Time filter

Source Type

Hsinchu, Taiwan

Yang Y.-J.,National Cheng Kung University | Sheu B.-S.,National Cheng Kung University | Yang H.-B.,Ton Yen General Hospital | Yang H.-B.,National Cheng Kung University | And 2 more authors.
World Journal of Gastroenterology | Year: 2012

AIM: To determine whether Helicobacter pylori (H. pylori)-infected children have reduced body weight (BW) and height (BH) growth, and if H. pylori eradication may restore growth while improving serum acylated ghrelin. METHODS: This longitudinal cohort study with one-year follow-up enrolled 1222 children aged 4 to 12 years old into an observation cohort (18 with and 318 without H. pylori) and intervention cohort (75 with and 811 without). The 7-d triple therapy was used for eradication in the intervention cohort. The net increases of BW and BH as well serum acylated ghrelin after one-year follow-up were compared between successful eradicated H. pylori-infected children and controls. RESULTS: In the observation cohort, the H. pylori-infected children had lower z score of BW (-1.11 ± 0.47 vs 0.35 ± 0.69, P = 0.01) and body mass index (BMI) (0.06 ± 0.45 vs 0.44 ± 0.73, P = 0.02) at enrollment and lower net BW gain after one-year follow-up (3.3 ± 2.1 kg vs 4.5 ± 2.4 kg, P = 0.04) than the non-infected controls. In the intervention cohort, the H. pylori-infected children had lower z score of BMI (0.25 ± 1.09 vs 0.68 ± 0.87, P = 0.009) and serum acylated ghrelin levels (41.8 ± 35.6 pg/mL vs 83.6 ± 24.2 pg/mL, P < 0.001) than the non-infected controls. In addition to restoring decreased serum ghrelin levels (87.7 ± 38.0 pg/mL vs 44.2 ± 39.0 pg/mL, P < 0.001), the H. pylori-infected children with successful eradication had higher net gains (P < 0.05) and increase of z scores (P < 0.05) of both BW and BH as compared with non-infected controls after one-year follow-up. CONCLUSION: H. pylori-infected children are associated with low serum acylated ghrelin and growth retardation. Successful eradication of H. pylori restores ghrelin levels and increases growth in children. © 2012 Baishideng. All rights reserved. Source

Chen I.C.,Ton Yen General Hospital
The journal of nursing research : JNR | Year: 2010

Nursing home residents usually suffer from a variety of medical conditions and are prescribed a wider variety of medications than any other subpopulation. Polypharmacy is associated with the occurrence of adverse events. The purposes of this study were to describe the medication prescription patterns of residents who died in a nursing home, to examine how this pattern changed as residents progressed toward death, and to identify correlates of increased medication prescriptions. Thirty-one residents who had lived at one nursing home for more than 6 months before death were included in the study. Medication records for participants were obtained at four data collection points: on admission, 6 months before death, 3 months before death, and at death. The mean number of medications prescribed immediately before death was 7.90 (SD = 3.27), and there was an upward trend in number of prescriptions written as patients neared death. The most frequent prescription was for medication for constipation, pulmonary care, and hypertension. There was a significant correlation between residents with heart disease and increased medication use. Medication prescribed for pulmonary care and hypertension increased from admission to death, but a decreased use of medication for pain relief in the time before death in these cases was found. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: This study surveyed and described the pattern of medication use in nursing home residents from admission to the end of life. Results can be used to reinforce clinician and nursing staff awareness of prescription frequency, amounts of medication, and change over time for elderly residents under their care. In addition to safer prescribing practices for the older people, nonpharmacological strategies (e.g., lifestyle modification and physiotherapy for function training) may be used to address common symptoms and complaints during chronic care. Source

Juang K.D.,Taichung Veterans General Hospital | Juang K.D.,National Yang Ming University | Yang C.-Y.,Ton Yen General Hospital
Current Pain and Headache Reports | Year: 2014

