerular filtration rates (eGFRs) in patients with diabetic retinopathy after 1-year follow-up. Compared to the control group, patients who received intravitreal VEGF inhibitor injections showed a declining eGFR trend in the repeated measurement model without statistical significance (p = 0.06). In subgroup analysis, patients with initial eGFR ≤ 30 mL/min/1.73 m2 who received intravitreal VEGF inhibitors had significantly decreased renal function (p < 0.01) compared to those without treatment. Intravitreal VEGF inhibitor injection was associated with renal function deterioration among patients with diabetic retinopathy and advanced chronic kidney disease. Strategies to monitor renal function after treatment should be considered in these high-risk populations.
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Affiliation(s)
- Shih-Hsiang Ou
- Division of Nephrology, Department of Internal Medicine, Pingtung Veterans General Hospital, Pingtung 900, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung 804, Taiwan
| | - Tung-Ling Chung
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Hsin-Yu Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Chien-Liang Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
| | - Jin-Shuen Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Faculty of Medicine, School of Medicine, National Defense Medicine Center, Taipei 114, Taiwan
| | - Po-Tsang Lee
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
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25
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Hung CJ, Kang BH, Chang KM, Kang YY, Yin CH, Lee CC. Chemotherapy dose per kilogram lean body mass increased dose-limiting toxicity event in male head and neck cancer with taxane and platinum-based induction therapy. BMC Cancer 2022; 22:1084. [PMID: 36271346 PMCID: PMC9587609 DOI: 10.1186/s12885-022-10152-y] [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: 03/04/2022] [Accepted: 10/05/2022] [Indexed: 11/10/2022] Open
Abstract
Background This study aimed to determine whether drug doses per kilogram of lean body mass (LBM) were associated with dose-limiting toxicity (DLT) events in head and neck cancer (HNC) patients. Methods This retrospective cohort study included 179 HNC patients who underwent induction chemotherapy (IC) at a medical center from May 1, 2014, to May 31, 2021. HNC patients’ characteristics, tumor factors, IC regimen and dose, laboratory data, and body composition factors, including lean body mass (LBM) and skeletal muscle index (SMI), derived from CT, MRI, or PET scan images and drug dose per kilogram LBM were recorded. Dose-limiting toxicity (DLT) events were regarded as the primary outcome. Multivariate logistic regression was used to establish a novel risk score for DLT events by the abovementioned variables. The above-mentioned risk score was validated in another cohort. Results The overall DLT events during the first cycle of IC for 179 HNC patients was 24%. After stratifying by gender, docetaxel per kilogram LBM > 2.52 mg/kg (adjusted odds ratio [aOR]: 3.18; 95% confidence interval [CI], 1.25–8.09), pre-treatment glutamic pyruvic transaminase (GPT) > 40 U/L (aOR, 2.61; 95% CI, 1.03–6.64), and history of chronic liver diseases (aOR, 3.98; 95% CI, 1.03–15.46) were significant variables in male HNC patients. The DLT events risk was categorized by summation of the above-mentioned risk factors for male HNC patients. Three risk groups were stratified by overall event of 17.6%, 25.8%, and 75%. The above-mentioned risk score had an acceptable discriminatory ability in another validation cohort. Conclusions Among male HNC patients treated with IC, docetaxel per kilogram LBM more than 2.52 mg/kg, pre-treatment GPT > 40 U/L, and history of chronic liver disease were significant risk factors for DLT events. Identifying high-risk patients could help physicians prevent severe/fatal complications among HNC patients undergoing IC, especially for the male individuals. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-022-10152-y.
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Affiliation(s)
- Chuan-Jen Hung
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan (R.O.C.)
| | - Bor-Hwang Kang
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan (R.O.C.).,Department of Pharmacy, Tajen University, Pingtung, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan
| | - Keng-Ming Chang
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan (R.O.C.)
| | - Ying-Ying Kang
- Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ching-Chih Lee
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan (R.O.C.). .,School of Medicine, National Defense Medical Center, Taipei, Taiwan. .,Department of Otolaryngology, Head and Neck Surgery, Tri-Service General Hospital, Taipei, Taiwan. .,Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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26
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Lai WY, Lin PC, Yin CH, Yang KT, Shih EJ, Chen JS. The Association between Elevated Hematocrit and Retinal Artery Occlusion in Adult Patients. J Clin Med 2022; 11:jcm11206116. [PMID: 36294436 PMCID: PMC9604686 DOI: 10.3390/jcm11206116] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/15/2022] [Accepted: 10/15/2022] [Indexed: 11/16/2022] Open
Abstract
Retinal artery occlusion (RAO) is most commonly caused by embolism. Evidence showed that hematocrit (Hct) levels are often associated with embolic events. In this study, we aim to investigate the relationship between Hct levels and RAO. This retrospective study enrolled RAO patients between January 2011 and March 2020, who were 1:4 matched by age, gender, index date, and relevant comorbidities with the non-RAO group. Patient characteristics and laboratory data were collected. Univariate conditional logistic regression was applied by estimating crude matched odds ratios to determine the relevant factors for the occurrence of RAO. Furthermore, a narrative review of the relevant study was conducted to explore the association between Hct levels and embolism. Between January 2011 to March 2020, 82 RAO patients and 328 non-RAO patients matched with age, gender, index date, comorbidities of hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, stroke, and atrial fibrillation were enrolled after excluding ineligible individuals. Conditional logistic regression analysis showed that Hct level ≥ 40% was associated with developing RAO. A forest plot showed a trend of a non-linear dose-response association between Hct levels and ischemic vascular events in male patients. Hct levels ≥ 40% in patients older than 65 years with at least six comorbidities could be associated with RAO. We suggest that older patients who have multiple comorbidities, combined with elevated Hct levels, should be informed of the possible occurrence of RAO.
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Affiliation(s)
- Wei-Yu Lai
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Pei-Chin Lin
- Department of Pharmacy, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- Institute of Health Care Management, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
| | - Kuang-Tsu Yang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- Division of Family Medicine, Department of Community Medicine, Kaohsiung Municipal Min-Sheng Hospital, Kaohsiung 80251, Taiwan
- Department of Medicine, National Taiwan University, Taipei 10617, Taiwan
- Institute of Biomedical Science, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
| | - En-Jie Shih
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 112304, Taiwan
- Correspondence: (E.-J.S.); (J.-S.C.); Tel.: +886-7-3422121 (E.-J.S.); +886-7-3422121 (J.-S.C.)
| | - Jin-Shuen Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- Deputy Superintendent, Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 38024, Taiwan
- Correspondence: (E.-J.S.); (J.-S.C.); Tel.: +886-7-3422121 (E.-J.S.); +886-7-3422121 (J.-S.C.)
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Fang NW, Chiou YH, Chen YS, Hung CW, Yin CH, Chen JS. Nomogram for diagnosing acute pyelonephritis in pediatric urinary tract infection. Pediatr Neonatol 2022; 63:380-387. [PMID: 35568634 DOI: 10.1016/j.pedneo.2022.03.006] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/15/2022] [Accepted: 03/10/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND For risk stratification and individualized treatment for children with urinary tract infection (UTI), they must be assessed for the presence of acute pyelonephritis (APN). Our study aimed to combine variables that can predict APN and establish a nomogram for clinical use. METHODS In total, 111 children <5 years old hospitalized at Kaohsiung Veterans General Hospital for UTI were classified into APN and simple UTI groups based on a technetium-99 m dimercaptosuccinic acid scan. Their demographic, laboratory test, and renal and urinary bladder sonography (RUBS) data were compared. RESULTS Fever peak of >39 °C, serum procalcitonin (PCT) ≥ 0.52 pg/mL, C-reactive protein (CRP) ≥ 2.86 mg/dL, and abnormal RUBS findings were independent variables for predicting APN in children. The nomogram established using the aforementioned variables had an area under the receiver operating characteristic curve (AUC) of 0.89, which was higher than those of PCT and CRP alone (0.776 and 0.774, respectively). CONCLUSION The combination of four variables had the highest power in predicting APN in children with UTI. The established nomogram is practical for clinical use.
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Affiliation(s)
- Nai-Wen Fang
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yee-Hsuan Chiou
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chi-Wen Hung
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Taiwan
| | - Jin-Shuen Chen
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung and School of Medicine, National Defense Medical Center, Taipei, Taiwan.
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Wu HY, Yang JR, Hung CC, Yin CH, Tzeng YDT. A nomogram to predict pathological complete response of neoadjuvant systemic therapy in HER2-positive breast cancer based on clinicopathologic characteristics and pretreatment systemic inflammation response index: A dual-center study. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e12590] [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: 11/20/2022] Open
Abstract
e12590 Background: Patients with human epidermal growth factor receptor 2 (HER2) positive breast cancer (BC) who achieve a pathologic complete response (pCR) after neoadjuvant systemic therapy (NST) have favorable prognoses. Multiple pretreatment systemic inflammatory markers (SIMs), based on peripheral blood cell counts, have been reported as predictors of pCR in BC patients. The markers include neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, lymphocyte-monocyte ratio, and systemic inflammation response index (SIRI= neutrophil × monocyte / lymphocyte count), etc. However, the most significant SIM remains controversial among studies and the variations among different molecular subtypes remain unknown. Methods: We retrospectively reviewed 233 patients with stage I–III HER2-positive BC who received NST and subsequently underwent surgery in Kaohsiung and Taichung Veterans General Hospital from 2011 to 2021. Data on multiple pretreatment SIMs were collected. The most significant SIM were analyzed for predictive significance with other clinicopathologic factors by using stepwise logistic regression with forward selection. The data was conducted to illustrate a nomogram plot for determining pCR probability. Results: Among the pretreatment SIMs, only SIRI was significantly related to pCR by optimal cut-off value of 1.7 ×109/L. Stepwise logistic analyses indicated that the clinical T and N stage, HER2 immunohistochemistry (IHC) score, PR expression, and targeted therapy regimen were independent predictors of pCR, with an area under the curve (AUC) of 0.74. Sub-analysis was performed after stratifying into T stage subgroups (T1-2 vs. T3-4). Significant predictors In the T1-2 subgroup were clinical N stage, HER2 IHC score, PR, and targeted therapy regimen (AUC=0.722). Significant predictors in the T3-4 subgroup were SIRI and ER (AUC=0.824). The Hosmer–Lemeshow test revealed the predictive ability was a good fit to actual observation. A T-stage-stratified nomogram based on the logistic model was built. Conclusions: In HER2 positive BC patients receiving NST, low pretreatment SIRI is predictive of pCR in T3-4 subgroup. Our nomogram served as an efficient tool to predict pCR and to assist clinical decision support before neoadjuvant treatment.
