Journal of the Formosan Medical Association最新文献

{"title":"Too early to be different? A multi-institutional study with 30-year follow-up for prognostic factors of completely resected early stage thymoma.","authors":"En-Kuei Tang, Yu-Feng Wei, Chao-Chun Chang, Wei-Ming Wang, Chen-Yu Wu, Wei-Li Huang, Ying-Yuan Chen, Yi-Ting Yen, Chien-Chung Lin, Ming-Ho Wu, Yau-Lin Tseng","doi":"10.1016/j.jfma.2024.12.009","DOIUrl":"https://doi.org/10.1016/j.jfma.2024.12.009","url":null,"abstract":"<p><strong>Background/purpose: </strong>This multi-institutional study was aimed to analyze prognostic factors of completely resected early stage thymoma.</p><p><strong>Methods: </strong>Patients with surgically treated early stage thymoma between 1988 and 2019 were enrolled. Statistical associations were evaluated using the χ² test, Fisher's exact test, and Student's t-test. Disease-free survival (DFS) and overall survival (OS) curves were established by the Kaplan-Meier method, and compared using the log-rank test.</p><p><strong>Results: </strong>A total of 229 patients with Masaoka stage I and 131 with Masaoka stage II thymoma were included. The DFS of patients with Masaoka stage I thymoma was associated with neutrophil-to-lymphocyte ratio (NLR, hazard ratio [HR] = 3.18, 95% confidence interval [CI]: 1.34-7.54), and extrathymic malignancies (HR = 4.51, 95% CI: 2.02-10.11), and the OS was associated with NLR (HR = 5.03, 95% CI: 1.61-15.66) and extrathymic malignancies (HR = 7.68, 95% CI: 3.12-18.97). In patients with Masaoka stage II thymoma, DFS was associated with age (HR = 2.50, 95% CI: 1.18-5.27), extent of surgery (HR = 0.41, 95% CI: 0.19-0.87), and NLR (HR = 3.23, 95% CI: 1.11-9.44), and OS was associated with age (HR = 5.77, 95% CI: 1.81-18.34), surgical approach (HR = 8.40, 95% CI: 1.91-37.00), and extrathymic malignancies (HR = 2.96, 95% CI: 1.08-8.12).</p><p><strong>Conclusion: </strong>In Masaoka stage I thymoma, preoperative NLR and extrathymic malignancies are independently associated with DFS and OS. In Masaoka stage II thymoma, age, extent of surgery, and NLR are independently associated with DFS, and age, surgical approach, and extrathymic malignancies are associated with OS.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Folate and vitamin B12 supplementation in patients with schizophrenia and low serum folate level: A 24-week randomized, double-blind, placebo-controlled study.","authors":"Chun-Hsin Chen, Chih-Chiang Chiu, Yi-Hang Chiu, Chin-Hao Chang, Yu-Han Chang, Ming-Chyi Huang, Mong-Liang Lu, Po-Yu Chen","doi":"10.1016/j.jfma.2024.11.019","DOIUrl":"https://doi.org/10.1016/j.jfma.2024.11.019","url":null,"abstract":"<p><strong>Purpose: </strong>We aimed to evaluate the effects of folate and vitamin B12 on psychopathology in patients with schizophrenia and low serum folate levels.</p><p><strong>Methods: </strong>Fifty-five schizophrenia patients with serum folate levels lower than 6 mg/L were randomized in a 2:1 ratio to supplementation with 5 mg of folate and 500 μg of vitamin B12 per day (the folate group, n = 36) or placebo (the placebo group, n = 19) for 24 weeks. We evaluated patients' symptomatology with the Positive and Negative Symptom Scale (PANSS) and cognitive functions with Cogstate.</p><p><strong>Results: </strong>During the 24-week intervention, serum folate and vitamin B12 levels significantly increased, and homocysteine level significantly decreased in the folate group, but these markers did not significantly change in the placebo group. There were no significant changes in scores of total and each subscale of PANSS, and Cogstate between the folate and placebo groups. A subgroup analysis within the folate groups revealed no significant differences in the changes of psychotic symptoms severity or cognitive functions among patients with different degrees of folate level increments.</p><p><strong>Conclusion: </strong>Our finding suggested that the extent of increased folate levels did not exert a notable impact on the changes of psychotic symptoms severity or cognitive function in our patients. It may also due to the relatively stable condition in our recruited patients, so supplementation of folate cannot show its effectiveness. Whether folate can improve psychopathology in moderate to severe patients with schizophrenia should be evaluated with a larger sample size in the future.