المؤلفون: Yu-Chi Tsai, Chun-Hao Yin, Jin-Shuen Chen, Yao-Shen Chen, Shih-Chung Huang, Jui-Kuang Chen

المصدر: Journal of Microbiology, Immunology and Infection, Vol 57, Iss 2, Pp 309-319 (2024)

مصطلحات موضوعية: Nasogastric tube, ICD-10, Enteral nutrition, m-NUTRIC scores, Norepinephrine equivalence, Bacteremia, Microbiology, QR1-502

الوصف: Introduction: Early enteral nutrition (EN) is a nutritional strategy for reducing the incidence of in-hospital infections. However, the benefits of early EN, under targeted temperature management (TTM) in patients with out-of-hospital cardiac arrest (OHCA), remain unclear. We aimed to evaluate the effect of early EN on the infective complications of OHCA patients who underwent TTM. Methods: We retrospectively searched the clinical databases of two adult emergency tertiary referral hospitals in southern Taiwan and identified patients admitted for OHCA who underwent TTM between 2017 and 2022. The 85 enrolled patients were divided into two groups based on timing: early EN (EN within 48 h of admission) and delayed EN (EN > 48 h after admission). Clinical outcomes of 7-day infective complications between the two groups were analyzed. Results: Early EN was provided to 57 (67 %) of 85 patients and delayed EN was provided to the remaining 28 (33 %) patients. No significant differences in baseline patient characteristics were observed between the two groups. In addition, no differences in clinical outcomes were observed, except that the early EN group had a lower 7-day bacteremia rate (5.3 % vs. 26.9 %, p = 0.013). Gram-negative bacteria were the major pathogen among the 7-day infective complications. Conclusion: In OHCA patients treated with TTM, early EN was associated with a lower 7-day bacteremia rate. Furthermore, the application of early EN in this population was well tolerated without significant adverse events.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S1684118223002396Test; https://doaj.org/toc/1684-1182Test

الوصول الحر: https://doaj.org/article/aced2afb678d4296a0b8f66f8ef8155cTest

المؤلفون: Tzu-Ya Huang, Ru-Yih Chen, Ying-Chun Li, Chun-Hao Yin, Chin-Hao Hsu, Chia Chen

المصدر: SAGE Open, Vol 14 (2024)

مصطلحات موضوعية: History of scholarship and learning. The humanities, AZ20-999, Social Sciences

الوصف: In Taiwan, hospice nurses often take family members of terminally ill patients on hospice ward tours and provide information on transfers. We conducted a study to investigate the tour’s effectiveness in encouraging family members to transfer their loved ones to hospice. We conceptualized our study framework based on the Andersen healthcare utilization model. The hospice nurses invited family members who participated in the tour to complete the survey to investigate the tour and hospice facilities’ influence on their willingness to transfer. A total of 87 participants responded to the study, with an average age of 48.84 ± 12.08 years. Most participants were women (78.16%) and the children of patients (55.17%). The results showed that the tour significantly increased willingness scores (before 4.46 ± 0.73, after 4.74 ± 0.58, p = .0036). Practical and activity-related facilities had the highest influence scores. However, binary logistic regression revealed that patients aged ≥65 years (odds ratio [OR]: 0.281, 95% confidence interval [CI] [0.099, 0.797]) and higher influence scores for psychospiritual care features (OR: 0.182, 95% CI [0.040, 0.821]) negatively affected the change in willingness score, possibly due to family members’ anticipatory grief. Hospice tour guides should be able to identify, assess, and deal with this issue. Overall, hospice tours can effectively encourage transfer to the hospice ward, but addressing psychological barriers such as anticipatory grief is crucial for success.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2158-2440Test

الوصول الحر: https://doaj.org/article/265a7facb7f6452b8e9d9b73aa3d4cfbTest

المؤلفون: Po-Hsiang Hsu, Renin Chang, Chun-Hao Yin, Yao-Shen Chen, Jin-Shuen Chen

المصدر: Heliyon, Vol 10, Iss 6, Pp e27957- (2024)