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Affiliation(s)
- Hong-Yu Wu
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jie-Ru Yang
- Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chih-Chiang Hung
- Department of Applied Cosmetology, College of Human Science and Social Innovation, Hungkuang University, Taichung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
| | - Yen-Dun Tony Tzeng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
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Lin CY, Huang SC, Tzou SJ, Yin CH, Chen JS, Chen YS, Chang ST. A Positive Correlation between Steroid Injections and Cuff Tendon Tears: A Cohort Study Using a Clinical Database. Int J Environ Res Public Health 2022; 19:ijerph19084520. [PMID: 35457390 PMCID: PMC9031762 DOI: 10.3390/ijerph19084520] [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: 02/28/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 02/06/2023]
Abstract
This cohort study aimed to investigate the association between steroid injections for shoulder diseases and the increased incidence of cuff tendon tears. The Kaohsiung Veterans General Hospital clinical database was used in this study. Patients were enrolled using the corresponding diagnostic codes for shoulder diseases. Patients who received steroid injections were included in the case group, and those without steroid injections were included in the control group. The outcome measure was the occurrence of cuff tendon tears during the study period. Adjusted hazard ratios for outcomes were calculated using Cox regression analysis adjusted for sex, age, and comorbidities. Of the 1025 patients with shoulder disease, 205 were in the case group and 820 were in the control group. The incidence of cuff tendon tears was 9.8% in patients who received steroid injections (p < 0.001). The adjusted hazard ratios for steroid injections, smoking, and chronic liver disease were 7.44 (p < 0.001), 2.40 (p = 0.046), 3.25 (p = 0.007), respectively. Steroid injections on the shoulder were associated with a raised risk of cuff tendon tears by 7.44 times compared to non-injection. The incidence of cuff tendon tears increased by 3.25 times with concurrent chronic liver disease and by 2.4 times with smoking.
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Affiliation(s)
- Ching-Yueh Lin
- Department of Physical Medicine and Rehabilitation, Kaohsiung Armed Forces General Hospital, Kaohsiung 802301, Taiwan;
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114202, Taiwan
| | - Shih-Chung Huang
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung 802301, Taiwan;
- Teaching and Researching Center, Kaohsiung Armed Forces General Hospital, Kaohsiung 802301, Taiwan;
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114202, Taiwan
| | - Shiow-Jyu Tzou
- Teaching and Researching Center, Kaohsiung Armed Forces General Hospital, Kaohsiung 802301, Taiwan;
- Institute of Medical Science and Technology, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan;
- Institute of Health Care Management, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
| | - Jin-Shuen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan; (J.-S.C.); (Y.-S.C.)
| | - Yao-Shen Chen
- Department of Administration, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan; (J.-S.C.); (Y.-S.C.)
| | - Shin-Tsu Chang
- Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei 114202, Taiwan
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
- Correspondence: ; Tel.: +886-7-3422121 (ext. 78204)
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Chang YC, Chen JS, Yin CH, Shin-Jung Lee S, Chen WC. Candidemia in hospitalized cirrhotic patients with bloodstream infection: A retrospective analysis and brief summary of published studies. J Chin Med Assoc 2022; 85:295-303. [PMID: 35259132 DOI: 10.1097/jcma.0000000000000695] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Candidemia is a life-threatening condition; however, the predictive markers for candidemia and mortality are inadequate in cirrhotic patients. This study was conducted to propose candidate predictors for the occurrence of candidemia and 30-day mortality in hospitalized cirrhotic patients with bloodstream infection (BSI) and review the related literature. METHODS Cirrhotic patients with BSI between January 2011 and March 2020 were screened from the databank of a medical center and eligible patients were enrolled. Patients were separated into candidemia and bacteremia groups according to the results of blood cultures. Baseline characteristics, clinical presentation, and biochemistry data were collected at this time, as were microbiological data, medical management, use of antimicrobial agents, and outcome of the patients. The parameters and 30-day mortality were compared between candidemia and bacteremia groups. A combination of the MeSH terms and text terms related to candidemia and cirrhosis was searched in the electronic databases. RESULTS Four hundred and sixty cirrhotic patients with BSI were enrolled. Thirty-five patients with candidemia (7.6%) were identified. Nosocomial infection, intensive care unit (ICU) admission, antibiotics exposure ≥14 days, white cell count >10 K/mm3, and model for end-stage liver disease (MELD) score >24 were associated with candidemia. The 30-day mortality was 65.7% in the candidemia group and 37.9% in the bacteremia group (p = 0.001). Nosocomial infection, ICU admission, hepatoma, hepatic encephalopathy, international normalized ratio ≥1.2, platelet ≤150 K/mm3, estimated glomerular filtration rate <60 mL/min/1.73m2, and MELD score >24 were associated with 30-day mortality. Six studies were identified. The results were consistent with our findings regarding low incidence of candidemia, and relevant risk factors are listed. CONCLUSION Candidemia had low incidence but high mortality in hospitalized cirrhotic patients with BSI. New predictors were proposed for the occurrence of candidemia and 30-day mortality in these patients.
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Affiliation(s)
- Yu-Chen Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Jin-Shuen Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Susan Shin-Jung Lee
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Infectious Disease, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Wen-Chi Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Institute of Biomedical Sciences, College of Science, National Sun Yat-Sen University, Kaohsiung, Taiwan, ROC
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Shen PW, Chou YM, Li CL, Liao EC, Huang HS, Yin CH, Chen CL, Yu SJ. Itraconazole improves survival outcomes in patients with colon cancer by inducing autophagic cell death and inhibiting transketolase expression. Oncol Lett 2021; 22:768. [PMID: 34589147 PMCID: PMC8442143 DOI: 10.3892/ol.2021.13029] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 02/04/2021] [Accepted: 08/09/2021] [Indexed: 12/26/2022] Open
Abstract
The incidence of colon cancer continues to increase annually, and it is the leading cause of cancer-associated mortality worldwide. Altering cell metabolism and inducing autophagic cell death have recently emerged as novel strategies in preventing tumor growth. Autophagy plays an essential role in energy production by degrading damaged cellular components and is also associated with tumor proliferation suppression. Itraconazole is an FDA-approved drug used as an antifungal medication and has been reported to induce autophagic cell death in breast cancer. However, the effects of itraconazole on cell metabolism and induction of apoptosis in colon cancer remain unclear. The present study analyzed extensive data from patients diagnosed with colon cancer using itraconazole between January 2011 and December 2015, from the Taiwanese National Health Insurance Research Database. The underlying molecular mechanisms of itraconazole in autophagy-induced cell death were also investigated. The results demonstrated that the 5-year survival rate was significantly higher in patients with colon cancer who received itraconazole treatment. In addition, itraconazole decreased the viability and cell colony formation, and induced cleaved caspase-3 expression and G1 cell cycle arrest of COLO 205 and HCT 116 cells. Notably, itraconazole induced autophagy by enhancing LC3B and p62 expression. Following LC3 knockdown, the viability of itraconazole-treated COLO 205 and HCT 116 cells notably improved. Taken together, the results of the present study suggest that itraconazole may have a beneficial effect on patients with colon cancer, and its underlying molecular mechanisms may be associated with the induction of autophagic cell death.
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Affiliation(s)
- Pei-Wen Shen
- Department of Anesthesiology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
| | - Yu-Mei Chou
- Department of Anesthesiology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
| | - Chia-Ling Li
- Children's Medical Center, Taichung Veterans General Hospital, Taichung 407, Taiwan, R.O.C
| | - En-Chih Liao
- Department of Medicine, MacKay Medical College, New Taipei City 252, Taiwan, R.O.C.,Institute of Biomedical Sciences, MacKay Medical College, New Taipei City 252, Taiwan, R.O.C
| | - Hung-Sen Huang
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
| | - Chien-Liang Chen
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C.,Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
| | - Sheng-Jie Yu
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan, R.O.C
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Ou SH, Chen HY, Fang NW, Yin CH, Chen CL, Chen JS. Effect of anti-diabetic drugs in dialysis patients with diabetes: a nationwide retrospective cohort study. Cardiovasc Diabetol 2021; 20:179. [PMID: 34496858 PMCID: PMC8424811 DOI: 10.1186/s12933-021-01364-w] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/15/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus is common in patients undergoing dialysis. However, the association between anti-diabetic drug use and survival outcomes is rarely discussed. We aimed to investigate whether continued anti-diabetic medication use affects the survival of diabetic dialysis patients and whether different hypoglycemic drug use influences prognosis. METHODS Using a nationwide database, we enrolled patients with incident end-stage renal disease under maintenance dialysis during 2011-2015 into the pre-existing diabetes dialysis (PDD), incident diabetes after dialysis (IDD), and non-diabetic dialysis (NDD) groups. The PDD group was further subclassified into patients who continued (PDD-M) and discontinued (PDD-NM) anti-diabetic drug use after dialysis. RESULTS A total of 5249 dialysis patients were examined. The PDD-NM group displayed a significantly higher mortality rate than the IDD, PDD-M, and NDD groups (log-rank test P < 0.001). The PDD-M group had a significantly lower risk of death, regardless of insulin (P < 0.001) or oral hypoglycemic agent (OHA) (P < 0.001) use. Initial insulin administration or OHA had no statistically significant effect on overall mortality in the IDD group. But OHA use had better survival trends than insulin administration for the older (P = 0.02) and male subgroups (P = 0.05). CONCLUSIONS For dialysis patients with diabetes, continuous administration of anti-diabetic drugs after dialysis and choice of medication may affect outcomes.
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Affiliation(s)
- Shih-Hsiang Ou
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hsin-Yu Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Nai-Wen Fang
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chien-Liang Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jin-Shuen Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
- Faculty of Medicine, School of Medicine, National Defense Medicine, Taipei, Taiwan.
