Diagnosing peripheral pulmonary lesions using a traditional bronchoscope is difficult. Reports on the learning experience for Veran’s SPiN electromagnetic navigation bronchoscopy (ENB) for the diagnosis of pulmonary lesions are limited. We aimed to evaluate the skills developed by trainees who underwent Veran ENB learning in a clinical setting. We retrospectively examined the data of patients who had undergone Veran ENB to guide instruments through the airways to a target lesion for biopsy or localization from November 2019 to March 2022. In total, 23 patients, including 16 with solid lesions (69.6%), 4 with pure ground-glass opacity (17.4%), and 3 with mixed (13.0%) were included. The median largest diameter of the pulmonary lesions was 2.7 ± 1.8 cm, whereas the median distance from the pleural surface to the edge of the pulmonary lesion in its shortest path was 1.9 ± 1.6 cm. Most lesions in this cohort had a positive air bronchus sign (69.6%). The mean procedure time for a young thoracic surgeon was longer after 10 cases of operation (45.6 ± 13.4 vs. 33.8 ± 9.2 min, P = 0.027). There were no complications reported related to the procedure. ENB is a safe and less invasive method for tissue diagnosis or preoperative localization for patients with pulmonary lesions. However, a young thoracic surgeon in the learning process requires more time to perform ENB. This study provides basic information about the learning experience of trainees while performing the ENB procedure.
{"title":"Initial Learning Experience for Electromagnetic Navigation Bronchoscopy: A Surgeon’s Experience while Introducing the Navigation Technology in Pulmonary Lesion Diagnosis","authors":"Y. Tsai, Yen-Shou Kuo, Ying-Yi Chen, Cheng-Hsi Yang, Yu-An Cheng, Hsu-Kai Huang","doi":"10.4103/jmedsci.jmedsci_234_23","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_234_23","url":null,"abstract":"\u0000 \u0000 \u0000 Diagnosing peripheral pulmonary lesions using a traditional bronchoscope is difficult. Reports on the learning experience for Veran’s SPiN electromagnetic navigation bronchoscopy (ENB) for the diagnosis of pulmonary lesions are limited.\u0000 \u0000 \u0000 \u0000 We aimed to evaluate the skills developed by trainees who underwent Veran ENB learning in a clinical setting.\u0000 \u0000 \u0000 \u0000 We retrospectively examined the data of patients who had undergone Veran ENB to guide instruments through the airways to a target lesion for biopsy or localization from November 2019 to March 2022.\u0000 \u0000 \u0000 \u0000 In total, 23 patients, including 16 with solid lesions (69.6%), 4 with pure ground-glass opacity (17.4%), and 3 with mixed (13.0%) were included. The median largest diameter of the pulmonary lesions was 2.7 ± 1.8 cm, whereas the median distance from the pleural surface to the edge of the pulmonary lesion in its shortest path was 1.9 ± 1.6 cm. Most lesions in this cohort had a positive air bronchus sign (69.6%). The mean procedure time for a young thoracic surgeon was longer after 10 cases of operation (45.6 ± 13.4 vs. 33.8 ± 9.2 min, P = 0.027). There were no complications reported related to the procedure.\u0000 \u0000 \u0000 \u0000 ENB is a safe and less invasive method for tissue diagnosis or preoperative localization for patients with pulmonary lesions. However, a young thoracic surgeon in the learning process requires more time to perform ENB. This study provides basic information about the learning experience of trainees while performing the ENB procedure.\u0000","PeriodicalId":16486,"journal":{"name":"Journal of Medical Sciences","volume":"69 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140444499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.4103/jmedsci.jmedsci_166_23
S. Chuang, Jo Yung-Wei Wu, C. Wang
People with schizophrenia experienced a higher level of internalized stigma compared to people with other mental disorders. Internalized stigma could lead to pervasive negative effects in their life. Although internalized stigma interventions have shown some benefits, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness in people with schizophrenia. This study aims at examining the effectiveness of internalized stigma reduction in people with schizophrenia through a systematic review and meta-analysis. Two electronic databases were searched. Studies were included if they (1) involved community or hospital-based interventions on internalized stigma, (2) included participants who were given a diagnosis of schizophrenia, and (3) were empirical and quantitative in nature. Thirteen articles were selected for extensive review and seven for meta-analysis. A variety of psychosocial interventions were utilized with the majority employing psychoeducation, cognitive behavioral therapy (CBT), social skills training, hope instillation program, and against stigma program. The internalized stigma was used to examine the efficacy of the intervention. Seven studies involving a total of 799 patients were included in the meta-analysis. Assuming a random effects model, the meta-analysis revealed an improvement in internalized stigma favoring the internalized stigma intervention (95% confidence interval [0.492; 1754], P = 0.001), but the heterogeneity among individual effect sizes was substantial (I 2 = 93.20%). Most internalized stigma reduction programs appear to be effective. This systematic review was unable to show light in indicating the most effective intervention, however, demonstrates evidence that psychoeducation is promising. Large-scale randomized control trials and multicomponents of intervention are required to further develop the evidence based of more targeted interventions.