مصطلحات موضوعية: Science (General), Q1-390, Social sciences (General), H1-99

الوصف: Importance: Previous investigations have found that time to positive blood culture (TTP) is a prognostic factor for clinical outcomes. In fact, what the emergency physician sees from the medical information system is TAT (turnaround time) defined as time required to post a bacterial culture report. We propose a definition of blood culture TAT that more closely aligns with clinical considerations by measuring the time from starting specimen culture to the release of an official blood culture report.We were curious to know whether the duration of TAT is as intricately linked to the prognosis of bacteremia as TTP. Objectives: To examine the association between TAT and outcomes of adult patients who present to the ED with community acquired bacteremia. Design: Setting, and Participants: This retrospective study utilized electronic medical records from Kaohsiung Veterans General Hospital (KVGH), a 1000-bed tertiary medical center in Taiwan. Patients were adults aged 18 years and older who presented to ED (Emergency department) for initial diagnosis of community acquired bacteremia from January 1, 2016 to March 31, 2021. Data analysis was performed from December 2022 to January 2023.Main outcomes and measures.The primary outcomes included mortality in the ED, all-cause in-hospital mortality, length of hospital stay, and all-cause 30-day mortality in relation to the individual first report of positive blood culture TAT. Results: A total of 4011 eligible patients with bacteremia were evaluated, of which 207 patients had a blood culture TAT of ≤48 h. The overall 30-day all-cause mortality rate was 13%. Contrary to expectation, no statistically significant differences were observed in clinical prognosis between the TAT groups (≤48 versus >48 h). Subgroup analyses indicated that the length of TAT did not have a significant effect on clinical prognosis in patients who underwent lactate level assessment. Furthermore, no difference in clinical outcome was noted between TAT groups (≤48 versus >48 h) in terms of Gram-negative bacilli or Gram-positive cocci bacteremia. However, in patients with delayed antibiotic treatment (>3 h), a shorter TAT was significantly associated with a fatal outcome. Conclusion: In adults with community-acquired bacteremia, this study did not observe a significant association between blood culture TAT and clinical prognosis, except in cases of delayed antibiotic treatment.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2405844024039884Test; https://doaj.org/toc/2405-8440Test

الوصول الحر: https://doaj.org/article/f18904d614e846aa9329d379e17686daTest

المؤلفون: Yao-Chung Yang, Yao-Shen Chen, Wei-Chuan Liao, Chun-Hao Yin, Yung-Shang Lin, Meng-Wei Chen, Jin-Shuen Chen

المصدر: Perioperative Medicine, Vol 12, Iss 1, Pp 1-11 (2023)

مصطلحات موضوعية: Glomerular filtration rate, Primary malignant brain tumor, Postoperative complication, Surgery, RD1-811

الوصف: Abstract Background The occurrence of postoperative complications within 30 days (PC1M) of a craniotomy for the removal of a primary malignant brain tumor has been associated with a poor prognosis. However, it is still unclear to early predict the occurrence of PC1M. This study aimed to identify the potential perioperative predictors of PC1M from its preoperative, intraoperative, and 24-h postoperative parameters. Methods Patients who had undergone craniotomy for primary malignant brain tumor (World Health Organization grades III and IV) from January 2011 to December 2020 were enrolled from a databank of Kaohsiung Veterans General Hospital, Taiwan. The patients were classified into PC1M and nonPC1M groups. PC1M was defined according to the classification by Landriel et al. as any deviation from an uneventful 30-day postoperative course. In both groups, data regarding the baseline characteristics and perioperative parameters of the patients, including a new marker-kinetic estimated glomerular filtration rate, were collected. Logistic regression was used to analyze the predictability of the perioperative parameters. Results The PC1M group included 41 of 95 patients. An American Society of Anesthesiologists score of > 2 (aOR, 3.17; 95% confidence interval [CI], 1.19–8.45; p = 0.021), longer anesthesia duration (aOR, 1.16; 95% CI, 0.69–0.88; p − 4.8% (aOR, 3.45; 95% CI, 1.22–9.73; p = 0.0019), and 24-h postoperative change in kinetic estimated glomerular filtration rate of

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2047-0525Test

الوصول الحر: https://doaj.org/article/f39dbfc03c9e4e0ebc9c3b390b514142Test

المؤلفون: Huei-Geng Chen, Jin-Shuen Chen, Yao-Shen Chen, Chun-Hao Yin, Hsiao-Ching Chen, Yee-Hsuan Chiou

المصدر: Journal of Microbiology, Immunology and Infection, Vol 56, Iss 5, Pp 1105-1113 (2023)

