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Ku Y.-C.,Kaohsiung Veterans General Hospital | Liu M.-E.,Kaohsiung Veterans General Hospital Pingtung Branch | Tsai Y.-F.,Chang Gung Memorial Hospital | Liu W.-C.,Yuli Veterans Hospital | And 2 more authors.
International Journal of Gerontology | Year: 2013

Background: The information exploring the falls, recurrent falls, and injurious falls simultaneously in a large scale of aged people was limited. This study investigated the prevalence and frequency of falls and identified the associated factors of fall among aged Chinese men. Methods: A cross-sectional study was carried out in four veteran homes in eastern Taiwan from 2009 to 2010. The investigated sample consisted of 940 elderly men. A questionnaire was used for collecting demographic background, comorbid medical conditions, and fall characteristics. Depression status was evaluated by the Geriatric Depression Scale-Short Form. Results: The prevalence of fall and recurrent falls were 17.2 % and 6.9%, respectively. The injury rate after falls was 51.9%.The advanced age [odds ratio (OR): 1.04; confidence interval (CI): 1.01-1.07), depression status (OR: 1.05; CI: 1.01-1.10), stroke (OR: 2.16; CI: 1.18-3.96), gouty arthritis (OR: 1.96; CI: 1.36-2.81), and cataract (OR: 1.48; CI: 1.03-2.15) were independent variables associated with falls. We also found that the greater the number of variables, the higher the risk of falling (χ2 for linear trend = 31.98, d.f.= 4, p < 0.001). Furthermore, depression was the only independent variable for predicting recurrent falls (OR: 1.22; CI: 1.12-1.32). However, no variable was found to be capable of predicting injurious falls. Conclusion: This study demonstrated that the advanced age, depression status, stroke, gouty arthritis, and cataract are independent variables for predicting falls; depression is the only clinical factor capable of predicting the recurrent falls. These variables were potential targets for effective prevention of falls. Copyright © 2013, Taiwan Society of Geriatric Emergency & Critical Care Medicine. Published by Elsevier Taiwan LLC. All rights reserved.

Lin Y.-H.,Kaohsiung Veterans General Hospital Pingtung Branch | Chen Y.-C.,Taitung Veterans Hospital | Tseng Y.-H.,Taipei Veterans General Hospital | Lin M.-H.,Taipei Veterans General Hospital | And 6 more authors.
PLoS ONE | Year: 2013

Aims:The palliative care has spread rapidly worldwide in the recent two decades. The development of hospice services in rural areas usually lags behind that in urban areas. The aim of our study was to investigate whether the urban-rural disparity widens in a country with a hospital-based hospice system.Methods:From the nationwide claims database within the National Health Insurance in Taiwan, admissions to hospices from 2000 to 2006 were identified. Hospices and patients in each year were analyzed according to geographic location and residence.Results:A total of 26,292 cancer patients had been admitted to hospices. The proportion of rural patients to all patients increased with time from 17.8% in 2000 to 25.7% in 2006. Although the numbers of beds and the utilizations in both urban and rural hospices expanded rapidly, the increasing trend in rural areas was more marked than that in urban areas. However, still two-thirds (898/1,357) of rural patients were admitted to urban hospices in 2006.Conclusions:The gap of hospice utilizations between urban and rural areas in Taiwan did not widen with time. There was room for improvement in sufficient supply of rural hospices or efficient referral of rural patients. © 2013 Lin et al.

Tsai H.-K.,Kaohsiung Veterans General Hospital Pingtung Branch | Wei S.-Y.,Kaohsiung Municipal United Hospital | Lam H.-C.,Kaohsiung Veterans General Hospital
Journal of Internal Medicine of Taiwan | Year: 2011

Propylthiouracil (PTU) is a common medication to treat hyperthyroidism. The U.S. Food and Drug Administration (FDA) has added a boxed warning to labeling about the increased risk of hepatic failure with the use of propylthiouracil in June, 2009. However, there are few papers to discuss other adverse effects of PTU, other than agranulocytosis and acute hepatic failure, such as antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis. Here we review the literature of PTU-related ANCA-positive vasculitis and related adverse complication.