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Chen MY, Ou SH, Yen MC, Lee MS, Chen NC, Yin CH, Chen CL. Vegetarian diet in dialysis patients: A significant gap between actual intake and current nutritional recommendations. Medicine (Baltimore) 2021; 100:e24617. [PMID: 33578571 PMCID: PMC7886433 DOI: 10.1097/md.0000000000024617] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 01/08/2021] [Indexed: 01/05/2023] Open
Abstract
Nutritional status is a predictor of mortality and morbidity in dialysis patients. This study aimed to assess dietary behaviors in dialysis patients compared to the recommendations of the Kidney Disease Outcomes Quality Initiative.Ninety five dialysis patients recruited from a hospital completed a 24-hour dietary recall questionnaire. Body weight, energy requirements, protein requirements, albumin, normalized protein catabolic rate, and 25(OH) vitamin D levels were measured.Of the 95 patients, 11 (11.6%) were below the desirable body mass index range, 59 (62.1%) were within the desired range, and 25 (26.3%) were above the desired range. However, only 32.7% of patients met the target energy intake, 29.5% reached the protein intake target, and 20.0% had adequate vitamin D concentrations. Vegetarian patients had lower energy, protein, fat, vitamin D intake, lower body mass index, serum blood urea nitrogen, creatinine, phosphate, normalized protein catabolic rate, and vitamin D status than the omnivorous patients (P < .05). After adjusting for age, sex, and body weight, vegetarianism was an independent risk factor for severe vitamin D deficiency (<10 ng/ml, P < .01).Most dialysis patients do not meet their dietary recommendations or goals. The risk of a vegetarian diet may outweigh the benefits in dialysis patients. Careful consideration of dietary behaviors is required for dialysis patients to prevent malnutrition, more so in vegetarians.
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Affiliation(s)
- Mei-Yin Chen
- Department of Nutrition and Food Service, Kaohsiung Veterans General Hospital
- Department of Nursing, Shu-Zen Junior College of Medicine and Management
| | - Shih-Hsiang Ou
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung
- National Yang-Ming University, College of Medicine, Taipei
| | - Ming-Chen Yen
- Department of Nutrition and Food Service, Kaohsiung Veterans General Hospital
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, Taipei
| | - Nai-Ching Chen
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- National Yang-Ming University, College of Medicine, Taipei
| | - Chien-Liang Chen
- Division of Nephrology, Kaohsiung Veterans General Hospital, Kaohsiung
- National Yang-Ming University, College of Medicine, Taipei
- Division of Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung
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Yang YC, Yin CH, Chen KT, Lin PC, Lee CC, Liao WC, Chen JS. Prognostic Nomogram of Predictors for Shunt-Dependent Hydrocephalus in Patients with Aneurysmal Subarachnoid Hemorrhage Receiving External Ventricular Drain Insertion: A Single-Center Experience and Narrative Review. World Neurosurg 2021; 150:e12-e22. [PMID: 33556600 DOI: 10.1016/j.wneu.2021.01.138] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 12/15/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study aimed to create a prediction model with a radiographic score, serum, and cerebrospinal fluid (CSF) values for the occurrence of shunt-dependent hydrocephalus (SDHC) in patients with aneurysmal subarachnoid hemorrhage (aSAH) and to review and analyze literature related to the prediction of the development of SDHC. METHODS Sixty-three patients with aSAH who underwent external ventricular drain insertion were included and separated into 2 subgroups: non-SDHC and SDHC. Patient characteristics, computed tomography scoring system, and serum and CSF parameters were collected. Multivariate logistic regression was conducted to illustrate a nomogram for determining the predictors of SDHC. Furthermore, we sorted and summarized previous meta-analyses for predictors of SDHC. RESULTS The SDHC group had 42 cases. Stepwise logistic regression analysis revealed 3 independent predictive factors associated with a higher modified Graeb (mGraeb) score, lower level of estimated glomerular filtration rate group, and lower level of CSF glucose. The nomogram, based on these 3 factors, was presented with significant predictive performance (area under curve = 0.895) for SDHC development, compared with other scoring systems (AUC = 0.764-0.885). In addition, a forest plot was generated to present the 12 statistically significant predictors and odds ratio for correlations with the development of SDHC. CONCLUSIONS First, the development of a nomogram with combined significant factors had a good performance in estimating the risk of SDHC in primary patient evaluation and assisted in clinical decision making. Second, a narrative review, presented with a forest plot, provided the current published data on predicting SDHC.
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Affiliation(s)
- Yao-Chung Yang
- Department of Surgery, Division of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Kuan-Ting Chen
- School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Radiology, Taichung Armed Force General Hospital, Taichung, Taiwan
| | - Pei-Chin Lin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Pharmacy, School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Chih Lee
- School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chuan Liao
- Department of Surgery, Division of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
| | - Jin-Shuen Chen
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Yang CC, Kang BH, Liu WS, Yin CH, Lee CC. Association of a multiple-step action with cervical lymph node yield of oral cancer patients in an Asian country. BMC Oral Health 2021; 21:29. [PMID: 33441108 PMCID: PMC7805045 DOI: 10.1186/s12903-021-01389-3] [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: 06/10/2020] [Accepted: 01/04/2021] [Indexed: 11/10/2022] Open
Abstract
Background High quality lymph node (LN) yield could increase survival, however strategies to improve LN yield have been seldom reported. This study aimed to assess the multiple-step action to promote quality of neck dissection in oral cancer. Methods A total of 400 patients with oral cancer who underwent primary tumor resection and neck dissection, including elective and radical neck dissection, were recruited after propensity score matching by clinical T and N categories between January 2009 and September 2018. Patients were treated by two independent departments in our institute. A multiple-step action was initiated in October 2015 in one department, and another department was as a control group. The impact of multiple-step action on LN yield and regional recurrence were analyzed using multivariate analysis and difference-in-differences (DID) linear regression analysis. Results The mean patient age was 55.2 + 11.1 years, and 92% were male. A total of 180 (45%) patients had T3-4 disease, and 129 (32%) patients had N2-3 disease. The multivariate linear regression and DID analyses revealed that multiple-step action had a positive effect on LN yield. A net improvement of LN yield with a coefficient of 13.78 (p < 0.001) after launching multiple-step action (since October 2015) was observed. A borderline protective effect of multiple-step action for cN0 patients with a reduced regional recurrence rate of 11.6% (p = 0.072) through DID analysis was noted. Conclusions Multiple-step action was associated with increased LN yield and decreased regional recurrence in patients with oral cancer. The observed activity may promote surgeons to improve the quality of neck dissections, is feasible, and could be applied to a widespread patient population.
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Affiliation(s)
- Ching-Chieh Yang
- Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Bor-Hwang Kang
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Pharmacy, Tajen University, Pingtung, Taiwan
| | - Wen-Shan Liu
- Department of Radiation Oncology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ching-Chih Lee
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. .,School of Medicine, National Defense Medical Center, Taipei, Taiwan. .,Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. .,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
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Yang CC, Kang BH, Liu WS, Yin CH, Lee CC. Postoperative radiotherapy is associated with improved survival in pT1-2N1 oral and oropharyngeal cancer without adequate neck dissection. Radiat Oncol 2021; 16:6. [PMID: 33407647 PMCID: PMC7788971 DOI: 10.1186/s13014-020-01736-8] [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: 09/11/2020] [Accepted: 12/17/2020] [Indexed: 11/18/2022] Open
Abstract
Background To assess the benefit of postoperative radiotherapy in patients with pT1-2N1M0 oral and oropharyngeal cancer by the quality of neck dissection. Methods In the Surveillance, Epidemiology, and End Results database, pT1-2N1M0 oral and oropharyngeal cancer patients treated by primary tumor resection and neck dissection with or without radiotherapy were included between 2004 and 2015. Univariate and multivariate analysis were used to explore the effect of adjuvant radiotherapy on 5-year overall survival (OS) and disease-specific survival (DSS) among different quality of neck dissection. Results Of the 1765 patients identified, 1108 (62.8%) had oral cancer, 1141 (64.6%) were men, and 1067 (60.5%) underwent adjuvant radiotherapy. After adjusting for confounding factors, postoperative radiotherapy reduced the adjusted hazard ratio (aHR) of 5-year OS to 0.64 (95% confidence interval [CI] 0.49–0.84) in those with < 18 lymph nodes (LNs) removed, but not in those with 19–24 LNs removed (aHR 0.78; 95% CI 0.73–1.13), and in those with ≥ 25 LNs removed (aHR 0.96; 95% CI 0.75–1.24). For 5-year DSS, similar effect was observed. The adjusted hazard ratio was 0.66 (95% confidence interval, 0.45–0.97) in those with < 18 LNs. The protective effect was not seen in those with 18–24 LNs (aHR 1.07; 95% CI 0.59–1.96), and in those with ≥ 25 LNs (aHR 1.12; 95% CI 0.81–1.56). Sensitivity testing also showed a robust protective effect of postoperative radiotherapy in patients with < 18 LNs removed. Conclusion Radiotherapy was associated with improved survival in pT1-2N1M0 oral and oropharyngeal cancer patients without adequate neck dissection.
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Affiliation(s)
- Ching-Chieh Yang
- Department of Radiation Oncology, Chi-Mei Medical Center, Tainan, Taiwan.,Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Bor-Hwang Kang
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,School of Medicine, National Defense Medical Center, Taipei, Taiwan.,Department of Pharmacy, Tajen University, Pingtung, Taiwan
| | - Wen-Shan Liu
- Department of Radiaton Oncology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ching-Chih Lee
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. .,School of Medicine, National Defense Medical Center, Taipei, Taiwan. .,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan.