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematopoietic cell transplantation for blood cancer patients living with HIV in Taiwan - A case series.","authors":"Yi-Wei Lee, Eve Chen, Yi-Ting Chuang, Wei-Li Ma, Shang-Ju Wu","doi":"10.1016/j.jfma.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.jfma.2024.12.002","url":null,"abstract":"<p><p>People living with HIV (PLWH) have an increased risk of developing cancers, especially hematologic malignancies (HM). Hematopoietic stem cell transplantation (HSCT) has been an important treatment modality for patients with HM. However, the experience of HSCT in PLWH with HM remains limited in Asia. Therefore, we describe a case series of PLWH treated with HSCT in Taiwan. In these PLWH patients, HSCT procedures, either autologous (auto-HSCT) or allogeneic (allo-HSCT), were feasible with acute toxicity profiles comparable to those in non-HIV patients. However, auto-HSCT seemed unable to lead toward durable remission in PLWH with relapsed/refractory lymphoma, implicating that allo-HSCT might warrant early considerations for consolidation purposes in this distinct patient group.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights.","authors":"Jia-Horng Kao","doi":"10.1016/j.jfma.2024.12.011","DOIUrl":"https://doi.org/10.1016/j.jfma.2024.12.011","url":null,"abstract":"","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical COVID-19 in children and adolescents during the 2022 Omicron Surge in Taiwan: Risk factors and vaccine effectiveness.","authors":"Jin-Yu Tsai, Yun-Chung Liu, Jeng-Hung Wu, Song-Ming Huang, Ya-Li Hu, Luan-Yin Chang, Chi-Tai Fang","doi":"10.1016/j.jfma.2024.11.018","DOIUrl":"https://doi.org/10.1016/j.jfma.2024.11.018","url":null,"abstract":"<p><strong>Background/aim: </strong>Critical coronavirus disease 2019 (COVID-19) is a rare but devastating complication of SARS-CoV-2 Omicron variant infection in children and adolescents. This study aimed to assess the risk factors for, and evaluate the vaccine effectiveness against, critical COVID-19 during the 2022 Omicron Surge in Taiwan.</p><p><strong>Methods: </strong>We retrospectively enrolled 41 pediatric patients with critical COVID-19 (which required mechanical ventilation, inotropic agents, extracorporeal membrane oxygenator, or resulting in in-hospital death) and 793 with non-critical COVID-19 who were hospitalized at National Taiwan University Children Hospital during the 2022 Omicron Surge. To estimate vaccine effectiveness, population controls generated using the Monte Carlo method from national vaccination statistics were matched to critical COVID-19 cases at a ratio of 10:1 by age group and disease onset date.</p><p><strong>Results: </strong>Only one of 41 critical COVID-19 cases had no underlying diseases. Underlying cardiovascular diseases (adjusted odds ratio [aOR] 5.4, 95% confidence interval [CI] 2.5-11.5), hematological diseases (aOR 4.9, 95% CI 2.3-10.6), neuropsychological disorders (aOR 3.8, 95% CI 1.8-7.9), or respiratory diseases (aOR 2.8, 95% CI 1.3-6.4) were risk factors for critical COVID-19. The effectiveness of two-dose and one-dose vaccination against critical diseases were 93.5% (95% CI: 70.4%-98.6%) and 75.2% (95% CI 9.2%-93.2%), respectively.</p><p><strong>Conclusions: </strong>Underlying diseases are the major risk factors for critical COVID-19 among children and adolescents during the Omicron Surge. The two-dose COVID-19 vaccination is highly effective against critical diseases.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Higher patient-to-physician ratios associated with worse outcomes in the emergency department.","authors":"Yi-Ying Chen, Chien-Yu Chi, Wan-Ching Lien, Patrick Chow-In Ko, Kah Meng Chong, Yen-Pin Chen, Chien-Hua Huang","doi":"10.1016/j.jfma.2024.11.020","DOIUrl":"https://doi.org/10.1016/j.jfma.2024.11.020","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between patient-to-physician ratios, a measure of physician workload, and various patient outcomes in the emergency department (ED).