{"title":"Interventions for Reduction of Stigma in People with Schizophrenia: A Systematic Review and Meta-analysis","authors":"S. Chuang, Jo Yung-Wei Wu, C. Wang","doi":"10.4103/jmedsci.jmedsci_166_23","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_166_23","url":null,"abstract":"\u0000 People with schizophrenia experienced a higher level of internalized stigma compared to people with other mental disorders. Internalized stigma could lead to pervasive negative effects in their life. Although internalized stigma interventions have shown some benefits, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness in people with schizophrenia. This study aims at examining the effectiveness of internalized stigma reduction in people with schizophrenia through a systematic review and meta-analysis. Two electronic databases were searched. Studies were included if they (1) involved community or hospital-based interventions on internalized stigma, (2) included participants who were given a diagnosis of schizophrenia, and (3) were empirical and quantitative in nature. Thirteen articles were selected for extensive review and seven for meta-analysis. A variety of psychosocial interventions were utilized with the majority employing psychoeducation, cognitive behavioral therapy (CBT), social skills training, hope instillation program, and against stigma program. The internalized stigma was used to examine the efficacy of the intervention. Seven studies involving a total of 799 patients were included in the meta-analysis. Assuming a random effects model, the meta-analysis revealed an improvement in internalized stigma favoring the internalized stigma intervention (95% confidence interval [0.492; 1754], P = 0.001), but the heterogeneity among individual effect sizes was substantial (I\u0000 2 = 93.20%). Most internalized stigma reduction programs appear to be effective. This systematic review was unable to show light in indicating the most effective intervention, however, demonstrates evidence that psychoeducation is promising. Large-scale randomized control trials and multicomponents of intervention are required to further develop the evidence based of more targeted interventions.","PeriodicalId":16486,"journal":{"name":"Journal of Medical Sciences","volume":"39 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139871785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.4103/jmedsci.jmedsci_47_23
Chetan Shivaram, Suresh Bhat, Neeta Santha
Propofol is the preferred drug for the induction of anesthesia in many centers. However, its ubiquitous use is hampered by adverse effects. The rationale behind our study is to prove that whether the administration of an opioid drug before propofol induction, lowers the amount of propofol requirement for balanced anesthesia, and enhances hemodynamic stability. The present study intends to know the consequence of the differing time intervals between the administration of fentanyl and propofol on the dosage of propofol required to achieve induction of general anesthesia. In this observational study, 84 patients were included in the study. Patients who received propofol immediately after fentanyl injection were included in Group 1, whereas patients who received propofol at 3 min and 6 min after fentanyl injection, respectively, were grouped as Group 2 and Group 3. The total propofol required, the hemodynamic variations and the entropy values were recorded. SSPS version 25.09 (IBM) was used for statistical analysis. In this study, it was observed that there was a significant reduction in propofol requirement in Group 2 and Group 3 compared with Group 1. The incidence of hypotension was seen in about 42.9% of Group 1 when compared to Group 2 and 3, which was 28.6% and 17.8%, respectively. Furthermore, the entropy values in Group 3 were initially higher and later were comparable in all the groups. Our study concluded that as the duration between the administration of propofol and fentanyl increases, the hemodynamic stability also increases and there is no variation in the depth of anesthesia attained in the distinct study population.