مصطلحات موضوعية: Cyclophosphamide, Lupus nephritis, Mycophenolic acid, Pediatric, Microbiology, QR1-502

الوصف: Background: This study aimed to compare the efficacy of mycophenolic acid (MPA) and cyclophosphamide (CYC) for treating pediatric lupus nephritis (pLN). Methods: Data on patients with pLN class III, IV, and V, diagnosed by renal biopsy, were collected from the Databank of Kaohsiung Veterans General Hospital between February 2005 and December 2020. The study included 31 pLN patients. Of these, 15 received MPA (MPA group) and 16 received CYC (CYC group). Systemic lupus erythematosus disease activity index score, laboratory findings, complete remission (CR), and partial remission (PR) were assessed at 6, 12, and 24 months. Results: In the MPA group, CR occurred in 7/15 (47%) patients at month 6 and in 11/15 (73%) at months 12 and 24. In the CYC group, CR was reached in 5/16 (31%) patients at month 6, in 8/16 (50%) at month 12, and in 9/16 (56%) at month 24. PR was seen in 3/15 (20%) patients in the MPA group and in 3/16 (19%) in the CYC group at month 24. The cumulative probability of CR and PR showed no statistically significant difference between the two groups. However, the estimated glomerular filtration rate (eGFR) improved significantly in the MPA group at months 6, 12 and 24 compared to that in the CYC group (p

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S1684118223001536Test; https://doaj.org/toc/1684-1182Test

الوصول الحر: https://doaj.org/article/5030bd6255094698ba23d9a56f0f73c4Test

المؤلفون: Yi-Ting Chu, Jin-Shuen Chen, Yao-Shen Chen, Chih-Chieh Yang, Chun-Hao Yin, Hsiao-Ping Wang, Yee-Hsuan Chiou

المصدر: Pediatrics and Neonatology, Vol 64, Iss 3, Pp 288-296 (2023)

مصطلحات موضوعية: apnea, bronchopulmonary dysplasia, prematurity, xanthines, Pediatrics, RJ1-570

الوصف: Background: Aminophylline use and the association between clinical outcomes and therapy timing have been less investigated. The objective of this study was to determine the efficacy of early aminophylline use (within the first two days of life) in premature infants. Method: A retrospective observational cohort of infants weighing

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S1875957222002522Test; https://doaj.org/toc/1875-9572Test

الوصول الحر: https://doaj.org/article/5b3da6fe7491492e9eb4e6e8f0ee7387Test

المؤلفون: Chi-Shen Chen, Hsien-Chung Yu, Chun-Hao Yin, Jin-Shuen Chen, Yao-Shen Chen, I-Shu Chen

المصدر: Diagnostics, Vol 14, Iss 8, p 784 (2024)

مصطلحات موضوعية: lung cancer, LDCT screening, risk factors, high-risk group, Medicine (General), R5-920

الوصف: Low-dose computed tomography screening for lung cancer is currently targeted at heavy smokers or those with a family history of lung cancer. This study aimed to identify risk factors for lung cancer in individuals who do not meet the current lung cancer screening criteria as stipulated by the Taiwan Health Promotion Agency’s low-dose computed tomography (LDCT) screening policy. A cohort analysis was conducted on 12,542 asymptomatic healthy subjects aged 20–80 years old who voluntarily underwent LDCT scans from January 2016 to December 2021. Logistic regression demonstrated that several factors, including age over 55 years, female gender, a body mass index (BMI) less than 23, a previous history of respiratory diseases such as tuberculosis or obstructive respiratory diseases (chronic obstructive pulmonary disease [COPD], asthma), and previous respiratory symptoms such as cough or dyspnea, were associated with high-risk lung radiology scores according to LDCT scans. These findings indicate that risk-based assessments using primary data and questionnaires to identify risk factors other than heavy smoking and a family history of lung cancer may improve the efficiency of lung cancer screening.