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Fang NW, Chen YC, Ou SH, Yin CH, Chen JS, Chiou YH. Incidence and risk factors for chronic kidney disease in patients with congenital heart disease. Pediatr Nephrol 2021; 36:3749-3756. [PMID: 34036446 PMCID: PMC8497455 DOI: 10.1007/s00467-021-05129-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 04/21/2021] [Accepted: 05/07/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUNDS Chronic kidney disease (CKD) is underdiagnosed in children with congenital heart disease (CHD). Our aim was to study the incidence of CKD in CHD children and identify risk factors for CKD. METHODS CHD patients were enrolled from the Kaohsiung Veterans General Hospital database between 2010 and 2019. Patient age at enrollment was age at first visit to the hospital. The end of follow-up was marked by the last measurement of serum creatinine, urine protein-to-creatinine ratio (UPCR), or urine microalbumin-to-creatinine ratio (UACR) after enrollment, and only patients who underwent the aforementioned tests in 2 different years were included. Patients with an estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73m2 were diagnosed as having CKD and were further classified into clinically recognized CKD (CR-CKD, defined as eGFR <60 mL/min/1.73m2, UPCR >0.5, or UACR >30 mg/g) and non-clinically recognized CKD (NCR-CKD). Their demographic data, CHD category, heart surgery types, medications, and contrast-related examinations during follow-up were collected. RESULTS The study included 359 CHD patients, of whom 167 (46.5%) developed CKD (18 patients with CR-CKD and 341 with NCR-CKD). Patients with CR-CKD were significantly older at enrollment than patients with NCR-CKD. Corrective heart surgery may be a protective factor for CKD. Furthermore, cyanotic heart disease, two or more image-related contrast exposures, and diuretic use may be associated with CKD. CONCLUSION CHD patients have a high incidence of CKD. The early detection of CKD and prompt corrective heart surgery for CHD may be beneficial for kidney function.
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Affiliation(s)
- Nai-Wen Fang
- Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, No 386, Dazhong 1st Rd, Zuoying Dist, Kaohsiung City, 813, Taiwan
| | - Yu-Chieh Chen
- Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, No 386, Dazhong 1st Rd, Zuoying Dist, Kaohsiung City, 813, Taiwan
| | - Shih-Hsiang Ou
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Jin-Shuen Chen
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yee-Hsuan Chiou
- Division of Pediatric Nephrology, Department of Pediatrics, Kaohsiung Veterans General Hospital, No 386, Dazhong 1st Rd, Zuoying Dist, Kaohsiung City, 813, Taiwan.
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Lai WY, Kuo TJ, Lee CC, Yin CH. Risk factors of strabismus surgery among pediatric cerebral palsy population with strabismus in Taiwan: A population-based cohort study. J Chin Med Assoc 2020; 83:1107-1110. [PMID: 33009210 DOI: 10.1097/jcma.0000000000000440] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND To identify the risk factors of strabismus surgery among Taiwanese children with severe cerebral palsy (CP) and strabismus. METHODS This retrospective nationwide population-based cohort study examined a cohort of newly diagnosed pediatric CP patients (age ≤ 10 y) between 1997 and 2013 with strabismus. The primary endpoint was strabismus surgery. A stepwise logistic regression was applied to determine the demographic factors, ophthalmic conditions, and comorbidities associated with strabismus surgery. RESULTS Out of 808 patients, 115 had received strabismus surgery. The significant factors correlated to strabismus surgery in pediatric patients with severe CP and strabismus were CP diagnosis age < 4 years, residency in a suburban/rural area, low birth weight, and strabismic amblyopia. CONCLUSION In CP children with strabismus who have risk factors of younger CP diagnosis age (age < 4 y), residency in a suburban/rural area, a low birthweight, and the presence of strabismic amblyopia, strabismus surgery should be considered.
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Affiliation(s)
- Wei-Yu Lai
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
| | - Tsu-Jen Kuo
- Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan, ROC
- Department of Dental Technology, Shu-Zen junior College of Medicine and Management, Kaohsiung, Taiwan, ROC
| | - Ching-Chih Lee
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, ROC
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Chen CL, Liang CK, Yin CH, Lin YT, Lee CC, Chen NC. Corrigendum to 'Effects of Socioeconomic Status on Alzheimer Disease Mortality in Taiwan' [The American Journal of Geriatric Psychiatry 28 (2020) 205-216]. Am J Geriatr Psychiatry 2020; 28:1232. [PMID: 32278747 DOI: 10.1016/j.jagp.2020.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Hsu CH, Hung YM, Chu KA, Chen CF, Yin CH, Lee CC. Prognostic nomogram for elderly patients with acute respiratory failure receiving invasive mechanical ventilation: a nationwide population-based cohort study in Taiwan. Sci Rep 2020; 10:13161. [PMID: 32753615 PMCID: PMC7403322 DOI: 10.1038/s41598-020-70130-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 05/21/2020] [Indexed: 11/13/2022] Open
Abstract
Patients in critical care medicine are ageing. There is limited literature evaluating long-term outcomes and prognostic factors for the growing number of elderly patients with acute respiratory failure (ARF) receiving invasive mechanical ventilation (IMV). Data on elderly patients (≧ 65 years old) with ARF receiving intubation and IMV during 2003–2012 were retrospectively collected from the national health database in Taiwan. We included 7,095 elderly patients. The 28-day mortality was 33%, the 60-day mortality was 47.5%, and the 1-year mortality was 70.4%. Patients were divided into groups: young-old (65–74 years), middle-old (75–84 years), and oldest-old (≧ 85 years). Patients in the oldest-old and middle-old groups had higher 1-year mortality than the young-old group (p < 0.001). The multivariate logistic regression revealed 9 significant factors associated with 1-year mortality, and these factors were used to develop a prognostic nomogram. The present study showed that the long-term prognosis of elderly patients with ARF and IMV is very poor. This nomogram can help physicians estimate the 1-year mortality of elderly patients in the early stage of ARF and assist in clinical decision making.
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Affiliation(s)
- Chun-Hsiang Hsu
- Division of Chest Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yao-Min Hung
- School of Medicine, National Yang Ming University, Taipei, Taiwan.,Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan.,Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan
| | - Kuo-An Chu
- Division of Chest Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. .,School of Medicine, National Yang Ming University, Taipei, Taiwan. .,Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan.
| | - Chiu-Fan Chen
- Division of Chest Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. .,Department of Internal Medicine, Taitung Branch, Taipei Veterans General Hospital, Taitung, Taiwan.
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ching-Chih Lee
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
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Kuo TJ, Hsu CL, Liao PH, Huang SJ, Hung YM, Yin CH. Nomogram for pneumonia prediction among children and young people with cerebral palsy: A population-based cohort study. PLoS One 2020; 15:e0235069. [PMID: 32628682 PMCID: PMC7337291 DOI: 10.1371/journal.pone.0235069] [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] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 06/08/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Pneumonia is the leading cause of death among children and young people (CYP) with severe cerebral palsy (CP). Only a few studies used nomogram for assessing risk factors and the probability of pneumonia. Therefore, we aimed to identify risk factors and devise a nomogram for identifying the probability of severe pneumonia in CYP with severe CP. METHODS This retrospective nationwide population-based cohort study examined CYP with newly diagnosed severe CP before 18 years old between January 1st, 1997 and December 31st, 2013 and followed them up through December 31st, 2013. The primary endpoint was defined as the occurrence of severe pneumonia with ≥ 5 days of hospitalization. Logistic regression analysis was used for determining demographic factors and comorbidities associated with severe pneumonia. These factors were assigned integer points to create a scoring system to identify children at high risk for severe pneumonia. RESULTS Among 6,356 CYP with newly diagnosed severe CP, 2,135 (33.59%) had severe pneumonia. Multivariable logistic regression analysis revealed that seven independent predictive factors, namely age <3 years, male sex, and comorbidities of pressure ulcer, gastroesophageal reflux, asthma, seizures, and perinatal complications. A nomogram was devised by employing these seven significant predictive factors. The prediction model presented favorable discrimination performance. CONCLUSIONS The nomogram revealed that age, male sex, history of pressure ulcer, gastroesophageal reflux, asthma, seizures, and perinatal complications were potential risk factors for severe pneumonia among CYP with severe CP.
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Affiliation(s)
- Tsu Jen Kuo
- Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
| | - Chiao-Lin Hsu
- Center of Health Management, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Taiwan
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Pei-Hsun Liao
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Shih-Ju Huang
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yao-Min Hung
- Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan
- School of Medicine, National Yang Ming University, Taipei, Taiwan
- Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan
- Department of Emergency Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- * E-mail: (YMH); (CHY)
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- * E-mail: (YMH); (CHY)
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Yang KT, Yin CH, Hung YM, Huang SJ, Lee CC, Kuo TJ. Continuity of Care Is Associated with Medical Costs and Inpatient Days in Children with Cerebral Palsy. Int J Environ Res Public Health 2020; 17:ijerph17082913. [PMID: 32340141 PMCID: PMC7215569 DOI: 10.3390/ijerph17082913] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 04/01/2020] [Revised: 04/20/2020] [Accepted: 04/21/2020] [Indexed: 01/05/2023]
Abstract
Background: Children with cerebral palsy (CP) place a considerable burden on medical costs and add to an increased number of inpatient days in Taiwan. Continuity of care (COC) has not been investigated in this population thus far. Materials and Methods: We designed a retrospective population-based cohort study using Taiwan’s National Health Insurance Research Database. Patients aged 0 to 18 years with CP catastrophic illness certificates were enrolled. We investigated the association of COC index (COCI) with medical costs and inpatient days. We also investigated the possible clinical characteristics affecting the outcome. Results: Over five years, children with CP with low COCI levels had higher medical costs and more inpatient days than did those with high COCI levels. Younger age at CP diagnosis, more inpatient visits one year before obtaining a catastrophic illness certificate, pneumonia, and nasogastric tube use increased medical expenses and length of hospital stay. Conclusions: Improving COC reduces medical costs and the number of inpatient days in children with CP. Certain characteristics also influence these outcomes.