{"title":"An Entropy Based Observational Study to Assess the Dosage of Propofol required for Induction of Anaesthesia by Varying the Time Intervals between Fentanyl and Propofol Administration","authors":"Chetan Shivaram, Suresh Bhat, Neeta Santha","doi":"10.4103/jmedsci.jmedsci_47_23","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_47_23","url":null,"abstract":"\u0000 \u0000 \u0000 Propofol is the preferred drug for the induction of anesthesia in many centers. However, its ubiquitous use is hampered by adverse effects. The rationale behind our study is to prove that whether the administration of an opioid drug before propofol induction, lowers the amount of propofol requirement for balanced anesthesia, and enhances hemodynamic stability.\u0000 \u0000 \u0000 \u0000 The present study intends to know the consequence of the differing time intervals between the administration of fentanyl and propofol on the dosage of propofol required to achieve induction of general anesthesia.\u0000 \u0000 \u0000 \u0000 In this observational study, 84 patients were included in the study. Patients who received propofol immediately after fentanyl injection were included in Group 1, whereas patients who received propofol at 3 min and 6 min after fentanyl injection, respectively, were grouped as Group 2 and Group 3. The total propofol required, the hemodynamic variations and the entropy values were recorded. SSPS version 25.09 (IBM) was used for statistical analysis.\u0000 \u0000 \u0000 \u0000 In this study, it was observed that there was a significant reduction in propofol requirement in Group 2 and Group 3 compared with Group 1. The incidence of hypotension was seen in about 42.9% of Group 1 when compared to Group 2 and 3, which was 28.6% and 17.8%, respectively. Furthermore, the entropy values in Group 3 were initially higher and later were comparable in all the groups.\u0000 \u0000 \u0000 \u0000 Our study concluded that as the duration between the administration of propofol and fentanyl increases, the hemodynamic stability also increases and there is no variation in the depth of anesthesia attained in the distinct study population.\u0000","PeriodicalId":16486,"journal":{"name":"Journal of Medical Sciences","volume":"40 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139810065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.4103/jmedsci.jmedsci_47_23
Chetan Shivaram, Suresh Bhat, Neeta Santha
Propofol is the preferred drug for the induction of anesthesia in many centers. However, its ubiquitous use is hampered by adverse effects. The rationale behind our study is to prove that whether the administration of an opioid drug before propofol induction, lowers the amount of propofol requirement for balanced anesthesia, and enhances hemodynamic stability. The present study intends to know the consequence of the differing time intervals between the administration of fentanyl and propofol on the dosage of propofol required to achieve induction of general anesthesia. In this observational study, 84 patients were included in the study. Patients who received propofol immediately after fentanyl injection were included in Group 1, whereas patients who received propofol at 3 min and 6 min after fentanyl injection, respectively, were grouped as Group 2 and Group 3. The total propofol required, the hemodynamic variations and the entropy values were recorded. SSPS version 25.09 (IBM) was used for statistical analysis. In this study, it was observed that there was a significant reduction in propofol requirement in Group 2 and Group 3 compared with Group 1. The incidence of hypotension was seen in about 42.9% of Group 1 when compared to Group 2 and 3, which was 28.6% and 17.8%, respectively. Furthermore, the entropy values in Group 3 were initially higher and later were comparable in all the groups. Our study concluded that as the duration between the administration of propofol and fentanyl increases, the hemodynamic stability also increases and there is no variation in the depth of anesthesia attained in the distinct study population.