وصف الملف: electronic resource

العلاقة: https://www.mdpi.com/2075-4418/14/8/784Test; https://doaj.org/toc/2075-4418Test

الوصول الحر: https://doaj.org/article/8d0cc87da11f436e9c200e6169c19ab2Test

المؤلفون: Mei-Yin Chen, Shih-Hsiang Ou, Nai-Ching Chen, Chun-Hao Yin, Chien-Liang Chen

المصدر: Renal Failure, Vol 44, Iss 1, Pp 1595-1603 (2022)

مصطلحات موضوعية: Aluminum, aluminum overload, desferroxime, dialysis, Diseases of the genitourinary system. Urology, RC870-923

الوصف: Background Aluminum accumulation is a well-described complication in dialysis patients. Improvements in hemodialysis technology have possibly eliminated the occurrence of aluminum overload. Limited evidence suggests that aluminum overload may decline in the era of aluminum removal from dialysis fluids, even with the use of aluminum binders.Methods We examined the data from January 2014 to June 1, 2020, identified through our electronic records, to evaluate the desferrioxamine (DFO) test results for aluminum overload. The presentation and treatment of aluminum overload were recorded.Results Ninety-nine dialysis patients were enrolled for the DFO test. Forty-seven patients (47.5%) were identified as DFO test positive for aluminum overload, of which 14 (14/47) patients had symptoms, including one patient with an unexplained fracture, eight patients with unexplained anemia despite high-dose erythropoiesis-stimulating agents, and five patients with hypercalcemia (serum calcium >11 mg dL-1). None of the patients with aluminum overload developed encephalopathy. Only four of the 47 patients had microcytic anemia. Patients requiring longer treatments (>10 months versus

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/0886-022XTest; https://doaj.org/toc/1525-6049Test

الوصول الحر: https://doaj.org/article/a883daec99864dec85ffecac583c68f3Test

المؤلفون: Shin-Ying Li, Chun-Hao Yin, Jin-Shuen Chen, Yao-Shen Chen, Chih-Chieh Yang, Nai-Wen Fang, Hsiao-Ping Wang, Yee-Hsuan Chiou

المصدر: Pediatrics and Neonatology, Vol 63, Iss 6, Pp 605-612 (2022)

مصطلحات موضوعية: febrile neonates, nomogram, serious bacterial infection, Pediatrics, RJ1-570

الوصف: Background: Serious bacterial infections (SBIs) could lead to mortality or severe long-term sequelae in neonates and infants aged 2.5 mg/dL, and pyuria were associated with an increased risk of SBIs. Accordingly, these four factors were used to develop a nomogram for SBI prediction, which exhibited significantly high performance (area under curve = 0.848, p < 0.001) in predicting SBI risk. Conclusion: We developed a nomogram combining clinical appearance, serum myelocyte/metamyelocyte presence, CRP, and pyuria for predicting SBI risk in febrile neonates. This tool can assist clinicians in making early diagnoses and delivering the appropriate treatment.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S1875957222001504Test; https://doaj.org/toc/1875-9572Test

الوصول الحر: https://doaj.org/article/377cc99be1664904b3c3d12ac8182e96Test

المؤلفون: Ming-Yun Hsieh, Jin-Shuen Chen, Chun-Hao Yin

المصدر: Journal of International Medical Research, Vol 51 (2023)

مصطلحات موضوعية: Medicine (General), R5-920

الوصف: Objective To assess the spectrum of patients who developed recurrent acute transfusion reactions (TRs) and to characterize these recurrent TRs. Methods This retrospective study included patients who developed ≥2 acute TRs between April 2017 and March 2020 in a tertiary medical centre. Results Among 216 TRs that occurred after 2024 transfusions in 87 patients, 66 (75.9%) patients reported a history of transfusions before the first TR and 70 (80.5%) patients received further transfusions after the last TR; with the same type of TR and reaction to the same type of blood product observed in 59 (67.8%) patients and 56 (64.4%) patients, respectively. TRs were most commonly associated with packed red blood cell (PRBC) transfusions and a febrile non-haemolytic transfusion reaction (FNHTR) was the most common type of TR. However, leukocyte reduced (LR) PRBCs were less common than LR platelets among transfusions with TR (22.7% [27/119] versus 75.0% [57/76], respectively) and premedication was prescribed before 196 of 216 (90.7%) transfusions with TR. Conclusion Most patients with recurrent TRs received repeated transfusions in addition to transfusions with TR. Instead of considering premedication, an increase in the use of LR might be the strategy to reduce the recurrence of TR.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1473-2300Test

الوصول الحر: https://doaj.org/article/dcde462cfdfa413fb4183051f5231354Test