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Huang C.-T.,Taipei Veterans General Hospital | Lee Y.-H.,Taipei Veterans General Hospital | Chow K.-C.,Yang Ming Branch of Taipei City Hospital | Yang C.-F.,Taipei Veterans General Hospital | And 10 more authors.
Internal Medicine Journal | Year: 2014

Background: The diagnosis of Adult T-cell leukaemia/lymphoma (ATL) in non-endemic regions is challenging. Aim: This study analyses the clinicopathologic features and diagnostic processes of ATL patients in Taiwan. Methods: ATL patients diagnosed and treated at Taipei Veterans General Hospital from 1998 through 2010 were retrospectively identified. The diagnosis of ATL was confirmed by in situ detection of human T-cell leukaemia virus type 1 (HTLV-1) when necessary. Patients' data were reviewed and analysed. Results: Fourteen ATL patients were identified, among whom six (42.9%) had an antecedent diagnosis of other malignant lymphomas before the ATL diagnosis, including two diagnosed with Hodgkin disease (HD), one with peripheral T-cell lymphoma, two with chronic lymphocytic leukaemia and one with angioimmunoblastic T-cell lymphoma. Of the 14 patients, eight (57%) were subclassified as the acute type, three (21.4%) as the lymphoma type, and three (21.4%) as the chronic type ATL. Five of six (83.3%) patients with initial non-ATL misdiagnosis were diagnosed with non-acute type ATL. In particular, a patient with an antecedent diagnosis of HD presented with typical Reed-Sternberg (RS)-like cells harbouring Epstein-Barr virus genomes in affected lymph nodes. The patient progressed to acute type ATL 3 years after the initial diagnosis, and HTLV-1 genomes were identified in the previous RS-like cells. Conclusion: In non-endemic areas, such as Taiwan, ATL, particularly the non-acute type, may mimic other lymphomas and easily be misdiagnosed. HTLV-1 serology should be routinely screened in all malignant lymphoma patients. In situ detection of HTLV-1 is helpful in cases with diagnostic dilemmas. © 2014 Royal Australasian College of Physicians.

Wu M.-P.,Yang Ming Branch of Taipei City Hospital | Wu S.-F.V.,National Taipei University of Nursing and Health Sciences | Wang T.-C.,Taipei Medical University Hospital | Kao M.-J.,Physical Medicine and Rehabilitation | Yang W.-L.,The Superintendents Office
Nursing and Health Sciences | Year: 2012

The purpose of this study was to evaluate the effectiveness of a community-based health promotion program targeting people with hypertension and high cholesterol. A pre-experimental study was conducted. A total of 60 residents were recruited to participate. Participants were assessed at baseline and at a 6month follow up at a regional hospital in northern Taiwan. The questionnaires used for data collection consisted of an assessment of self-efficacy, self-care activities, health outcomes, and physical fitness. Several teaching resources were used, including a DVD, a self-care booklet, group support (exercise and counseling sessions), and telephone follow up. A significant decrease in waist circumference (t=2.20, P=0.03) and high density lipoprotein-cholesterol level (t=4.71, P<0.00) was found at follow up. Moreover, the level of physical fitness activity, and sit-ups specifically (t=3.10, P<0.00), was increased. Participants also showed significant increases between baseline and 6month follow up in their efficacy expectation score (t=-5.81, P<0.00), outcome expectation scores (t=-4.76, P<0.00) and self-care behavior scores (t=-2.78, P=0.007). The community-based health promotion program is an effective means of helping people with hypertension and high cholesterol and should be instituted regularly and evaluated in clinical practice. © 2012 Blackwell Publishing Asia Pty Ltd.

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