{"title":"An Entropy Based Observational Study to Assess the Dosage of Propofol required for Induction of Anaesthesia by Varying the Time Intervals between Fentanyl and Propofol Administration","authors":"Chetan Shivaram, Suresh Bhat, Neeta Santha","doi":"10.4103/jmedsci.jmedsci_47_23","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_47_23","url":null,"abstract":"\u0000 \u0000 \u0000 Propofol is the preferred drug for the induction of anesthesia in many centers. However, its ubiquitous use is hampered by adverse effects. The rationale behind our study is to prove that whether the administration of an opioid drug before propofol induction, lowers the amount of propofol requirement for balanced anesthesia, and enhances hemodynamic stability.\u0000 \u0000 \u0000 \u0000 The present study intends to know the consequence of the differing time intervals between the administration of fentanyl and propofol on the dosage of propofol required to achieve induction of general anesthesia.\u0000 \u0000 \u0000 \u0000 In this observational study, 84 patients were included in the study. Patients who received propofol immediately after fentanyl injection were included in Group 1, whereas patients who received propofol at 3 min and 6 min after fentanyl injection, respectively, were grouped as Group 2 and Group 3. The total propofol required, the hemodynamic variations and the entropy values were recorded. SSPS version 25.09 (IBM) was used for statistical analysis.\u0000 \u0000 \u0000 \u0000 In this study, it was observed that there was a significant reduction in propofol requirement in Group 2 and Group 3 compared with Group 1. The incidence of hypotension was seen in about 42.9% of Group 1 when compared to Group 2 and 3, which was 28.6% and 17.8%, respectively. Furthermore, the entropy values in Group 3 were initially higher and later were comparable in all the groups.\u0000 \u0000 \u0000 \u0000 Our study concluded that as the duration between the administration of propofol and fentanyl increases, the hemodynamic stability also increases and there is no variation in the depth of anesthesia attained in the distinct study population.\u0000","PeriodicalId":16486,"journal":{"name":"Journal of Medical Sciences","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139870089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zika virus is a mosquito-borne virus that has resurfaced. It has been confirmed to cause microcephaly and Guillain–Barré syndrome. The number of Zika virus infections in South America has increased considerably since 2015. This study confirmed the epidemiological characteristics of the cases of Zika virus infections imported into Taiwan. Patients with travel history to areas at risk of Zika virus infections and had their blood, urine, or saliva samples tested positive for Zika virus through reverse transcription polymerase chain reaction by the Taiwan Centers for Disease Control were included in this study. Taiwan reported its first case of Zika virus infection in January 2016, and it has reported 26 cases as of December 2021. Most of the patients were men (76.9%, 20/26), aged 20–59 years (73.1%, 19/26), and lived in Northern Taiwan (73.1%, 19/26). Most of the cases were reported in summer and autumn (76.9%, 20/26). The 26 patients included one 4-year-old girl and three teenage boys aged 15–19 years; 22 patients were from Southeast Asia, three patients were from the Americas, and one patient was from Africa. This study is the first to report on the epidemiological characteristics of Zika virus infections imported into Taiwan between 2016 and 2021. These findings can aid policymakers and clinical experts in developing prevention and control measures targeting Zika virus infections, which cause severe illness and imposes a considerable burden on the population.