</p><p><strong>Methods: </strong>This retrospective observational study analyzed 406,220 ED visits at a tertiary care center in Taipei, Taiwan, between January 2015 and December 2019. The dynamic patient-to-physician ratio was calculated using minute-by-minute data to reflect real-time physician workload. Multivariable regression models, adjusted for potential confounders, assessed the association between this ratio and 7-day mortality (primary outcome), ED length of stay, waiting time, and medical expenses (secondary outcomes). Generalized additive models were used to explore non-linear relationships. Sensitivity analyses evaluated alternative mortality timeframes, missing data handling, and a simplified patient-to-physician ratio. External validation was performed using data from two additional hospitals.</p><p><strong>Results: </strong>Higher patient-to-physician ratios were significantly associated with increased odds of 7-day mortality. Compared to ratios of less than 10, the adjusted odds ratios were 1.46 (95% CI 1.16, 1.83) for ratios between 10 and 19, 1.79 (95% CI 1.43, 2.25) for ratios between 20 and 29, and 1.95 (95% CI 1.53, 2.49) for ratios of 30 and above. Similar trends of increased risk were observed for longer ED length of stay, prolonged waiting times, and higher medical expenses. Sensitivity analyses using alternative mortality timeframes, missing data handling methods, and the simplified patient-to-physician ratio yielded consistent results, supporting the main findings.</p><p><strong>Conclusions: </strong>Higher patient-to-physician ratios are associated with worse outcomes for ED patients. Our findings suggest that maintaining ratios below 10 may be ideal for optimizing care quality, while ratios exceeding 20 pose significant risks to patients.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Government subsidy for infertility treatment: Impact on quality of life for infertile women undergoing in vitro fertilization-embryo transfer.","authors":"Chih-Wei Lin, Yu-Hsien Wu, Pei-Fang Su, Yu-Lin Mau, Chun-Tzu Hsu, Huang-Tz Ou, Meng-Hsing Wu","doi":"10.1016/j.jfma.2024.11.022","DOIUrl":"https://doi.org/10.1016/j.jfma.2024.11.022","url":null,"abstract":"<p><strong>Background: </strong>Infertility and the economic burden of treatment can impose considerable psychosocial stress with negative consequences for the quality of life for all involved. The objective of this study was to determine the effects of government subsidies for infertility treatment on the quality of life among infertile women undergoing in vitro fertilization-embryo transfer.</p><p><strong>Methods: </strong>Infertile women undergoing in intro fertilization-embryo transfer were recruited from the Assisted Reproductive Technology Center at National Cheng Kung University Hospital, Taiwan, between 2019 and 2022. This study examined the issue of fertility using the FertiQoL survey, which measures the quality of life among individuals facing the struggles associated with infertility. Generalized estimating equation analysis was used to examine the relationship between government subsidies and pregnancy outcomes and quality of life following infertility treatment.</p><p><strong>Results: </strong>This study analyzed 497 infertile women with 727 embryo transfer cycles. The mean core domain and total FertiQoL scores of subsidy recipients were significantly higher (2.68 score increase, p = 0.026 and 2.38 score increase, p = 0.026, respectively) than those of women who did not receive a subsidy. We also observed a negative correlation between the provision of subsidies and the likelihood of clinical pregnancy (odds ratio = 0.57, 95% confidence interval: [0.35, 0.93], p = 0.03) and ongoing (odds ratio = 0.56, 95% confidence interval: [0.33, 0.95], p = 0.03).</p><p><strong>Conclusions: </strong>The government subsidy for infertility treatment was negatively correlated with clinical and live birth rates while positively correlated with quality of life.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colchicine to prevent cardiovascular death after an acute myocardial infarction.","authors":"Yu-Ching Chang, Lo-Chia Yeh, Ting-Tse Lin, Ching-Chang Huang, Chi-Sheng Hung, Yen-Yun Yang, Shu-Lin Chuang, Lian-Yu Lin, Lung-Chun Lin, Hsien-Li Kao, Yen-Hung Lin","doi":"10.1016/j.jfma.2024.11.014","DOIUrl":"https://doi.org/10.1016/j.jfma.2024.11.014","url":null,"abstract":"<p><strong>Background: </strong>Clinical and experimental evidence have demonstrated the protective benefits of colchicine in acute myocardial infarction (AMI) through its potential anti-inflammatory effect. However, investigations on the Asian population are limited.