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Chen S.C.-C.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Lin H.-J.,Chi Mei Medical Center | Lin H.-J.,Chia Nan University of Pharmacy and Science | Chen Y.-W.,Landseed Hospital | And 3 more authors.
Stroke | Year: 2013

Background and Purpose-Various risk score models have been developed to predict symptomatic intracerebral hemorrhage (SICH) after intravenous thrombolysis for acute ischemic stroke. In this study, we aimed to determine the prediction performance of these risk scores in a Taiwanese population Methods-Prospectively collected data from 4 hospitals were used to calculate probability of SICH with the scores developed by Cucchiara et al, the Hemorrhage After Thrombolysis (HAT) score, the Safe Implementation of Thrombolysis in Stroke-SICH risk score, the Glucose Race Age Sex Pressure Stroke Severity score, and the Stroke Prognostication using Age and National Institutes of Health Stroke Scale-100 index. We used logistic regression to evaluate the effectiveness of each risk model in predicting SICH and the c statistic to assess performance. Results-A total of 548 patients were included. The rates of SICH were 7.3% by the National Institute of Neurological Diseases and Stroke definition, 5.3% by the European-Australasian Cooperative Acute Stroke Study II definition, and 3.5% by the Safe Implementation of Thrombolysis in Stroke-Monitoring Study definition. The Cucchiara score, the HAT score, and the Safe Implementation of Thrombolysis in Stroke-SICH risk score were significant predictors of SICH for all 3 definitions, whereas the Glucose Race Age Sex Pressure Stroke Severity score and the Stroke Prognostication using Age and National Institutes of Health Stroke Scale-100 index predicted well only for 1 or 2 definitions of SICH. The c statistic was highest for the HAT score (range, 0.69-0.73) across the definitions of SICH. Conclusions-The Cucchiara score, the HAT score, and the Safe Implementation of Thrombolysis in Stroke-SICH risk score predicted SICH reasonably well regardless of which SICH definition was used. However, only the HAT score had an acceptable discriminatory ability. © 2013 American Heart Association, Inc.

Liou S.-R.,Chang Gung University | Wang P.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Cheng C.-Y.,Chang Gung University
Women and Birth | Year: 2016

Background: Adverse effects of maternal mental distress during pregnancy have been extensively investigated, but the impact of prenatal maternal mental distress at various time periods during pregnancy on birth outcomes is rarely discussed. By understanding the relationship between maternal mental distress and unfavourable birth outcomes throughout pregnancy, appropriate evidence-based preventative care or intervention may be adopted in a timely manner. Aim: This study intended to investigate the effects of maternal stress, anxiety, and depressive symptoms across pregnancy on preterm birth and low birth weight. Methods: With a prospective longitudinal design, this study used the 10-item Perceived Stress Scale, Center for Epidemiologic Studies Depression Scale, and Zung Self-reported Anxiety Scale to investigate 197 participants who, at greater than 24 gestational weeks, completed the self-administered questionnaires during regular checkups in a hospital in southern Taiwan. Descriptive statistics, Mann-Whitney U test/Kruskal-Wallis test, and hierarchical logistic regression were applied for data analysis. Findings: The study found that anxiety and depressive symptoms at 25-29 gestational weeks could predict preterm birth, and that anxiety at greater than 30 gestational weeks was able to predict low birthweight. However, stress was not able to predict any kind of negative birth outcomes. Conclusion: Adverse birth outcomes were somewhat predictable by maternal mental distress; therefore, we suggested that prenatal visits incorporate psychological assessment for early detection and management to prevent possible adverse birth outcomes. © 2016 Australian College of Midwives.

Chen J.-J.,Taipei Medical University | Hsu Y.-C.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Chen D.-L.,G Home Clinic
Journal of Headache and Pain | Year: 2012

Hormonal changes related to the menstrual cycle have a great impact on migraines in women. Menstrual migraine attacks are almost invariably without aura. Categorizing migraines into menstrual or non-menstrual types is one way to stratify migraines without aura according to the appendix criteria of the International Classification of Headache Disorders. We report a peri-menopausal woman whose sensory aura exclusively heralded menstrual migraine. A 51-year-old woman had suffered from monthly episodic headaches since the age of 46. Before a headache, and within 1 h on the first day of her menstruation, she always experienced numbness in her entire left upper limb. After the sensory aura, migrainous headaches occurred with nausea and photophobia. In the postmenopausal period, she no longer had sensory aura, and her headache pattern changed and became less severe. Her physical and neurologic exams as well as electroencephalography, brain magnetic resonance imaging, and conventional angiography were all normal. She fulfilled the diagnosis of pure menstrual migraine with typical sensory aura. To our knowledge, this is the first formal case report of pure menstrual migraine with aura. © The Author(s) 2012.

Ditmanson Medical Foundation Chia Yi Christian Hospital and Kun Shan University | Date: 2013-10-03

An administration method for a medical spray inhaler and the medical spray inhaler, which utilizes an inhaling sensing unit to sense an air flow change for generating an inhaling signal after a user inhales by an inhaler body. A control unit is then used to receive the inhaling signal and calculate a delay time. After the delay time, the control unit outputs a control instruction to control a medicine container disposed on the inhaler body to spray a medical spray and concurrently records the ventilation volume per inhalation of the user.

Yang P.-Y.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Yan Y.-H.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Jou H.-J.,Taiwan Adventist Hospital | Lu M.-C.,Ditmanson Medical Foundation Chia Yi Christian Hospital | Wu S.-C.,National Yang Ming University
Journal of Maternal-Fetal and Neonatal Medicine | Year: 2016

Objective: To compare the short-term maternal postpartum complications associated with cesarean section (CS), vaginal delivery (VD), repeated CS and vaginal birth after cesarean section (VBAC) in a large national sample.Methods: This was a population-based study of the Taiwan National Health Insurance Research Database (NHIRD). Outcomes include post-discharge (2 weeks) urinary tract infection (p-UTI), complications of obstetrical surgical wounds (p-wound) and postpartum hemorrhage (p-hemorrhage). A logistic regression model with generalized estimating equations were utilized, and adjustments were made for maternal and hospital characteristics.Results: The incidence of p-UTI was 0.79%. CS was associated with a significantly higher risk of p-UTI compared with VD (odds ratio [OR] 1.14; 95% confidence interval [CI], 1.003-1.29). The incidence of p-wound was 4.07%. CS and repeated CS were associated with a higher risk of p-wound compared with VD (OR 1.68; 95% CI, 1.28-2.21 and OR 1.64; 95% CI, 1.22-2.20, respectively). Age, maternal diseases and hospital and obstetrician volumes were associated with patient outcomes.Conclusions: Women with a delivery mode of CS have a higher risk of p-UTI and p-wound than women with VD. Maternal characteristics and hospital and obstetrician volumes may also influence postpartum outcomes. © 2015 Taylor & Francis.

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