{"title":"Epidemiological Characteristics of Zika Virus Infections Imported into Taiwan between 2016 and 2021","authors":"C. Hsieh, Wen-Tung Wu, Ming-Hsun Lin, Hung-Che Lin, Yueh-Feng Sung, Chia-Peng Yu","doi":"10.4103/jmedsci.jmedsci_170_23","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_170_23","url":null,"abstract":"\u0000 \u0000 \u0000 Zika virus is a mosquito-borne virus that has resurfaced. It has been confirmed to cause microcephaly and Guillain–Barré syndrome. The number of Zika virus infections in South America has increased considerably since 2015.\u0000 \u0000 \u0000 \u0000 This study confirmed the epidemiological characteristics of the cases of Zika virus infections imported into Taiwan.\u0000 \u0000 \u0000 \u0000 Patients with travel history to areas at risk of Zika virus infections and had their blood, urine, or saliva samples tested positive for Zika virus through reverse transcription polymerase chain reaction by the Taiwan Centers for Disease Control were included in this study.\u0000 \u0000 \u0000 \u0000 Taiwan reported its first case of Zika virus infection in January 2016, and it has reported 26 cases as of December 2021. Most of the patients were men (76.9%, 20/26), aged 20–59 years (73.1%, 19/26), and lived in Northern Taiwan (73.1%, 19/26). Most of the cases were reported in summer and autumn (76.9%, 20/26). The 26 patients included one 4-year-old girl and three teenage boys aged 15–19 years; 22 patients were from Southeast Asia, three patients were from the Americas, and one patient was from Africa.\u0000 \u0000 \u0000 \u0000 This study is the first to report on the epidemiological characteristics of Zika virus infections imported into Taiwan between 2016 and 2021. These findings can aid policymakers and clinical experts in developing prevention and control measures targeting Zika virus infections, which cause severe illness and imposes a considerable burden on the population.\u0000","PeriodicalId":16486,"journal":{"name":"Journal of Medical Sciences","volume":"36 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139811422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-02DOI: 10.4103/jmedsci.jmedsci_166_23
S. Chuang, Jo Yung-Wei Wu, C. Wang
People with schizophrenia experienced a higher level of internalized stigma compared to people with other mental disorders. Internalized stigma could lead to pervasive negative effects in their life. Although internalized stigma interventions have shown some benefits, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness in people with schizophrenia. This study aims at examining the effectiveness of internalized stigma reduction in people with schizophrenia through a systematic review and meta-analysis. Two electronic databases were searched. Studies were included if they (1) involved community or hospital-based interventions on internalized stigma, (2) included participants who were given a diagnosis of schizophrenia, and (3) were empirical and quantitative in nature. Thirteen articles were selected for extensive review and seven for meta-analysis. A variety of psychosocial interventions were utilized with the majority employing psychoeducation, cognitive behavioral therapy (CBT), social skills training, hope instillation program, and against stigma program. The internalized stigma was used to examine the efficacy of the intervention. Seven studies involving a total of 799 patients were included in the meta-analysis. Assuming a random effects model, the meta-analysis revealed an improvement in internalized stigma favoring the internalized stigma intervention (95% confidence interval [0.492; 1754], P = 0.001), but the heterogeneity among individual effect sizes was substantial (I 2 = 93.20%). Most internalized stigma reduction programs appear to be effective. This systematic review was unable to show light in indicating the most effective intervention, however, demonstrates evidence that psychoeducation is promising. Large-scale randomized control trials and multicomponents of intervention are required to further develop the evidence based of more targeted interventions.