Chen S.-C.,Kaohsiung Veterans General Hospital Pingtung Branch | Lin Y.-H.,Bariatric and Metabolic International Surgery Center | Huang H.-P.,Bariatric and Metabolic International Surgery Center | Hsu W.-L.,Bariatric and Metabolic International Surgery Center | And 3 more authors.
Nutrition | Year: 2012

Objective: Conjugated linoleic acid (CLA) has several benefits, including body fat reduction, as proved in animals. However, the results of CLA-induced body composition alterations in humans are inconsistent, and no related data are available for Chinese populations. This study aimed to determine whether CLA affects body weight (BW) loss and body composition of overweight and obese Chinese subjects. Methods: In this randomized, double-blind, placebo-controlled trial, subjects with a body mass index (BMI) of 24 to 35 kg/m 2 randomly received 1.7 g of cis-9,trans-11 and trans-10,cis-12 CLA (n = 30) or placebo (salad oil; n = 33) in 200 mL of sterilized milk twice daily for 12 wk. Changes in body composition were determined by bioimpedance measurements. Results: Sixty-three subjects completed the study (CLA, n = 30). After 12 wk, compared with the baseline, the BW, BMI, total fat mass, fat percentage, subcutaneous fat mass, and waist-to-hip ratio decreased in the CLA group (P < 0.05). The CLA group was stratified by BMI and gender. The BW, BMI, subcutaneous fat mass, and waist-to-hip ratio decreased in 27 subjects with a BMI ≥ 27, and these indices, except subcutaneous fat mass, were lower in female subjects. The levels of total cholesterol, triacylglycerol, low-density lipoprotein, and plasma fasting glucose increased, whereas those of high-density lipoprotein decreased after 3 mo of CLA treatment. The changes were not significantly different from the baseline values. Conclusion: The supplementation of CLA for 12 wk in overweight and grade I obese Chinese subjects yielded lower obesity indices, with no obvious adverse effects. © 2012 .

Horng C.-T.,Kaohsiung Armed Force General Hospital | Chiang N.-N.,Kaohsiung Veterans General Hospital Pingtung Branch | Chen I.-L.,Tajen University | Liang W.-Z.,Kaohsiung Veterans General Hospital | And 4 more authors.
Journal of Receptors and Signal Transduction | Year: 2013

Clotrimazole is an antimycotic imidazole derivative that interferes with cellular Ca2+ homeostasis. This study examined the effect of clotrimazole on cytosolic Ca2+ concentrations ([Ca2+]i) and viability in HA59T human hepatoma cells. The Ca2+-sensitive fluorescent dye fura-2 was applied to measure [Ca2+]i. Clotrimazole induced [Ca2+]i rises in a concentration-dependent manner. The response was reduced by removing extracellular Ca2+. Clotrimazole-evoked Ca2+ entry was suppressed by store-operated channel inhibitors (nifedipine, econazole and SK&F96365) and protein kinase C modulators (GF109203X and phorbol, 12-myristate, 13-acetate). In Ca 2+-free medium, incubation with the endoplasmic reticulum Ca 2+ pump inhibitor 2,5-di-tert-butylhydroquinone abolished clotrimazole-induced [Ca2+]i rise. Inhibition of phospholipase C with U73122 abolished clotrimazole-induced [Ca2+]i rise. At 10-40 M, clotrimazole inhibited cell viability, which was not reversed by chelating cytosolic Ca2+. Clotrimazole at 10 and 30 M also induced apoptosis. Collectively, in HA59T cells, clotrimazole-induced [Ca2+]i rises by evoking phospholipase C-dependent Ca2+ release from the endoplasmic reticulum and Ca2+ entry via store-operated Ca2+ channels. Clotrimazole also caused apoptosis. © 2013 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.

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