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Taichung, Taiwan

Hsu T.-C.,Chiayi Branch | Wang J.-D.,Taichung Veterans General Hospital | Wang J.-D.,National Yang Ming University | Wang J.-D.,China Medical University at Taichung | And 5 more authors.
Pediatrics and Neonatology

Background: Hemangioma in infants has a benign self-limited course, but the 10% of cases with complications need further treatment. Successful treatment with propranolol in western countries has been reported over the past few years. We evaluated the efficacy of propranolol for treating infantile hemangioma in Taiwanese newborns and young infants. Methods: Patients below 1 year of age treated with propanolol between November 2009 and March 2011 were enrolled. Demographic data, clinical features, imaging findings, treatment regimens of propranolol, and outcome were investigated. Results: Thirteen patients were treated with propranolol at a dose of 2-3 mg/kg/day. Seven (53.8%) patients had solitary hemangioma and six had multiple ones. The indications for treatment were risk of local event in nine patients, functional risk in four, local complication in one, and life-threatening complication in one. The median age for starting propranolol was 4 months (range: 1-11 months). Responses to propranolol, such as decolorization, regression in tumor size, or improvement of hemangioma-associated complications were observed in all patients within 1-2 weeks after treatment. Propranolol-associated adverse effects occurred in two patients. One infant had occasional tachypnea, and the other had occasional pale-looking appearance. The symptoms resolved after dosage tapering. Conclusion: Propranolol may be a promising therapeutic modality for infantile hemangioma. Therapeutic strategies are needed to evaluate the optimal treatment protocol and long-term adverse effects. Copyright © 2012, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved. Source

Hsu Y.-C.,Chiayi Branch | Chen C.-H.,Taichung Veterans General Hospital | Chen C.-H.,National Yang Ming University | Chen C.-H.,China Medical University at Taichung | And 4 more authors.
Pediatrics and Neonatology

Background The primary aim of the study was to investigate the changes in composition of breast milk from mothers with preterm infants (gestation age < 35 weeks) during the first 4-6 weeks of lactation.Methods Breast milk from 17 mothers who had delivered preterm infants was collected longitudinally for 4-6 weeks. Breast milk from 15 mothers of full-term infants was also collected at the 1st week and 4th week. Fat, protein, lactose, energy, minerals (calcium and phosphate), and immune components [secretory immunoglobulin A (IgA), leptin, lysozyme, and lactoferrin] content were measured weekly in each participant. A mid-infrared human milk analyzer was used to measure the protein, fat, and lactose contents. Calcium and phosphate components were checked via spectrophotometry. The concentrations of major immune components (secretory IgA, lactoferrin, lysozyme, and leptin) were quantified using enzyme-linked immunosorbent assay kits.Results Eighty samples from 17 preterm mothers were collected. The mean gestational age was 29.88 ± 2.39 weeks. There were significant changes in nutrient components during these periods, with increases in lactose (p < 0.001), lipid (p = 0.001), calorie (p = 0.012), and phosphate (p = 0.022) concentration and decreases in protein (p < 0.001) and secretory IgA (p < 0.001) concentration. There were no differences in calcium (p = 0.919), lactoferrin (p = 0.841), leptin (p = 0.092), and lysozyme (p = 0.561) levels. Furthermore, there were no significant differences in most components of breast milk between full-term and preterm mothers.Conclusion The longitudinal study revealed significant changes in macronutrient contents and secretory IgA concentration in preterm milk over the 4-6 week period, which is compatible with the results of previous studies. The quantification of phosphate in preterm breast milk was lower than the normal range, suggesting that close monitoring of body bone mass may be indicated. More studies are warranted to evaluate the clinical significance of alterations of major milk components during the postnatal stage. © 2014, Taiwan Pediatric Association. Published by Elsevier Taiwan LLC. All rights reserved. Source

Tsai K.-Y.,Municipal Kaohsiung Kai Syuan Psychiatric Hospital | Tsai K.-Y.,Meiho University | Lee C.-C.,Buddhist Dalin Tzu Chi General Hospital | Lee C.-C.,Tzu Chi University | And 8 more authors.
Schizophrenia Research