{"title":"Interventions for Reduction of Stigma in People with Schizophrenia: A Systematic Review and Meta-analysis","authors":"S. Chuang, Jo Yung-Wei Wu, C. Wang","doi":"10.4103/jmedsci.jmedsci_166_23","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_166_23","url":null,"abstract":"\u0000 People with schizophrenia experienced a higher level of internalized stigma compared to people with other mental disorders. Internalized stigma could lead to pervasive negative effects in their life. Although internalized stigma interventions have shown some benefits, there is a dearth of interventions and meanwhile a lack of evidence as to their effectiveness in people with schizophrenia. This study aims at examining the effectiveness of internalized stigma reduction in people with schizophrenia through a systematic review and meta-analysis. Two electronic databases were searched. Studies were included if they (1) involved community or hospital-based interventions on internalized stigma, (2) included participants who were given a diagnosis of schizophrenia, and (3) were empirical and quantitative in nature. Thirteen articles were selected for extensive review and seven for meta-analysis. A variety of psychosocial interventions were utilized with the majority employing psychoeducation, cognitive behavioral therapy (CBT), social skills training, hope instillation program, and against stigma program. The internalized stigma was used to examine the efficacy of the intervention. Seven studies involving a total of 799 patients were included in the meta-analysis. Assuming a random effects model, the meta-analysis revealed an improvement in internalized stigma favoring the internalized stigma intervention (95% confidence interval [0.492; 1754], P = 0.001), but the heterogeneity among individual effect sizes was substantial (I\u0000 2 = 93.20%). Most internalized stigma reduction programs appear to be effective. This systematic review was unable to show light in indicating the most effective intervention, however, demonstrates evidence that psychoeducation is promising. Large-scale randomized control trials and multicomponents of intervention are required to further develop the evidence based of more targeted interventions.","PeriodicalId":16486,"journal":{"name":"Journal of Medical Sciences","volume":"40 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139811601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zika virus is a mosquito-borne virus that has resurfaced. It has been confirmed to cause microcephaly and Guillain–Barré syndrome. The number of Zika virus infections in South America has increased considerably since 2015. This study confirmed the epidemiological characteristics of the cases of Zika virus infections imported into Taiwan. Patients with travel history to areas at risk of Zika virus infections and had their blood, urine, or saliva samples tested positive for Zika virus through reverse transcription polymerase chain reaction by the Taiwan Centers for Disease Control were included in this study. Taiwan reported its first case of Zika virus infection in January 2016, and it has reported 26 cases as of December 2021. Most of the patients were men (76.9%, 20/26), aged 20–59 years (73.1%, 19/26), and lived in Northern Taiwan (73.1%, 19/26). Most of the cases were reported in summer and autumn (76.9%, 20/26). The 26 patients included one 4-year-old girl and three teenage boys aged 15–19 years; 22 patients were from Southeast Asia, three patients were from the Americas, and one patient was from Africa. This study is the first to report on the epidemiological characteristics of Zika virus infections imported into Taiwan between 2016 and 2021. These findings can aid policymakers and clinical experts in developing prevention and control measures targeting Zika virus infections, which cause severe illness and imposes a considerable burden on the population.
{"title":"Epidemiological Characteristics of Zika Virus Infections Imported into Taiwan between 2016 and 2021","authors":"C. Hsieh, Wen-Tung Wu, Ming-Hsun Lin, Hung-Che Lin, Yueh-Feng Sung, Chia-Peng Yu","doi":"10.4103/jmedsci.jmedsci_170_23","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_170_23","url":null,"abstract":"\u0000 \u0000 \u0000 Zika virus is a mosquito-borne virus that has resurfaced. It has been confirmed to cause microcephaly and Guillain–Barré syndrome. The number of Zika virus infections in South America has increased considerably since 2015.\u0000 \u0000 \u0000 \u0000 This study confirmed the epidemiological characteristics of the cases of Zika virus infections imported into Taiwan.\u0000 \u0000 \u0000 \u0000 Patients with travel history to areas at risk of Zika virus infections and had their blood, urine, or saliva samples tested positive for Zika virus through reverse transcription polymerase chain reaction by the Taiwan Centers for Disease Control were included in this study.\u0000 \u0000 \u0000 \u0000 Taiwan reported its first case of Zika virus infection in January 2016, and it has reported 26 cases as of December 2021. Most of the patients were men (76.9%, 20/26), aged 20–59 years (73.1%, 19/26), and lived in Northern Taiwan (73.1%, 19/26). Most of the cases were reported in summer and autumn (76.9%, 20/26). The 26 patients included one 4-year-old girl and three teenage boys aged 15–19 years; 22 patients were from Southeast Asia, three patients were from the Americas, and one patient was from Africa.