Tseng T.-H.,National Taiwan University Hospital |
Mu C.-F.,Puli Christian Hospital |
Hsu C.-Y.,Puli Christian Hospital
Minerva Urologica e Nefrologica | Year: 2014
Aim.The moderate, severe chronic kidney disease (CKD) and end stage renal disease (ESRD) are well-recognized risk factors of bone loss. However, it is uncertain whether mild CKD stage affects bone mineral density (BMD).The objective of this study is to investigate whether mild and/or more severe reduction of GFR is associated with BMD decreasing. Methods. Between April and November 2011, 305 patients were included in this study. Estimated glomerular filtration rate (GFR) was calculated by Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. According to the GFR, we divided the participants into 3 groups: CKD stage I, stage II and stage ≥III. BMD was compared between different groups. Results. Eighty-one women and 65 men were enrolled in the final study. The average age was 65.6. According to the eGFR, 54 (37.0%), 70 (47.9%) and 22 (15.1%) participants were classified into CKD stage I, II and ≥III, respectively. The mean T-score was -1.351±1.879.A significant bone loss was found in the stage ≥III group, especially in women (P<0.05). BMD decreasing was found significantly in male participants with CKD stage II (P=0.041). Conclusion. BMD significantly decreased in men with mild renal dysfunction. A significant BMD decreasing was also found in the group of CKD stage ≥III, especially in women. We suggest osteoporosis screening is necessary in patients with poor renal function.
Chang H.-Y.,Puli Christian Hospital |
Torng P.-C.,National Taipei University of Nursing and Health Sciences |
Wang T.-G.,National Taiwan University Hospital |
Chang Y.-C.,National Taiwan University Hospital
Archives of Physical Medicine and Rehabilitation | Year: 2012
Objective: To investigate whether acoustic voice analysis can identify the presence of penetration/aspiration (P/A) as confirmed by videofluoroscopic swallowing study (VFSS). Design: Repeated measures within subjects. Setting: Rehabilitation department in a tertiary teaching hospital. Participants: Patients (N=44) with swallowing disorders referred for VFSS. Interventions: Patients were asked to sustain phonations /a/ for at least 3 seconds before and after swallowing 5mL of liquid barium during a standardized VFSS. The acoustic voice analysis program was used to analyze vocal quality change. Main Outcome Measures: Five acoustic parameters including average fundamental frequency, relative average perturbation, shimmer percentage, noise-to-harmonic ratio, and voice turbulence index were analyzed for each participant before and after swallowing during VFSS. Differences in the pre- and postmeasures were compared between those participants who demonstrated VFSS-confirmed P/A (n=17) and those who did not (n=27). Results: No significant changes were noted in the 5 acoustic parameters in or between P/A and nonpenetration/aspiration groups (P>.05). Conclusions: As used in this study, acoustic voice analysis does not identify the presence of P/A confirmed by VFSS. © 2012 American Congress of Rehabilitation Medicine.
Hsiao M.-Y.,National Taiwan University Hospital |
Chang Y.-C.,National Taiwan University Hospital |
Chen W.-S.,National Taiwan University Hospital |
Chang H.-Y.,Puli Christian Hospital |
Wang T.-G.,National Taiwan University Hospital
Ultrasound in Medicine and Biology | Year: 2012
This study applied submental ultrasonography (SUS) to measure changes in dysphagic stroke patients' tongue thickness and hyoid bone displacement when swallowing 5 mL of water and correlated the results with the severity of clinical dysphagia. We included 60 stroke patients (30 tube-feeding-dependent and 30 on regular oral intake) and 30 healthy controls. An additional 10 healthy people were recruited to assess the reliability of SUS. Measurements of hyoid bone displacement using videofluoroscopic swallowing study (VFSS) and SUS were compared for 12 stroke patients to assess the correlation between the two methods. Changes in tongue thickness and hyoid bone displacement were significantly less in the tube-feeding group. Those with a tongue thickness change of less than 1.0 cm and hyoid bone displacement of less than 1.5 cm were likely to be tube-feeding. SUS showed good intra-rater/inter-rater reliability and correlated well with VFSS measurement. SUS can be an adjunct assessment tool of swallowing. © 2012 World Federation for Ultrasound in Medicine & Biology.