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Affiliation(s)
- Kuang-Tsu Yang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Chun-Hao Yin
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Yao-Min Hung
- Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung 80457, Taiwan
- School of Medicine, National Yang-Ming University, Taipei 11221, Taiwan
- Yuh-Ing Junior College of Health Care and Management, Kaohsiung 80776, Taiwan
| | - Shih-Ju Huang
- Department of Pediatrics, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
| | - Ching-Chih Lee
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei 11221, Taiwan
| | - Tsu-Jen Kuo
- Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung 81362, Taiwan
- Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung 80424, Taiwan
- Department of Dental Technology, Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan
- Correspondence: ; Tel.: +886-7-346-8214; Fax: +886-7-346-8392
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Hsu CH, Chan JK, Yin CH, Lee CC, Chern CU, Liao CI. Trends in the incidence of thymoma, thymic carcinoma, and thymic neuroendocrine tumor in the United States. PLoS One 2019; 14:e0227197. [PMID: 31891634 PMCID: PMC6938371 DOI: 10.1371/journal.pone.0227197] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [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: 05/30/2019] [Accepted: 12/14/2019] [Indexed: 12/12/2022] Open
Abstract
This study aimed to identify the trends in the incidence of thymic cancer, i.e., thymoma, thymic carcinoma, and thymic neuroendocrine tumor, in the United States. Data from the United States Cancer Statistics (USCS) database (2001-2015) and those from the Surveillance, Epidemiology, and End Results (SEER) database (SEER 9 [1973-2015], SEER 13 [1992-2015], and SEER 18 [2000-2015]) were used in this study. All incidences were per 100,000 population at risk. The trends in incidence were described as annual percent change (APC) using the Joinpoint regression program. Data from the USCS (2001-2015) database showed an increase in thymic cancer diagnosis with an APC of 4.89% from 2001 to 2006, which is mainly attributed to the significant increase in the incidence of thymoma and thymic carcinoma particularly in women. The incidence of thymic cancer did not increase from 2006 to 2015, which may be attributed to the increase in the diagnosis of thymic carcinoma from 2004 to 2015, with a concomitant decrease in thymoma from 2008 to 2015. Before declining, the age-specific incidence of thymic cancer peaked at ages 70-74 years, with a peak incidence at 1.06 per 100,000 population, and decreased in older age groups. The incidence of thymic cancer was higher in men than in women. Asian/Pacific Islanders had the highest incidence of thymoma, followed by black and then white people. The incidence of thymic carcinoma increased from 2004 to 2015, with a concomitant decrease in thymoma from 2008 to 2015. Asian/Pacific Islanders had the highest incidence of thymoma than other races.
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Affiliation(s)
- Chun-Hsiang Hsu
- Division of Chest Medicine, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - John K. Chan
- Division of Gynecologic Oncology, California Pacific & Palo Alto Medical Foundation Sutter Health, San Francisco, CA, the United States of Amaerica
| | - Chun-Hao Yin
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Ching-Chih Lee
- Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Otolaryngology, Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chyi-Uei Chern
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Cheng-I Liao
- Department of Obstetrics and Gynecology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- National Yang-Ming University School of Medicine, Taipei, Taiwan
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Kuo TJ, Wu PC, Tang PL, Yin CH, Chu CH, Hung YM. Effects of continuity of care on the postradiotherapy survival of working-age patients with oral cavity cancer: A nationwide population-based cohort study in Taiwan. PLoS One 2019; 14:e0225635. [PMID: 31841525 PMCID: PMC6913929 DOI: 10.1371/journal.pone.0225635] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 11/09/2019] [Indexed: 01/17/2023] Open
Abstract
Objectives Cancer of the oral cavity, a well-known global health concern, remains one of most common causes of cancer mortality. Continuity of care (COC), a measurement of the extent to which an individual patient receives care from a given provider over a specified period of time, can help cancer survivors process their experiences of dealing with the illness and recuperation; however, limited research has focused on the survival rate of working-age patients with oral cancer. Methods A total of 14,240 working-age patients (20 <age ≤65 years) with oral cavity cancer treated with radiotherapy (RT) during 2000–2013 were included in this study from a registry of patients with catastrophic illnesses maintained by the Taiwan National Health Insurance Research Database. We evaluated the effects of the Continuity of Care Index (COCI) proposed by Bice and Boxerman, sociodemographic factors, and comorbidities on the survival rate. This study categorized COC into three groups—low (COCI < 0.23), intermediate (COCI = 0.23–0.37), and high (COCI ≥ 0.38)—according to the distribution of scores in our sample. A multivariate Cox proportional hazards regression model was used to determine the demographic factors and comorbidities associated with the survival rate. Results Among all the relevant variables, low COCI, male sex, low socioeconomic status, no receipt of prior dental treatment before RT, residence outside northern Taiwan, chemotherapy receipt, and a history of diabetes increased the risk of mortality. Pre-RT dental evaluation and management was significantly associated with reduced post-RT mortality (adjusted hazard ratio [aHR] = 0.767, 95% confidence interval [CI] = 0.729–0.806, p < 0.001). Compared with patients with a high COCI, those with a low COCI exhibited an increased risk of mortality (aHR = 1.170, 95% CI = 1.093–1.252, p < 0.001). The mortality risk in the intermediate COC group was significantly higher than that in the high COC group (aHR = 1.194, 95% CI = 1.127–1.266, p < 0.001). To balance the distribution of the potential risk factors, propensity-score matching was used for the high COC (COCI > 0.38) and non-high COC (COCI ≤ 0.38) groups. After propensity-score matching, the mortality risk in the low and intermediate COC groups was also found to be significantly higher than that in the high COC group (aHR = 1.178, 95% CI = 1.074–1.292, p < 0.001 and aHR = 1.189, 95% CI = 1.107–1.277, p = 0.001, respectively). Conclusions In Taiwan, COC and prior dental treatment before RT significantly affected the survival rate of working-age patients with oral cancer. This result merits policymakers’ attention.
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Affiliation(s)
- Tsu Jen Kuo
- Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan.,Department of Dental Technology, Shu-Zen junior College of Medicine and Management, Kaohsiung, Taiwan
| | - Pei Chen Wu
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien, Taiwan
| | - Pei Ling Tang
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.,Department of Nursing, Meiho University, Pingtung, Taiwan.,College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Hao Yin
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chi Hsiang Chu
- Clinical Trial Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Institute of Statistics, National University of Kaohsiung, Kaohsiung, Taiwan
| | - Yao-Min Hung
- Department of Internal Medicine, Kaohsiung Municipal United Hospital, Kaohsiung, Taiwan.,School of Medicine, National Yang Ming University, Taipei, Taiwan.,Yuhing Junior College of Health Care and Management, Kaohsiung, Taiwan
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He Y, Wu YM, Yin CH, Geng YN, Yang SL, Kang LD. [Natural changes of high-risk HPV in women with negative for intraepithelial lesion or malignancy: a prospective 1 year study]. Zhonghua Fu Chan Ke Za Zhi 2018; 52:740-744. [PMID: 29179268 DOI: 10.3760/cma.j.issn.0529-567x.2017.11.005] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the natural changes of high-risk HPV (HR-HPV) in women with negative for intraepithelial lesion or malignancy (NILM) for regulating HR-HPV screening. Methods: Four hundred and thirty-three newly-diagnosed women were enrolled from January 1st, 2015 to December 31, 2015 in Beijing Obstetrics and Gynecology Hospital. The ages of these patients were between 22 and 74 years, the average age was (45±21) years old. Two hundred and sixty-three cases were less than 50 years old, 170 cases were more and equal to 50 years old. One hundred and fifty-six cases were HR-HPV positive, 277 cases were HR-HPV negative. Follow up tests were conducted for all 433 patients, who were screened by ThinPrep cytologic test (TCT) combined with HR-HPV and were diagnosed with NILM, for a period of 1 year (at the 3, 6, 9 and 12 months intervals respectively), if the TCT results are abnormal and the HR-HPV test results are positive, will follow up colposcopy directed cervical biopsy. Results: (1) HR-HPV natural changes: of 156 NILM cases with HR-HPV infection, 42 cases (26.9%, 42/156) turned negative within 3 months, 88 cases (56.4%, 88/156) turned negative within 6 months, 99 cases (63.5%, 99/156) turned negative within 9 months, and 100 cases (64.1%, 100/156) turned negative within 12 months. The negative conversion ratio at 3, 6, 9 and 12 months for women at childbearing age (<50 years) were significantly higher than those at non-childbearing age (≥50 years old; all P<0.05). Of 277 NILM cases without HR-HPV infection, 35 cases (12.6%, 35/277) had new HR-HPV positive infections within 3 months, 70 cases (25.3%, 70/277) had new infections within 6 months, 80 cases (28.9%, 80/277) had new infections within 9 months, and 83 cases (30.0%, 83/277) had new infections within 12 months. The new infections rate at 3, 6, 9 and 12 months for women at childbearing age (<50 years old) were slightly higher than those at non-childbearing age (≥50 years old; all P>0.05). (2) The progress of cervical leision: of 156 NILM cases with HR-HPV positive, no case progressed during 12 months follow-up. Of 277 NILM cases with HR-HPV negative, 4 cases progressed to cervical intraepithelial neoplaisa (CIN) with HR-HPV infection and TCT abnormal during 12 months follow-up, including 2 cases pathology diagnosed with CINⅠ, 1 case with CINⅡ, and 1 case with CINⅢ. The progression rate was 1.4%(4/277), which accounts for 4.8% (4/83) of new HR-HPV infections cases in women. Conclusions: The results of cytology combined with HR-HPV screenings suggest every 6 months for simple HR-HPV positive women, colposcopy directed cervical biopsy is recommended to assess cervical lesions if necessary. Cytology combined with HR-HPV screenings suggest every 12 months for simple HR-HPV negative women to early detection of cervical leision.