\u0000 \u0000 \u0000 \u0000 This study is the first to report on the epidemiological characteristics of Zika virus infections imported into Taiwan between 2016 and 2021. These findings can aid policymakers and clinical experts in developing prevention and control measures targeting Zika virus infections, which cause severe illness and imposes a considerable burden on the population.\u0000","PeriodicalId":16486,"journal":{"name":"Journal of Medical Sciences","volume":"49 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139871375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diabetic neuropathy (DN) is one of the common chronic complications, leading to limb disability and increased risks of hospitalization and mortality. Traditional Chinese medicine (TCM) has been commonly applied in Taiwan as an adjunctive treatment to ameliorate diabetes-associated chronic complications, including neuropathy. We aimed to investigate whether the clinical treatment of DN combined with TCM can reduce the associated hospitalization and mortality using the National Health Insurance Research Database (NHIRD) of Taiwan. We selected 1,152 patients with DN who received TCM treatment as the study cohort group, and 4,940 patients with DN who did not receive TCM treatment from Taiwan NHIRD were further matched 1:1 for sex, age, and index year as the comparison cohort group. Cox proportional hazards analysis was performed to compare hospitalization and mortality during a mean follow-up period of 15 years. A total of 687/225 enrolled patients (29.82%/9.77%) had hospitalization/mortality, including 298/97 in the TCM group (25.87%/8.42%) and 389/128 in the comparison group (33.77%/11.11%). Cox proportional hazard regression analysis showed a lower rate of hospitalization and mortality for patients in the TCM group (adjusted hazard ratio [HR] of 0.434, 95 confidence interval [CI] =0.172–0.798, P < 0.001; adjusted HR of 0.689, 95 CI = 0.372–0.981, P = 0.039). The Kaplan–Meier analysis showed that the cumulative risk of hospitalization and mortality in the study and comparison cohort groups was significantly different (log-rank P < 0.001 and P = 0.007, respectively). Our results suggest that the application of TCM might be beneficial for patients with DN to lower the risks of hospitalization and mortality; however, further prospective cohort studies are still required to confirm our observations.
{"title":"Study on the Prognosis Effect of Traditional Chinese Medicine Treatment in Patients with Diabetic Neuropathy – A Nationwide, Population-based Study in Taiwan","authors":"Ting-Shuo Chen, Peng-Fei Li, Chia-Luen Huang, Li-Ju Ho, Feng-Chih Kuo, Sheng-Chiang Su","doi":"10.4103/jmedsci.jmedsci_157_23","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_157_23","url":null,"abstract":"\u0000 \u0000 \u0000 Diabetic neuropathy (DN) is one of the common chronic complications, leading to limb disability and increased risks of hospitalization and mortality. Traditional Chinese medicine (TCM) has been commonly applied in Taiwan as an adjunctive treatment to ameliorate diabetes-associated chronic complications, including neuropathy.\u0000 \u0000 \u0000 \u0000 We aimed to investigate whether the clinical treatment of DN combined with TCM can reduce the associated hospitalization and mortality using the National Health Insurance Research Database (NHIRD) of Taiwan.\u0000 \u0000 \u0000 \u0000 We selected 1,152 patients with DN who received TCM treatment as the study cohort group, and 4,940 patients with DN who did not receive TCM treatment from Taiwan NHIRD were further matched 1:1 for sex, age, and index year as the comparison cohort group. Cox proportional hazards analysis was performed to compare hospitalization and mortality during a mean follow-up period of 15 years.\u0000 \u0000 \u0000 \u0000 A total of 687/225 enrolled patients (29.82%/9.77%) had hospitalization/mortality, including 298/97 in the TCM group (25.87%/8.42%) and 389/128 in the comparison group (33.77%/11.11%). Cox proportional hazard regression analysis showed a lower rate of hospitalization and mortality for patients in the TCM group (adjusted hazard ratio [HR] of 0.434, 95 confidence interval [CI] =0.172–0.798, P < 0.001; adjusted HR of 0.689, 95 CI = 0.372–0.981, P = 0.039). The Kaplan–Meier analysis showed that the cumulative risk of hospitalization and mortality in the study and comparison cohort groups was significantly different (log-rank P < 0.001 and P = 0.007, respectively).\u0000 \u0000 \u0000 \u0000 Our results suggest that the application of TCM might be beneficial for patients with DN to lower the risks of hospitalization and mortality; however, further prospective cohort studies are still required to confirm our observations.\u0000","PeriodicalId":16486,"journal":{"name":"Journal of Medical Sciences","volume":"124 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140476096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-29DOI: 10.4103/jmedsci.jmedsci_218_23