Jyun-You L.,National Taiwan University Hospital |
Chia-Fen M.,Puli Christian Hospital |
Chao-Yu H.,Puli Christian Hospital
Australian Journal of Rural Health | Year: 2012
Objective: To determine whether diabetes control is less optimal in Taiwanese aborigines and identify the risk factors associated with poor glycaemic control. Design: Cross-sectional analysis of data from Taiwan Diabetes Shared Care Program Setting: A rural hospital in central Taiwan. Methods: Patients enrolled in Diabetes Shared Care Program in 2010 were surveyed. The average HbA1c in 2010 was compared between the aboriginal and non-aboriginal groups. Age, gender, body mass index and disease duration were selected to represent biological factors. Combined with the existence of geographic barrier to medical service and rate of medical appointment no-shows, multivariate linear regression model was applied to determine the predictive power of each factor to glycaemic status. Results: Only 26% of patients achieved average HbA1c of less than 7%. The average HbA1c of the aboriginal group is significantly higher than that of the non-aboriginal group (8.73% versus 7.93%, P<0.001). However, in multivariate linear regression model, racial background was no longer a risk factor for poor glycaemic control. Medical appointment no-shows was found as the most significant risk factor for poor glycaemic control (b=1.48, P<0.001). Conclusion: Taiwanese aboriginal diabetes patients as a group have poorer glycaemic control than the non-aboriginal group. Medical appointment no-shows may significantly contribute to the development of hyperglycaemia among Taiwanese aborigines. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.
Chien H.-Y.,National Chi Nan University |
Yang C.-C.,PuLi Christian Hospital |
Wu T.-C.,National Taiwan University of Science and Technology |
Lee C.-F.,Chaoyang University of Technology
Journal of Medical Systems | Year: 2011
Owing to the low cost and convenience of identifying an object without physical contact, Radio Frequency Identification (RFID) systems provide innovative, promising and efficient applications in many domains. An RFID grouping protocol is a protocol that allows an off-line verifier to collect and verify the evidence of two or more tags simultaneously present. Recently, Huang and Ku (J. Med. Syst, 2009) proposed an efficient grouping protocol to enhance medication safety for inpatients based on low-cost tags. However, the Huang-Ku scheme is not secure; an attacker can easily make up fake grouping records to cheat the verifier. This weakness would seriously endanger the safety of inpatient medication safety. This paper will show the weaknesses, and then propose two RFID-based solutions to enhance medication safety for two different scenarios. The proposed schemes are practical, secure and efficient for medication applications. © 2009 Springer Science+Business Media, LLC.
PubMed | Puli Christian Hospital and National Taiwan University Hospital
Type: | Journal: Ethnicity & health | Year: 2016
The ethnic difference in the risk factors of acute pancreatitis remains unknown. The objective of this study is to investigate the differences in the risk factors of acute pancreatitis between Taiwanese aborigines and nonaborigines.A retrospective study of 622 patients with acute pancreatitis admitted to our hospital (Puli Christian Hospital) from 2006 to 2014. The risk factors and biochemical properties of acute pancreatitis were comapred between aborgines and nonaborgines.The first episode of acute pancreatitis amongst the aboriginal group was commonly observed in young age groups (39.3 versus 47.8 years, p<0.05), female patients (0.61 versus 0.27, p<0.05), and patients with a habit of drinking alcohol (84% versus 65%, p<0.05). Analysis of the biochemical properties and risk factors demonstrated siginifcantly high uric acid levels (7.63 versus 6.56mg/dL, p<0.05), and an increased prevalence of alcohol-related pancreatitis (60.0% versus 49.6%, p<0.05) in the aboriginal group.Taiwanese aborigines were reported to be more susceptible to alcohol-related pancreatitis than nonaborigines. The decreasing levels of excessive alcohol consumption may reduce the disease burden of acute pancreatitis.
Joniau S.,University Hospitals Leuven |
Joniau S.,Puli Christian Hospital |
Hsu C.-Y.,University of Turin |
Gontero P.,University of Würzburg |
And 2 more authors.
Scandinavian Journal of Urology and Nephrology | Year: 2012
Objective. The objective of this study was to present the long-term outcomes and determine outcome predictors in very high-risk (cT3bT4) prostate cancer (PCa) after radical prostatectomy (RP). Material and methods. Between January 1989 and December 2004, 51 patients with cT3bT4 PCa underwent RP. Kaplan-Meier survival analysis was used to calculate the biochemical progression-free survival (BPFS), clinical progression-free survival (CPFS), cancer-specific survival (CSS) and overall survival (OS) rate. Multivariate Cox proportional hazard models were used to determine the predictive power of clinical and pathological variables in BPFS and CPFS. Results. Median follow-up was 108 months [interquartile range (IQR) 73.5144.5]. The median serum prostate-specific antigen (PSA) was 16.9 ng/ml (IQR 737.2). Median biopsy and pathological Gleason (pGS) score were both scored as 7 (range 410 and 59, respectively). Overstaging was frequent (37.2%); four patients (7.8%) had organ-confined stage pT2, while 15 (29.4%) had extracapsular extension only (pT3a). Another 23 (45.1%) were confirmed with seminal vesicle invasion (pT3b) and nine (17.7%) had adjacent structure invasion (pT4). Eleven patients (21.6%) had lymph-node involvement. Thirty-two patients (62.7%) had positive surgical margins. The BPFS, CPFS, CSS and OS at 5 and 10 years were 52.7%, 45.8%;78.0%, 72.5%; 91.9%, 91.9% and 88.0%, 70.7%. In the multivariate Cox proportional hazard models, pathological stage was an independent predictor of BPFS while preoperative PSA and pGS was an independent predictor of CPFS. Conclusions. The management of cT3bT4 PCa typically consists of a multimodality treatment in which RP is a valuable first step. Overstaging was frequent (37.2%), and almost one-quarter of the patients remained free of additional treatments. Long-term cancer-related outcomes were very satisfactory. © 2012 Informa Healthcare.