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Affiliation(s)
- Y He
- Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China
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Andre E, Yaniz-Galende E, Hamilton C, Dusting GJ, Hellen N, Poulet CE, Diez Cunado M, Smits AM, Lowe V, Eckardt D, Du Pre B, Sanz Ruiz R, Moerkamp AT, Tribulova N, Smani T, Liskova YV, Greco S, Guzzolino E, Franco D, Lozano-Velasco E, Knorr M, Pavoine C, Bukowska A, Van Linthout S, Miteva K, Sulzgruber P, Latet SC, Portnychenko A, Cannavo A, Kamilova U, Sagach VF, Santin Y, Octavia Y, Haller PM, Octavia Y, Rubies C, Dei Zotti F, Wong KHK, Gonzalez Miqueo A, Kruithof BPT, Kadur Nagaraju C, Shaposhnikova Y, Songia P, Lindner D, Wilson C, Benzoni P, Fabbri A, Campostrini G, Jorge E, Casini S, Mengarelli I, Nikolov A, Bublikov DS, Kheloufi M, Rubies C, Walker RE, Van Dijk RA, Posthuma JJ, Dumitriu IE, Karshovska E, Sakic A, Alexandru N, Martin-Lorenzo M, Molica F, Taylor RF, Mcarthur L, Crocini C, Matsuyama TA, Mazzoni L, Lin WK, Owen TJ, Scigliano M, Sheehan A, Bezerra Gurgel AR, Bromage DI, Kiss A, Ikeda G, Pickard JMJ, Wirth G, Casos K, Khudiakov A, Nistal JF, Ferrantini C, Park SJ, Di Maggio S, Gentile F, Dini L, Buyandelger B, Larrasa-Alonso J, Schirmer I, Chin SH, Cimiotti D, Martini H, Hohensinner PJ, Garabito M, Zeni F, Licholai S, De Bortoli M, Sivitskaya L, Viczenczova C, Rainer PP, Smith LE, Suna G, Gambardella J, Cozma A, De Gonzalo Calvo D, Scoditti E, Clark BJ, Mansfield C, Eckardt D, Gomez L, Llucia-Valldeperas A, De Pauw A, Porporato P, Bouzin C, Draoui N, Sonveaux P, Balligand JL, Mougenot N, Formicola L, Nadaud S, Dierick F, Hajjar RJ, Marazzi G, Sassoon D, Hulot JS, Zamora VR, Burton FL, Macquaide N, Smith GL, Hernandez D, Sivakumaran P, Millard R, Wong RCB, Pebay A, Shepherd RK, Lim SY, Owen T, Jabbour RJ, Kloc M, Kodagoda T, Denning C, Harding SE, Ramos S, Terracciano C, Gorelik J, Wei K, Bushway P, Ruiz-Lozano P, Mercola M, Moerkamp AT, Vegh AMD, Dronkers E, Lodder K, Van Herwaarden T, Goumans MJ, Pellet-Many C, Zachary I, Noack K, Bosio A, Feyen DAM, Demkes EJ, Dierickx PJ, Doevendans PA, Vos MA, Van Veen AAB, Van Laake LW, Fernandez Santos ME, Suarez Sancho S, Fuentes Arroyo L, Plasencia Martin V, Velasco Sevillano P, Casado Plasencia A, Climent AM, Guillem M, Atienza Fernandez F, Fernandez-Aviles F, Dingenouts CKE, Lodder K, Kruithof BPT, Van Herwaarden T, Vegh AMD, Goumans MJ, Smits AM, Knezl V, Szeiffova Bacova B, Egan Benova T, Viczenczova C, Goncalvesova E, Slezak J, Calderon-Sanchez E, Diaz I, Ordonez A, Salikova SP, Zaccagnini G, Voellenkle C, Sadeghi I, Maimone B, Castelvecchio S, Gaetano C, Menicanti L, Martelli F, Hatcher C, D'aurizio R, Groth M, Baugmart M, Mercatanti A, Russo F, Mariani L, Magliaro C, Pitto L, Lozano-Velasco E, Jodar-Garcia A, Galiano-Torres J, Lopez-Navarrete I, Aranega A, Wagensteen R, Quesada A, Aranega A, Franco D, Finger S, Karbach S, Kossmann S, Muenzel T, Wenzel P, Keck M, Mougenot N, Favier S, Fuand A, Atassi F, Barbier C, Lompre AM, Hulot JS, Nikonova Y, Pluteanu F, Kockskaemper J, Chilukoti RK, Wolke C, Lendeckel U, Gardemann A, Goette A, Miteva K, Pappritz K, Mueller I, El-Shafeey M, Ringe J, Tschoepe C, Pappritz K, El-Shafeey M, Ringe J, Tschoepe C, Van Linthout S, Koller L, Richter B, Blum S, Koprak M, Huelsmann M, Pacher R, Goliasch G, Wojta J, Niessner A, Van Herck PL, Claeys MJ, Haine SE, Lenders GD, Miljoen HP, Segers VF, Vandendriescche TR, Hoymans VY, Vrints CJ, Lapikova-Bryhinska T, Gurianova V, Portnichenko H, Vasylenko M, Zapara Y, Portnichenko V, Liccardo D, Lymperopoulos A, Santangelo M, Leosco D, Koch WJ, Ferrara N, Rengo G, Alieva T, Rasulova Z, Masharipova D, Dorofeyeva NA, Drachuk KO, Sicard P, Yucel Y, Dutaur M, Vindis C, Parini A, Mialet-Perez J, Van Deel ED, De Boer M, De Waard MC, Duncker DJ, Nagel F, Inci M, Santer D, Hallstroem S, Podesser BK, Kararigas G, De Boer M, Kietadisorn R, Swinnen M, Duimel H, Verheyen F, Chrifi I, Brandt MM, Cheng C, Janssens S, Moens AL, Duncker DJ, Batlle M, Dantas AP, Sanz M, Sitges M, Mont L, Guasch E, Lobysheva I, Beauloye C, Balligand JL, Vanhoutte PM, Tang EHC, Beaumont J, Lopez B, Ravassa S, Hermida N, Valencia F, Gomez-Doblas JJ, San Jose G, De Teresa E, Diez J, Van De Merbel AF, Kruithof-De Julio M, Goumans MJ, Claus P, Dries E, Angelo Singh A, Vermeulen K, Roderick HL, Sipido KR, Driesen RB, Ilchenko I, Bobronnikova L, Myasoedova V, Alamanni F, Tremoli E, Poggio P, Becher PM, Gotzhein F, Klingel K, Blankenberg S, Westermann D, Zi M, Cartwright E, Campostrini G, Bonzanni M, Milanesi R, Bucchi A, Baruscotti M, Difrancesco D, Barbuti A, Fantini M, Wilders R, Severi S, Benzoni P, Dell' Era P, Serzanti M, Olesen MS, Muneretto C, Bisleri G, Difrancesco D, Baruscotti M, Bucchi A, Barbuti A, Amoros-Figueras G, Raga S, Campos B, Alonso-Martin C, Rodriguez-Font E, Vinolas X, Cinca J, Guerra JM, Mengarelli I, Schumacher CA, Veldkamp MW, Verkerk AO, Remme CA, Veerman C, Guan K, Stauske M, Tan H, Barc J, Wilde A, Verkerk A, Bezzina C, Tsinlikov I, Tsinlikova I, Nicoloff G, Blazhev A, Garev A, Andrienko AV, Lychev VG, Vorobova EN, Anchugina DA, Vion AC, Hammoutene A, Poisson J, Dupont N, Souyri M, Tedgui A, Codogno P, Boulanger CM, Rautou PE, Dantas AP, Batlle M, Guasch E, Torres M, Montserrat JM, Almendros I, Mont L, Austin CA, Holt CM, Rijs K, Wezel A, Hamming JF, Kolodgie FD, Virmani R, Schaapherder AF, Lindeman JHN, Posma JJN, Van Oerle R, Spronk HMH, Ten Cate H, Dinkla S, Kaski JC, Schober A, Chaabane C, Ambartsumian N, Grigorian M, Bochaton-Piallat ML, Dragan E, Andrei E, Niculescu L, Georgescu A, Gonzalez-Calero L, Maroto AS, Martinez PJ, Heredero A, Aldamiz-Echevarria G, Vivanco F, Alvarez-Llamas G, Meens MJ, Pelli G, Foglia B, Scemes E, Kwak BR, Caldwell JL, Eisner DA, Dibb KM, Trafford AW, Chilton L, Smith GL, Nicklin SA, Coppini R, Ferrantini C, Yan P, Loew LM, Poggesi C, Cerbai E, Pavone FS, Sacconi L, Tanaka H, Ishibashi-Ueda H, Takamatsu T, Coppini R, Ferrantini C, Gentile F, Pioner JM, Santini L, Sartiani L, Bargelli V, Poggesi C, Mugelli A, Cerbai E, Maciejewska M, Bolton EL, Wang Y, O'brien F, Ruas M, Lei M, Sitsapesan R, Galione A, Terrar DA, Smith JG, Garcia D, Barriales-Villa R, Monserrat L, Harding SE, Denning C, Marston SB, Watson S, Tkach S, Faggian G, Terracciano CM, Perbellini F, Eiros Zamora J, Papadaki M, Messer A, Marston S, Gould I, Johnston A, Dunne M, Smith G, Kemi OJ, Pillai M, Davidson SM, Yellon DM, Tratsiakovich Y, Jang J, Gonon AT, Pernow J, Matoba T, Koga J, Egashira K, Burke N, Davidson SM, Yellon DM, Korpisalo P, Hakkarainen H, Laidinen S, Yla-Herttuala S, Ferrer-Curriu G, Perez M, Permanyer E, Blasco-Lucas A, Gracia JM, Castro MA, Barquinero J, Galinanes M, Kostina D, Kostareva A, Malashicheva A, Merino D, Ruiz L, Gomez J, Juarez C, Gil A, Garcia R, Hurle MA, Coppini R, Pioner JM, Gentile F, Mazzoni L, Rossi A, Tesi C, Belardinelli L, Olivotto I, Cerbai E, Mugelli A, Poggesi C, Eun-Ji EJ, Lim BK, Choi DJ, Milano G, Bertolotti M, De Marchis F, Zollo F, Sommariva E, Capogrossi MC, Pompilio G, Bianchi ME, Raucci A, Pioner JM, Coppini R, Scellini B, Tardiff J, Tesi C, Poggesi C, Ferrantini C, Mazzoni L, Sartiani L, Coppini R, Diolaiuti L, Ferrari P, Cerbai E, Mugelli A, Mansfield C, Luther P, Knoell R, Villalba M, Sanchez-Cabo F, Lopez-Olaneta MM, Ortiz-Sanchez P, Garcia-Pavia P, Lara-Pezzi E, Klauke B, Gerdes D, Schulz U, Gummert J, Milting H, Wake E, Kocsis-Fodor G, Brack KE, Ng GA, Kostareva A, Smolina N, Majchrzak M, Moehner D, Wies A, Milting H, Stehle R, Pfitzer G, Muegge A, Jaquet K, Maggiorani D, Lefevre L, Dutaur M, Mialet-Perez J, Parini A, Cussac D, Douin-Echinard V, Ebenbauer B, Kaun C, Prager M, Wojta J, Rega-Kaun G, Costa G, Onetti Y, Jimenez-Altayo F, Vila E, Dantas AP, Milano G, Bertolotti M, Scopece A, Piacentini L, Bianchi ME, Capogrossi MC, Pompilio G, Colombo G, Raucci A, Blaz M, Kapelak B, Sanak M, Bauce B, Calore C, Lorenzon A, Calore M, Poloni G, Mazzotti E, Rigato I, Daliento L, Basso C, Thiene G, Melacini P, Corrado D, Rampazzo A, Danilenko NG, Vaikhanskaya TG, Davydenko OG, Szeiffova Bacova B, Kura B, Egan Benova T, Yin CH, Kukreja R, Slezak J, Tribulova N, Lee DI, Sorge M, Glabe C, Paolocci N, Guarnieri C, Tomaselli GF, Kass DA, Van Eyk JE, Agnetti G, Cordwell SJ, White MY, Wojakowski W, Lynch M, Barallobre-Barreiro J, Yin X, Mayr U, White S, Jahingiri M, Hill J, Mayr M, Sorriento D, Ciccarelli M, Fiordelisi A, Campiglia P, Trimarco B, Iaccarino G, Sitar Taut AV, Schiau S, Orasan O, Halloumi W, Negrean V, Zdrenghea D, Pop D, Van Der Meer RW, Rijzewijk LJ, Smit JWA, Revuelta-Lopez E, Nasarre L, Escola-Gil JC, Lamb HJ, Llorente-Cortes V, Pellegrino M, Massaro M, Carluccio MA, Calabriso N, Wabitsch M, Storelli C, De Caterina R, Church SJ, Callagy S, Begley P, Kureishy N, Mcharg S, Bishop PN, Unwin RD, Cooper GJS, Mawad D, Perbellini F, Tonkin J, Bello SO, Simonotto JD, Lyon AR, Stevens MM, Terracciano CM, Harding SE, Kernbach M, Czichowski V, Bosio A, Fuentes L, Hernandez-Redondo I, Guillem MS, Fernandez ME, Sanz R, Atienza F, Climent AM, Fernandez-Aviles F, Soler-Botija C, Prat-Vidal C, Galvez-Monton C, Roura S, Perea-Gil I, Bragos R, Bayes-Genis A. Poster session 1Cell growth, differentiation and stem cells - Heart72Understanding the metabolism of cardiac progenitor cells: a first step towards controlling their proliferation and differentiation?73Expression of pw1/peg3 identifies a new cardiac adult stem cell population involved in post-myocardial infarction remodeling74Long-term stimulation of iPS-derived cardiomyocytes using optogenetic techniques to promote phenotypic changes in E-C coupling75Benefits of electrical stimulation on differentiation and maturation of cardiomyocytes from human induced pluripotent stem