A. Adekeye
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Renal hyperparathyroidism can be effectively treated with parathyroidectomy. However, managing persistence or recurrence after the initial surgery is still challenging. Understanding the anatomical patterns observed in reoperative parathyroidectomies can help localize the disease during initial and subsequent surgeries. This study aimed to identify the patterns of persistence and recurrence following parathyroidectomy for renal hyperparathyroidism and assess the performance of various localization studies. A retrospective cohort study was conducted on dialysis patients who underwent reoperative parathyroidectomy at a single center. Patient demographics, laboratory test results, localization study findings, surgical details, and postoperative outcomes were obtained through the chart reviews. Persistence was defined as an intact parathyroid hormone level >300 pg/mL within 6 months after the primary surgery; otherwise, recurrence was defined as > 6 months. Among 377 patients who underwent parathyroidectomies, 20 (5.3%) required reoperations. Supernumerary glands were the primary cause of persistence (70%) and recurrence (50%), predominantly located posteriorly within the tracheoesophageal groove. Besides, overgrowth of the forearm graft accounted for 30% of recurrences. Neck ultrasound (US) showed 6 out of 19 false negatives (68% sensitivity and 100% specificity), whereas 99mTc-sestamibi scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT) had one false negative (95% sensitivity and 100% specificity). CT scans accurately localized the disease in cases where US and sestamibi scintigraphy yielded discordant results. Supernumerary glands frequently contribute to the persistence and recurrence of renal hyperparathyroidism after parathyroidectomy. In the reoperative context, sestamibi SPECT/CT and CT scans detect affected parathyroid tissue in the neck and mediastinum more effectively than neck USs.
{"title":"The Patterns of Persistence and Recurrence Following Parathyroidectomy for Renal Hyperparathyroidism: A 10-year Review","authors":"Si-Yuan Wu, Yu-Cheng Chiu, Shun-Neng Hsu, Fu-Chiu Yu, Shih-Hua Lin, Ming-Lang Shih","doi":"10.4103/jmedsci.jmedsci_181_23","DOIUrl":"https://doi.org/10.4103/jmedsci.jmedsci_181_23","url":null,"abstract":"\u0000 \u0000 Renal hyperparathyroidism can be effectively treated with parathyroidectomy. However, managing persistence or recurrence after the initial surgery is still challenging. Understanding the anatomical patterns observed in reoperative parathyroidectomies can help localize the disease during initial and subsequent surgeries.\u0000 \u0000 \u0000 \u0000 This study aimed to identify the patterns of persistence and recurrence following parathyroidectomy for renal hyperparathyroidism and assess the performance of various localization studies.\u0000 \u0000 \u0000 \u0000 A retrospective cohort study was conducted on dialysis patients who underwent reoperative parathyroidectomy at a single center. Patient demographics, laboratory test results, localization study findings, surgical details, and postoperative outcomes were obtained through the chart reviews. Persistence was defined as an intact parathyroid hormone level >300 pg/mL within 6 months after the primary surgery; otherwise, recurrence was defined as > 6 months.\u0000 \u0000 \u0000 \u0000 Among 377 patients who underwent parathyroidectomies, 20 (5.3%) required reoperations. Supernumerary glands were the primary cause of persistence (70%) and recurrence (50%), predominantly located posteriorly within the tracheoesophageal groove. Besides, overgrowth of the forearm graft accounted for 30% of recurrences. Neck ultrasound (US) showed 6 out of 19 false negatives (68% sensitivity and 100% specificity), whereas 99mTc-sestamibi scintigraphy with single-photon emission computed tomography (SPECT)/computed tomography (CT) had one false negative (95% sensitivity and 100% specificity). CT scans accurately localized the disease in cases where US and sestamibi scintigraphy yielded discordant results.\u0000 \u0000 \u0000 \u0000 Supernumerary glands frequently contribute to the persistence and recurrence of renal hyperparathyroidism after parathyroidectomy. In the reoperative context, sestamibi SPECT/CT and CT scans detect affected parathyroid tissue in the neck and mediastinum more effectively than neck USs.\u0000","PeriodicalId":16486,"journal":{"name":"Journal of Medical Sciences","volume":"55 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139597717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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