PubMed | Nantou Hospital, Puli Christian Hospital, Central Taiwan University of Science and Technology, Taichung Veterans General Hospital Puli branch and 4 more.
Type: | Journal: The Australian journal of rural health | Year: 2016
Out-of-hospital cardiac arrest (OHCA) studies are usually conducted at metropolitan medical centres. Because rural studies are rare, our study aimed to assess non-traumatic OHCA prevalence and resuscitation outcomes in rural Taiwan.A retrospective observational study.All seven designated community hospital emergency departments (ED) in Nantou County, Taiwan.All OHCA patients from May 2011 to March 2013.Any return of spontaneous circulation (ROSC) and survival for ED discharge.In the 23-month period, 850 OHCA cases were reported; 741 (87.2%) were non-traumatic. The overall ROSC achievement rate was 19.7%, with 16.4% case survival for ED discharge. Logistic regression identified that arrest in public (OR: 2.62, 95% CI: 1.19-5.78), witness when collapsed (OR: 2.14, 95% CI: 1.28-3.60), and cardiopulmonary resuscitation (CPR) by bystander (OR: 2.09, 95% CI: 1.02-4.26) might increase the likelihood of any ROSC; arrest in public (OR: 2.68, 95% CI: 1.10-6.50), witnessed collapse (OR: 2.26, 95% CI: 1.24-4.09) and CPR by bystander (OR: 2.79, 95% CI: 1.28-6.05) might also increase the likelihood of survival. For non-traumatic OHCA patients conveyed to EDs via emergency medical service system (EMS), a shorter response time (OR: 1.09, 95% CI: 1.01-1.18) and travelling time (OR: 1.04, 95% CI: 1.00-1.09) might also increase the chance of survival.Compared to previous data from metropolitan areas, ROSC achievement rate was lower in rural Taiwan. Witness presence, response and travelling times affect ROSC achievement in non-traumatic OHCA patients in rural Taiwan.
PubMed | China Medical University at Taichung, Data Management and Puli Christian Hospital
Type: Journal Article | Journal: Rheumatology international | Year: 2016
Splenectomy may be necessary to treat systemic lupus erythematosus (SLE) patients with thrombocytopenia; however, whether performing a splenectomy on patients without SLE increases the subsequent risk of SLE remains unknown. Therefore, this study was conducted to determine the association between splenectomy and SLE. We conducted a cohort study by using data from the Taiwan National Health Institute Research Database to identify 10,298 patients with received a splenectomy between 2000 and 2006 and 41,192 participants without received a splenectomy who were selected by frequency matched based on sex, age, and the index year. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of developing SLE associated with splenectomy compared with patients who did not receive a splenectomy. During the study period, the overall incidence density rate of SLE was higher in the splenectomy cohort than in the non-splenectomy cohort (adjusted HR 10.55; 95 % CI 50.55-20.05). The incidence density rates of SLE in women and men who received a splenectomy were higher than those of patients who did not receive a splenectomy. Non-traumatic splenectomy increases the subsequent risk of SLE. The risk of SLE should be considered before performing a splenectomy, particularly in women and younger patients.
Sun T.-K.,Puli Christian Hospital
Journal of Clinical Gerontology and Geriatrics | Year: 2015
Takotsubo cardiomyopathy is a recognized cardiac syndrome that mimics acute coronary syndrome, without occlusion of the coronary artery. This syndrome is usually triggered by emotional or physical stress. Acute infection as a trigger condition is rarely reported. We report a case of an elderly woman who experienced chest pains with ST-segment elevation on electrocardiography, and who was later confirmed to have this cardiac syndrome by cardiac catheterization in coexistence with shock status related to suspected acute infection. Copyright © 2014, Asia Pacific League of Clinical Gerontology & Geriatrics. Published by Elsevier Taiwan LLC. All rights reserved.