cells76Constitutive beta-adrenoceptor-mediated cAMP production controls spontaneous automaticity of human induced pluripotent stem cell-derived cardiomyocytes77Formation and stability of T-tubules in cardiomyocytes78Identification of miRNAs promoting human cardiomyocyte proliferation by regulating Hippo pathway79A direct comparison of foetal to adult epicardial cell activation reveals distinct differences relevant for the post-injury response80Role of neuropilins in zebrafish heart regeneration81Highly efficient immunomagnetic purification of cardiomyocytes derived from human pluripotent stem cells82Cardiac progenitor cells posses a molecular circadian clock and display large 24-hour oscillations in proliferation and stress tolerance83Influence of sirolimus and everolimus on bone marrow-derived mesenchymal stem cell biology84Endoglin is important for epicardial behaviour following cardiac injuryCell death and apoptosis - Heart87Ultrastructural alterations reflecting Ca2+ handling and cell-to-cell coupling disorders precede occurrence of severe arrhythmias in intact animal heart88Urocortin-1 promotes cardioprotection through ERK1/2 and EPAC pathways: role in apoptosis and necrosis89Expression p38 MAPK and Cas-3 in myocardium LV of rats with experimental heart failure at melatonin and enalapril introductionTranscriptional control and RNA species - Heart92Accumulation of beta-amyloid 1-40 in HF patients: the role of lncRNA BACE1-AS93Role of miR-182 in zebrafish and mouse models of Holt-Oram syndrome94Mir-27 distinctly regulates muscle-enriched transcription factors and growth factors in cardiac and skeletal muscle cells95AF risk factors impair PITX2 expression leading to Wnt-microRNA-ion channel remodelingCytokines and cellular inflammation - Heart98Post-infarct survival depends on the interplay of monocytes, neutrophils and interferon gamma in a mouse model of myocardial Infarction99Inflammatory cd11b/c cells play a protective role in compensated cardiac hypertrophy by promoting an orai3-related pro-survival signal100Anti-inflammatory effects of endothelin receptor blockade in the atrial tissue of spontaneously hypertensive rats101Mesenchymal stromal cells reduce NLRP3 inflammasome activity in Coxsackievirus B3-induced myocarditis102Mesenchymal stromal cells modulate monocytes trafficking in Coxsackievirus B3-induced myocarditis103The impact of regulatory T lymphocytes on long-term mortality in patients with chronic heart failure104Temporal dynamics of dendritic cells after ST-elevation myocardial infarction relate with improvement of myocardial functionGrowth factors and neurohormones - Heart107Preconditioning of hypertrophied heart: miR-1 and IGF-1 crosstalk108Modulation of catecholamine secretion from human adrenal chromaffin cells by manipulation of G protein-coupled receptor kinase-2 activity109Evaluation of cyclic adenosin-3,5- monophosphate and neurohormones in patients with chronic heart failureNitric oxide and reactive oxygen species - Heart112Hydrogen sulfide donor inhibits oxidative and nitrosative stress, cardiohemodynamics disturbances and restores cNOS coupling in old rats113Role and mechanisms of action of aldehydes produced by monoamine oxidase A in cardiomyocyte death and heart failure114Exercise training has contrasting effects in myocardial infarction and pressure-overload due to different endothelial nitric oxide synthase regulation115S-Nitroso Human Serum Albumin dose-dependently leads to vasodilation and alters reactive hyperaemia in coronary arteries of an isolated mouse heart model116Modulating endothelial nitric oxide synthase with folic acid attenuates doxorubicin-induced cardiomyopathy119Effects of long-term very high intensity exercise on aortic structure and function in an animal model120Electron paramagnetic resonance spectroscopy quantification of nitrosylated hemoglobin (HbNO) as an index of vascular nitric oxide bioavailability in vivo121Deletion of repressor activator protein 1 impairs acetylcholine-induced relaxation due to production of reactive oxygen speciesExtracellular matrix and fibrosis - Heart124MicroRNA-19b is associated with myocardial collagen cross-linking in patients with severe aortic stenosis. Potential usefulness as a circulating biomarker125A new ex vivo model to study cardiac fibrosis126Heterogeneity of fibrosis and fibroblast differentiation in the left ventricle after myocardial infarction127Effect of carbohydrate metabolism degree compensation to the level of galectin-3 changes in hypertensive patients with chronic heart failure and type 2 diabetes mellitus128Statin paradox in association with calcification of bicuspid aortic valve interstitial cells129Cardiac function remains impaired despite reversible cardiac fibrosis after healed experimental viral myocarditisIon channels, ion exchangers and cellular electrophysiology - Heart132Identifying a novel role for PMCA1 (Atp2b1) in heart rhythm instability133Mutations of the caveolin-3 gene as a predisposing factor for cardiac arrhythmias134The human sinoatrial node action potential: time for a computational model135iPSC-derived cardiomyocytes as a model to dissect ion current alterations of genetic atrial fibrillation136Postextrasystolic potentiation in healthy and diseased hearts: effects of the site of origin and coupling interval of the preceding extrasystole137Absence of Nav1.8-based (late) sodium current in rabbit cardiomyocytes and human iPSC-CMs138hiPSC-derived cardiomyocytes from Brugada Syndrome patients without identified mutations do not exhibit cellular electrophysiological abnormalitiesMicrocirculation141Atherogenic indices, collagen type IV turnover and the development of microvascular complications- study in diabetics with arterial hypertension142Changes in the microvasculature and blood viscosity in women with rheumatoid arthritis, hypercholesterolemia and hypertensionAtherosclerosis145Shear stress regulates endothelial autophagy: consequences on endothelial senescence and atherogenesis146Obstructive sleep apnea causes aortic remodeling in a chronic murine model147Aortic perivascular adipose tissue displays an aged phenotype in early and late atherosclerosis in ApoE-/- mice148A systematic evaluation of the cellular innate immune response during the process of human atherosclerosis149Inhibition of Coagulation factor Xa increases plaque stability and attenuates the onset and progression of atherosclerotic plaque in apolipoprotein e-deficient mice150Regulatory CD4+ T cells from patients with atherosclerosis display pro-inflammatory skewing and enhanced suppression function151Hypoxia-inducible factor (HIF)-1alpha regulates macrophage energy metabolism by mediating miRNAs152Extracellular S100A4 is a key player of smooth muscle cell phenotypic transition: implications in atherosclerosis153Microparticles of healthy origins improve atherosclerosis-associated endothelial progenitor cell dysfunction via microRNA transfer154Arterial remodeling and metabolism impairment in early atherosclerosis155Role of pannexin1 in atherosclerotic plaque formationCalcium fluxes and excitation-contraction coupling158Amphiphysin II induces tubule formation in cardiac cells159Interleukin 1 beta regulation of connexin 43 in cardiac fibroblasts and the effects of adult cardiac myocyte:fibroblast co-culture on myocyte contraction160T-tubular electrical defects contribute to blunted beta-adrenergic response in heart failure161Beat-to-beat variability of intracellular Ca2+ dynamics of Purkinje cells in the infarct border zone of the mouse heart revealed by rapid-scanning confocal microscopy162The efficacy of late sodium current blockers in hypertrophic cardiomyopathy is dependent on genotype: a study on transgenic mouse models with different mutations163Synthesis of cADPR and NAADP by intracellular CD38 in heart: role in inotropic and arrhythmogenic effects of beta-adrenoceptor signalingContractile apparatus166Towards an engineered heart tissue model of HCM using hiPSC expressing the ACTC E99K mutation167Diastolic mechanical load delays structural and functional deterioration of ultrathin adult heart slices in culture168Structural investigation of the cardiac troponin complex by molecular dynamics169Exercise training restores myocardial and oxidative skeletal muscle function from myocardial infarction heart failure ratsOxygen sensing, ischaemia and reperfusion172A novel antibody specific to full-length stromal derived factor-1 alpha reveals that remote conditioning induces its cleavage by endothelial dipeptidyl peptidase 4173Attenuation of myocardial and vascular arginase activity by vagal nerve stimulation via a mechanism involving alpha-7 nicotinic receptor during cardiac ischemia and reperfusion174Novel nanoparticle-mediated medicine for myocardial ischemia-reperfusion injury simultaneously targeting mitochondrial injury and myocardial inflammation175Acetylcholine plays a key role in myocardial ischaemic preconditioning via recruitment of intrinsic cardiac ganglia176The role of nitric oxide and VEGFR-2 signaling in post ischemic revascularization and muscle recovery in aged hypercholesterolemic mice177Efficacy of ischemic preconditioning to protect the human myocardium: the role of clinical conditions and treatmentsCardiomyopathies and fibrosis180Plakophilin-2 haploinsufficiency leads to impaired canonical Wnt signaling in ARVC patient181Improved technique for customized, easier, safer and more reliable transverse aortic arch banding and debanding in mice as a model of pressure overload hypertrophy182Late sodium current inhibitors for the treatment of inducible obstruction and diastolic dysfunction in hypertrophic cardiomyopathy: a study on human myocardium183Angiotensin II receptor antagonist