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Taichung, Taiwan

Lian I.-B.,National Changhua University of Education | Chien Y.-Z.,National Changhua University of Education | Hsu P.-S.,Taichung Hospital | Chao D.-Y.,National Chung Hsing University
Vaccine | Year: 2011

The varicella vaccine has been available in the Taiwan market since July 1997. Beginning 1998-1999, Taipei City and Taichung City/County as the early launch areas included the varicella vaccine in their free pediatric vaccination programs. By contrast, the national free vaccination program was not implemented until 2004. We aim to investigate the changing epidemiology of varicella incidence through an analysis of age-period-cohort effects. With the greatest decrease in varicella incidence occurring in children aged below 6, the incidence of varicella shifted to older age groups as reflected in different birth cohorts. The current study provides important implications for the current vaccination policy. © 2010 Elsevier Ltd. Source

As the renal stone size increases, the stone clearance rate using extracorporeal shock wave lithotripsy (ESWL) for renal calculi decreases. For stone sizes >2. cm in diameter, the stone clearance rate of ESWL is unsatisfactory. Thereafter, percutaneous nephrolithotomy (PCNL) is the preferred treatment of choice because of a better stone-free rate. However, increased complications and a longer convalescence period with PCNL became more important issues in certain cases. Previous literature reviews reported that ureteroscopic lithotripsy (URSL) can be used as adjunct therapy in combination with PCNL. Some authors even reported an excellent stone-free rate with minimal complications by performing URSL for large renal calculi. Because of the availability of technologically advanced ureteroscope and improved ancillary equipment, such as the holmium laser and ureteral access sheath, this procedure has become more feasible and effective for treating renal calculi. In addition to reviewing stone-free and complication rates, the literature was also reviewed for the total number of procedures carried out, and medical expenses were compared although only a few reports are available on this subject. The contemporary literature supports URSL as a safer, more-efficient, and more cost-effective alternative to PCNL in selected patients. © 2012. Source

Studies on the effects of tuberculosis on a patient's quality of life (QOL) are scant. The objective of this study was to evaluate the psychometric properties of the Taiwan short version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire using patients with tuberculosis in Taiwan and healthy referents. The Taiwanese short version of the WHOQOL-BREF was administered to patients with tuberculosis undergoing treatment and healthy referents from March 2007 to July 2007. Patients with tuberculosis (n = 140) and healthy referents (n = 130), matched by age, sex, and ethnicity, agreed to an interview. All participants lived in eastern Taiwan. Reliability assessments included internal consistency, whereas validity assessments included construct validity, convergent validity, and discriminant validity. More than half of these patients and referents were men (70.7% and 66.2%, respectively), and their average ages were 50.1 and 47.9 years, respectively. Approximately 60% of patients and referents were aboriginal Taiwanese (60.7% and 61.1%, respectively). The proportion with low socioeconomic status was greater for these patients. The internal consistency reliability coefficients were .92 and .93 for the patients and healthy referents, respectively. Exploratory factor analysis on the healthy referents displayed a 4-domain model, which was compatible with the original WHOQOL-BREF 4-domain model. However, for the TB patient group, after deleting 3 items, both exploratory and confirmatory factor analysis revealed a 6-domain model. Psychometric evaluation of the Taiwan short version of the WHOQOL-BREF indicates that it has adequate reliability for use in research with TB patients in Taiwan. However, the factor structure generated from this TB patient sample differed from the WHO's original 4-factor model, which raised a validity concern to apply the Taiwan short version of the WHOQOL-BREF to Taiwanese TB patients. Future research recruiting another sample to revisit this validity issue must be conducted to determine the validity of the WHOQOL-BREF TW in patients with TB. Source

Chung W.-S.,Taichung Hospital | Chung W.-S.,China Medical University at Taichung | Lin C.-L.,Data Management | Lin C.-L.,China Medical University at Taichung | Kao C.-H.,China Medical University at Taichung
Journal of Epidemiology and Community Health | Year: 2015

Background Few studies have investigated the relationship between carbon monoxide (CO) poisoning and risk of deep vein thrombosis (DVT) and pulmonary embolism (PE). Therefore, we conducted a nationwide longitudinal cohort study in Taiwan to determine whether patients with CO poisoning are associated with increased risk of developing DVT and PE. Methods This study investigated the incidence and risk factors for DVT and PE in 8316 patients newly diagnosed with CO poisoning from the Taiwan National Health Insurance Research Database between 2000 and 2011. The comparison cohort contained 33 264 controls without CO poisoning from the general population. Follow-up was initiated on the date of initial diagnosis of CO poisoning and continued until the date of a DVT or PE event, censoring or December 31, 2011. Cox proportional hazard regression models were used to analyse the risk of DVT and PE according to sex, age and comorbidities. Results The incidences of DVT and PE were higher in the patients with CO poisoning than in the controls (5.67 vs 1.47/10 000 person-years and 1.97 vs 1.02/10 000 person-years, respectively). After adjusting for age, sex and comorbidities, the patients with CO poisoning were associated with a 3.85-fold higher risk of DVT compared with the comparison cohort, and nonsignificantly associated with risk of PE. CO poisoning patients with a coexisting comorbidity or acute respiratory failure were associated with significantly and substantially increased risk of DVT. Conclusion Risk of DVT is significantly higher in patients with CO poisoning than in the general population. Source

Wei C.-C.,Chaoyang University of Technology | Huang S.-W.,Chaoyang University of Technology | Bau C.-T.,Taichung Hospital
Cardiovascular Diabetology | Year: 2012

Background: This study tests the validity of a newly-proposed spring constant method to analyze arterial elasticity in type 2 diabetic patients.Methods: The experimental group comprised 66 participants (36 men and 30 women) ranging between 46 and 86 years of age, all with diabetes mellitus. In the experimental group, 21 participants suffered from atherosclerosis. All were subjected to the measurements of both the carotid-femoral pulse wave velocity (cfPWV) and the spring constant method. The comparison (control) group comprised 66 normal participants (37 men and 29 women) with an age range of 40 to 80 years who did not have diabetes mellitus. All control group members were subjected to measurement by the spring constant method.Results: Statistical analysis of the experimental and control groups indicated a significant negative correlation between the spring constant and the cfPWV (P < .001; r = - 0.824 and - 0.71). Multivariate analysis similarly indicated a close relationship. The Student's t test was used to examine the difference in the spring constant parameter between the experimental and control groups. A P-value less than .05 confirmed that the difference between the 2 groups was statistically significant. In receiver operating characteristic curve (ROC), the Area Under Curve (AUC, = 0.85) indicates good discrimination. These findings imply that the spring constant method can effectively identify normal versus abnormal characteristics of elasticity in normal and diabetic participants.Conclusions: This study verifies the use of the spring constant method to assess arterial elasticity, and found it to be efficient and simple to use. The spring constant method should prove useful not only for improving clinical diagnoses, but also for screening diabetic patients who display early evidence of vascular disease. © 2012 Wei et al.; licensee BioMed Central Ltd. Source

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