</p><p><strong>Methods: </strong>This retrospective longitudinal cohort study used electronic medical records from a tertiary medical center in Taiwan. Patients with their first AMI from the emergency department between 2010 and 2020 were included. The outcomes included all-cause death, hospitalization for heart failure, stroke, and emergency admission for angina. Propensity-score matching (PSM, 5 to 1) and Cox's proportional hazards regression model were used to estimate hazard ratios (HRs).</p><p><strong>Results: </strong>A total of 2841 patients with their first admission for AMI were identified, of which 176 (6.2%) received colchicine and 2665 (93.8%) did not. After a median follow-up of 21.4 months, the incidence of all-cause death was significantly reduced in the colchicine group (HR, 0.560; 95% confidence interval [CI], 0.361-0.862; P = 0.008), driven by the significant risk reduction of cardiovascular death (HR, 0.291; 95% CI, 0.142-0.613; P = 0.001). There was no significant difference of other outcomes. After PSM, the protective effect remained in the colchicine group compared with non-users (HR, 0.331; 95% CI, 0.162-0.690; P = 0.003). The relationship between endpoints and various time-to-treatment initiation showed a significant reduction in the risk of all-cause death for whom colchicine was initiated < Day 3 compared with placebo.</p><p><strong>Conclusions: </strong>Low-dose colchicine led to a significantly lower risk of cardiovascular death than non-users among patients with a recent myocardial infarction. They benefit from early, in-hospital initiation of colchicine after AMI.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term results of stereotactic arrhythmia radioablation for refractory ventricular Arrhythmias-A Taiwanese population study.","authors":"Li-Ting Ho, Jenny Ling-Yu Chen, Jung-Chi Hsu, Hsing-Min Chan, Yu-Cheng Huang, Mao-Yuan Su, Sung-Hsin Kuo, Yeun-Chung Chang, Jiunn-Lee Lin, Wen-Jone Chen, Wen-Jeng Lee, Jyh-Ming Jimmy Juang, Lian-Yu Lin","doi":"10.1016/j.jfma.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.jfma.2024.11.013","url":null,"abstract":"<p><strong>Background: </strong>Stereotactic arrhythmia radioablation (STAR) has proven to be effective in refractory ventricular tachyarrhythmia (VT). We report the long-term results in first Asian series of STAR for refractory VT in a group of Taiwanese.</p><p><strong>Methods: </strong>This study prospectively enrolled patients with treatment-failure VT. 3D electroanatomic maps, delayed enhancement magnetic resonance imaging and dual energy computed tomography were used to identify scar substrates. The main target volume was treated with a single radiation dose of 25 Gy delivered by Varian/Edge TrueBeam System. Efficacy was assessed by VT events recorded by implantable cardioverter defibrillator.</p><p><strong>Results: </strong>From February 2019 to Feburary 2023, 11 patients were enrolled and followed up for at least 1 year. Ten male and one female patient received the treatment. During the median follow-up of 53 months, VT episodes decreased by 88% in post-treatment first 6 months. Late VT recurrence was observed in most of patients. Five patients received repeated catheter ablation for recurrent VTs. One-year survival rate was 83%. Among surviving patients, 1 received heart transplant and 2 had HeartMate III implantation.</p><p><strong>Conclusions: </strong>In patients with medication and catheter ablation refractory VT, STAR is associated with a marked acute reduction in the burden of VT. The acute response of VT burden reduction helps to bridge patients to the next treatment step of heart failure, including medical optimization or surgical management, and enhance clinical outcomes.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Clinical outcomes of different types of metallic stents in malignant distal duodenum stenosis: A retrospective study\".","authors":"Dongming Zhao","doi":"10.1016/j.jfma.2024.11.011","DOIUrl":"https://doi.org/10.1016/j.jfma.2024.11.011","url":null,"abstract":"","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}