fimasartan has protective role of left ventricular fibrosis and remodeling in the rat ischemic heart184Role of High-Mobility Group Box 1 (HMGB1) redox state on cardiac fibroblasts activities and heart function after myocardial infarction185Atrial remodeling in hypertrophic cardiomyopathy: insights from mouse models carrying different mutations in cTnT186Electrophysiological abnormalities in ventricular cardiomyocytes from a Maine Coon cat with hypertrophic cardiomyopathy: effects of ranolazine187ZBTB17 is a novel cardiomyopathy candidate gene and regulates autophagy in the heart188Inhibition of SRSF4 in cardiomyocytes induces left ventricular hypertrophy189Molecular characterization of a novel cardiomyopathy related desmin frame shift mutation190Autonomic characterisation of electro-mechanical remodeling in an in-vitro leporine model of heart failure191Modulation of Ca2+-regulatory function by three novel mutations in TNNI3 associated with severe infant restrictive cardiomyopathyAging194The aging impact on cardiac mesenchymal like stromal cells (S+P+)195Reversal of premature aging markers after bariatric surgery196Sex-associated differences in vascular remodeling during aging: role of renin-angiotensin system197Role of the receptor for advanced glycation end-products (RAGE) in age dependent left ventricle dysfunctionsGenetics and epigenetics200hsa-miR-21-5p as a key factor in aortic remodeling during aneurysm formation201Co-inheritance of mutations associated with arrhythmogenic and hypertrophic cardiomyopathy in two Italian families202Lamin a/c hot spot codon 190: form various amino acid substitutions to clinical effects203Treatment with aspirin and atorvastatin attenuate cardiac injury induced by rat chest irradiation: Implication of myocardial miR-1, miR-21, connexin-43 and PKCGenomics, proteomics, metabolomics, lipidomics and glycomics206Differential phosphorylation of desmin at serines 27 and 31 drives the accumulation of preamyloid oligomers in heart failure207Potential role of kinase Akt2 in the reduced recovery of type 2 diabetic hearts subjected to ischemia / reperfusion injury208A proteomics comparison of extracellular matrix remodelling in porcine coronary arteries upon stent implantationMetabolism, diabetes mellitus and obesity211Targeting grk2 as therapeutic strategy for cancer associated to diabetes212Effects of salbutamol on large arterial stiffness in patients with metabolic syndrome213Circulating microRNA-1 and microRNA-133a: potential biomarkers of myocardial steatosis in type 2 diabetes mellitus214Anti-inflammatory nutrigenomic effects of hydroxytyrosol in human adipocytes - protective mechanisms of mediterranean diets in obesity-related inflammation215Alterations in the metal content of different cardiac regions within a rat model of diabetic cardiomyopathyTissue engineering218A novel conductive patch for application in cardiac tissue engineering219Establishment of a simplified and improved workflow from neonatal heart dissociation to cardiomyocyte purification and characterization220Effects of flexible substrate on cardiomyocytes cell culture221Mechanical stretching on cardiac adipose progenitors upregulates sarcomere-related genes. Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Xu QQ, Yan H, Liu XL, Lv L, Yin CH, Wang P. Growth performance and meat quality of broiler chickens supplemented with Rhodopseudomonas palustris in drinking water. Br Poult Sci 2014; 55:360-6. [PMID: 24628388 DOI: 10.1080/00071668.2014.903326] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
1. The effect of the bacterium, Rhodopseudomonas palustris, on the growth performance and meat quality of broiler chickens was investigated. 2. A total of 900-d-old Arbor Acres broilers were allocated to three experimental treatments for 6 weeks. Chicks were administered with R. palustris in drinking water as follows: (i) control group without R. palustris; (ii) treatment 1 (R1) with R. palustris of 8 × 10(9) cells per chick per day in drinking water; (iii) treatment 2 (R2) with R. palustris of 1.6 × 10(10) cells per chick per day in drinking water. 3. The results showed that, compared with that of control, both groups of R. palustris treatment increased daily weight gain and improved feed conversion ratio of broiler chickens significantly during the whole growing period of 6 weeks. 4. Both total and glutamic acid contents of chicken breast fillet in R. palustris treatment R2 were higher, while the fat content was lower, than those of the control group. Furthermore, R. palustris treatments also improved sensory attributes of chicken breast fillet. 5. As a probiotic providing rich nutrients and biological active substances, R. palustris administration in drinking water displayed a growth promoting effect and improved meat quality of broiler chickens.
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Affiliation(s)
- Q Q Xu
- a School of Chemistry and Biological Engineering , University of Science and Technology Beijing , Beijing 100083 , China
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Pang CP, Poon PM, Chen QL, Lai KY, Yin CH, Zhao Z, Zhong N, Lau CH, Lam ST, Wong CK, Brown WT. Trinucleotide CGG repeat in the FMR1 gene in Chinese mentally retarded patients. Am J Med Genet 1999. [PMID: 10331586 DOI: 10.1002/(sici)1096-8628(19990528)84] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The fragile X syndrome of mental retardation is related to the number of trinucleotide CGG repeats at the 5'-untranslated region of the FMR1 gene located on the X-chromosome. We have studied X-chromosomes from 649 unaffected Chinese subjects and 324 patients with mild mental retardation. All study subjects were unrelated. The CGG repeat number was analysed by electrophoresis of a polymerase chain reaction followed by gel transfer and hybridisation with a 32P-labeled (CCG)5 probe. The DNA samples having detectable CGG expansion were further analysed by Southern blot analysis with probe StB12.3 after restriction digestion by EcoR I and Eag I. For the unaffected Chinese subjects, a different distribution pattern of CGG allele size from Caucasians was observed. It was a bimodal pattern and the CGG repeat number ranged from 19 to 54. The most common CGG repeat allele was 29 compared with 30 in Caucasians. The second mode appeared at 36 repeats. There was mild statistical difference in the repeat patterns between the mentally retarded patients and unaffected subjects, although the essential features were similar. Among the mentally retarded patients, one male had an unmethylated full mutation and one female had a full mutation. The fragile X prevalence was 0.6%, which is lower than two previous studies in Chinese mentally retarded patients utilising cytogenetic analysis. Our results indicate that a large-scale screening program would be worthwhile to determine the prevalence of the fragile X syndrome in the Chinese population.
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Affiliation(s)
- C P Pang
- Department of Ophthalmology & Visual Sciences, the Chinese University of Hong Kong, Shatin, NT.
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Huang HS, Ito K, Yin CH, Kabashima T, Yoshimoto T. Cloning, sequencing, high expression, and crystallization of the thermophile Thermus aquaticus glycerol kinase. Biosci Biotechnol Biochem 1998; 62:2375-81. [PMID: 9972264 DOI: 10.1271/bbb.62.2375] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Glycerol kinase (EC 2.7.1.30) is a key enzyme of glycerol uptake and metabolism in bacteria. Using PCR, we amplified and cloned a glycerol kinase gene, glpK, from Thermus aquaticus. The complete gene has 1488 base pairs, coding for a protein of 496 amino acids with a predicted molecular weight of 54,814. The amino acid sequence deduced from T. aquaticus glpK was found to have identities of 97 and 81%, respectively, with those of Thermus flavus and Bacillus subtilis glpK genes. After overproduction in Escherichia coli, the expressed enzyme was easily purified to homogeneity by DEAE-Toyopearl chromatography. The purified enzyme has been crystallized by the hanging drop vapor diffusion method at 22 degrees C. Comparison of the amino acid sequence with that of the B. subtilis enzyme showed that Ser and Lys are replaced by Ala and Arg, as was seen in mesophile and thermophile enzymes.
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Affiliation(s)
- H S Huang
- School of Pharmaceutical Sciences, Nagasaki University, Japan
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Huang HS, Kabashima T, Ito K, Yin CH, Nishiya Y, Kawamura Y, Yoshimoto T. Thermostable glycerol kinase from Thermus flavus: cloning, sequencing, and expression of the enzyme gene. Biochim Biophys Acta 1998; 1382:186-90. [PMID: 9540790 DOI: 10.1016/s0167-4838(97)00206-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The thermostable glycerol kinase (EC 2.7.1.30) gene from Thermus flavus was cloned and expressed in Escherichia coli DH5 alpha. An open reading frame of 1488 bp for the glycerol kinase gene (glpK) starting with an ATG methionine codon was found, which encodes a protein of 496 amino acid residues whose calculated molecular weight is 54,835. The amino acid sequence of T. flavus glycerol kinase is 80.6% and 64.1% identical with those of Bacillus subtilis and E. coli. Transformants of E. coli DH5 alpha harboring plasmid pGYK12 with a 1505 bp chromosomal DNA fragment containing the T. flavus glycerol kinase gene showed about 23.8-fold higher glycerol kinase activity than T. flavus.
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Affiliation(s)
- H S Huang
- School of Pharmaceutical Sciences, Nagasaki University, Japan
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