The fifth edition of the Diagnostic and Statistic Manual (DSM-5) reclassified some mental disorders recently. Post-traumatic stress disorder (PTSD) is in a new section termed "trauma- and stressor-related disorder". Community-based studies have shown that PTSD is associated with a notably high suicidal risk. In addition to previous findings of comorbidity between chronic daily headache (CDH) and both depressive disorders and anxiety disorders, recent data suggest that frequency of childhood maltreatment, PTSD, and suicidality are also increased in CDH. CDH patients with migraine aura are especially at risk of suicidal ideation. Research suggests that migraine attack, aura, frequency, and chronicity may all be related to serotonergic dysfunction. Vulnerability to PTSD and suicidality are also linked to brain serotonin function, including polymorphisms in the serotonin transporter gene (5-HTTLPR). In the present review, we focus on recent advances in knowledge of traumatic experiences in childhood, PTSD, and suicidality in relation to migraine and CDH. We hypothesize that vulnerability to PTSD is associated with migraine attack, migraine aura, and CDH. We further postulate that these associations may explain some of the elevated suicidal risks among patients with migraine, migraine aura, and/or CDH. Field studies are required to support these hypotheses. © Springer Science+Business Media New York 2014. Source

Lin C.-M.,Taipei Medical University | Doyle P.,London School of Hygiene and Tropical Medicine | Tsan Y.-T.,National Taiwan University | Tsan Y.-T.,Chung Shan Medical University | And 5 more authors.
European Journal of Nuclear Medicine and Molecular Imaging | Year: 2014

Purpose: To evaluate the association between 131I therapy for thyroid cancer and risk of developing primary hyperparathy roidism. Methods: This was a nationwide population-based cohort study of patients with thyroid cancer diagnosed during the period 1997-2008. The data were obtained from the Taiwan National Health Insurance Research dataset. The cumulative 131I dose in each patient was calculated. Hazard ratios (HRs) were calculated using a proportional hazards model to estimate the effect of 131I therapy on the risk of developing primary hyperparathyroidism in the cohort. Results: A total of 8,946 patients with thyroid cancer were eligible for the final analysis. Among these patients, 8 developed primary hyperparathyroidism during the follow-up period that represented 38,248 person-years giving an incidence rate of 20.9 per 105 person-years. 131I was used in the treatment of 6,153 patients (68.8 %) with a median cumulative dose of 3.7 GBq. The adjusted HRs were 0.21 (95% CI 0.02-1.86) and 0.46 (95% CI 0.10-2.10) for those receiving a cumulative 131I dose of 0.1-3.6 GBq and ≥3.7 GBq, respectively, compared to no therapy. The risk of developing primary hyperparathyroidism did not increase with increasing 131I dose (test for trend p =0.51). No interaction was found between 131I dose and age (p =0.94) or 131I dose and sex (p = 0.99). Conclusion: 131I treatment for thyroid cancer did not increase risk of primary hyperparathyroidism during a 10-year follow-up in this study population. Further research with a longer follow-up period is needed to assess late adverse effects beyond 10 years. © Springer-Verlag Berlin Heidelberg 2013. Source

Chang W.-L.,National Cheng Kung University | Yang H.-B.,Ton Yen General Hospital | Cheng H.-C.,National Cheng Kung University | Chuang C.-H.,National Cheng Kung University | And 2 more authors.
Helicobacter | Year: 2011

Background: Osteopontin (OPN) is involved in the gastric cancer progression. The study validated whether OPN expressions correlate with Helicobacter pylori-related chronic gastric inflammation and the precancerous change as intestinal metaplasia (IM). Methods: This study included 105 H. pylori-infected patients (63 without and 42 with IM) and 29 H. pylori-negative controls. In each subject, the gastric OPN expression intensity was evaluated by immunohistochemistry, and graded from 0 to 4 for the epithelium, lamina propria, and areas with IM, respectively. For the H. pylori-infected subjects, the gastric inflammation was assessed by the Updated Sydney System. Forty-nine patients received follow-up endoscopy to assess OPN change on gastric mucosa after H. pylori eradication. The in vitro cell-H. pylori coculture were performed to test the cell origin of OPN. Results: The H. pylori-infected patients had higher gastric OPN expression than the noninfected controls (p<001). For the H. pylori-infected patients, an increased OPN expression correlated with more severe chronic gastric inflammation (p<001) and the presence of IM (OR: 2.6, 95% CI: 1.15-5.94, p=02). Within the same gastric bits, lamina propria expressed OPN stronger than epithelium (p<001), suggesting OPN predominantly originates from inflammatory cells. The in vitro assay confirmed H. pylori stimulate OPN expression in the monocytes, but not in the gastric epithelial cells. After H. pylori eradication, the gastric OPN expression could be decreased only in areas without IM (p<05). Conclusions: Increased gastric OPN expression by H. pylori infection can correlate with a more severe gastric inflammation and the presence of IM. © 2011 Blackwell Publishing Ltd. Source

Discover hidden collaborations