Objective: The aim of the study is to explore the incidence and the risks associated with major osteoporotic fractures, all-cause mortality with osteoporotic fractures and the effect of the psychiatric drug exposure in patients with schizophrenia during a 10-year follow-up period. Methods: Two nationwide cohorts were selected from the Taiwan National Health Insurance Research Database (NHIRD) consisting of 30,335 patients with schizophrenia (age ≥ 40 years) and 121,340 age- and sex-matched control participants without schizophrenia. The psychiatric proportion of days covered (PDC) is an indicator of the intensity of drug exposure in patients with schizophrenia. The incidence and risk factors of major osteoporotic fractures were calculated for both cohorts. Additionally, the patient survival rate after major osteoporotic fractures was also calculated. Results: During a 10-year follow-up period, 1677 (5.53%) schizophrenia and 4257 (3.51%) control subjects had major osteoporotic fractures (P < 0.001). The schizophrenia patients with a PDC > 0.1 showed a significantly higher incidence of major osteoporotic fractures than did the non-schizophrenia controls; however, those with a psychiatric PDC ≤ 0.1 did not. After adjustment, the psychiatric PDC was significantly and independently associated with the risk of major osteoporotic fractures except some medical morbidities but the schizophrenia diagnosis was not. In addition, among all 5934 patients with major osteoporotic fracture, the adjusted mortality hazard ratio for psychiatric PDC was 1.92 (95% CI = 1.63-2.26). Conclusions: Patients with schizophrenia are at a higher risk for major osteoporotic fractures than the general population and also have a higher mortality rate due to major osteoporotic fractures. These findings may be caused by psychiatric drug use rather than schizophrenia, which suggests that directions can be taken in future studies. © 2014 Elsevier B.V. Source

Chiang H.-L.,National Taiwan University Hospital | Chiang H.-L.,National Taiwan University | Liu C.-J.,Taipei Veterans General Hospital | Liu C.-J.,National Yang Ming University | And 10 more authors.
Journal of Pediatrics

Objectives To investigate whether individuals with autism have an increased risk for cancer relative to the general population. Study design We enrolled patients with autistic disorder from the Taiwan National Health Insurance database in years 1997-2011. A total of 8438 patients diagnosed with autism were retrieved from the Registry for Catastrophic Illness Patients database. The diagnosis of cancers was also based on the certificate of catastrophic illness, which requires histological confirmation. The risk of cancer among the autism cohort was determined with a standardized incidence ratio (SIR). Results During the observation period, cancer occurred in 20 individuals with autism, which was significantly higher than a total number of expected cancers with a SIR estimate of 1.94 (95% CI 1.18-2.99). The number of cancer in males was greater than the expected number with a SIR of 1.95 (1.11-3.16), but no excess risk was found for females with a SIR of 1.91 (0.52-4.88). Cancer developed more than expected in individuals age 15-19 years with the SIR of 3.58 (1.44-7.38), but did not differ in other age range groups. The number of cancers of genitourinary system was significantly in excess of the expected number (SIR 4.15; 95% CI 1.13-10.65), and increased risk was found in ovarian cancer with SIR of 9.21 (1.12-33.29). Conclusions Our study demonstrated that patients with autistic disorder have an increased risk of cancer. © 2015 Elsevier Inc. Source

Li H.-H.,University of Mobile | Luo M.-H.,Chiayi Branch | Liao Y.-H.,Fujian University of Technology
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics)

People haven’t enough activity and bad eating habits in a busy life. And, people aren’t understanding nutrition health knowledge for foods and drink. People suffering from obesity and chronic disease risk are relatively high. People how to learn nutrition health knowledge are very important for reducing those risks. But, the applying of nutrition health education general is speech communication by nurse at the hospital. That learning situated is short time. People cannot enough understanding information. So, this paper proposed the use of mobile application to perform nutrition health education. When people or patients need health knowledge, they can use application system on the mobile device to get relation information anytime anywhere. Because the contents of nutrition health education are very large and complex, it’s impossible what people or patients want understanding at a short time. Therefore, this application can to apply people focusing on self-requirement to get relation information. © Springer International Publishing Switzerland 2016. Source

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