Journal of the Formosan Medical Association最新文献

{"title":"Posttreatment FIB-4 score change predicts hepatocellular carcinoma in chronic hepatitis C patients: Findings from the Taiwan hepatitis C registry program.","authors":"Hung-Wei Wang, Yu-Syuan Zeng, Chung-Feng Huang, Chi-Yi Chen, Hsing-Tao Kuo, Kuo-Chih Tseng, Lein-Ray Mo, Pin-Nan Cheng, Chi-Ming Tai, Chao-Hung Hung, Ching-Chu Lo, Chien-Hung Chen, Pei-Lun Lee, Chi-Chieh Yang, Chun-Ting Chen, Chun-Yen Lin, Tsai-Yuan Hsieh, Lee-Won Chong, Chih-Lang Lin, Jui-Ting Hu, Sheng-Shun Yang, Jia-Horng Kao, Chun-Jen Liu, Wan-Long Chuang, Jee-Fu Huang, Ming-Lun Yeh, Chia-Yen Dai, Yi-Hsiang Huang, Han-Chieh Lin, Ming-Jong Bair, Szu-Jen Wang, Chien-Wei Huang, Ming-Chang Tsai, Chia-Chi Wang, Wei-Wen Su, Chih-Wen Lin, Chih-Lin Lin, Cheng-Hsin Chu, Ming-Lung Yu, Cheng-Yuan Peng","doi":"10.1016/j.jfma.2025.02.014","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.02.014","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated whether Fibrosis-4 (FIB-4) score and its change can serve as predictors of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis C (CHC) infection receiving direct-acting antivirals (DAAs).</p><p><strong>Methods: </strong>This study identified 9679 patients who completed DAA treatment and achieved sustained virologic response (SVR) from the Taiwan Nationwide Real-World HCV Registry Program, and their risk of HCC was analyzed.</p><p><strong>Results: </strong>Multivariable Cox regression analyses identified diabetes mellitus (DM), alpha-fetoprotein (AFP) level, and FIB-4 score as independent predictors of HCC in both Model 1 (baseline) and Model 2 (SVR). Change in FIB-4 score (△FIB-4) of < -0.9086 from baseline to SVR achievement was a significant predictor of HCC only in Model 2 (SVR). In Model 2 (SVR), DM (hazard ratio [HR]: 1.53, 95% confidence interval [CI]: 1.04-2.26, p = 0.033), FIB-4 score (≥3.25 vs. <3.25; HR: 2.40, 95% CI: 1.63-3.53, p < 0.001), △FIB-4 (greater reduction: <-0.9086 vs. smaller reduction: ≥-0.9086; HR: 1.85, 95% CI: 1.25-2.74, p = 0.002), and AFP level (≥20 vs. <20 ng/mL; HR: 16.40, 95% CI: 9.16-29.36, p < 0.001) were significant predictors of HCC. At 3 years, the cumulative HCC incidence was 10.67% in patients with an FIB-4 score of ≥3.25 upon achieving SVR and △FIB-4 of < -0.9086 and 1.72% in those with an FIB-4 score of <3.25 upon achieving SVR and △FIB-4 of ≥ -0.9086.</p><p><strong>Conclusions: </strong>Posttreatment FIB-4 score and its change from baseline can be used to stratify HCC risk in patients with CHC receiving DAAs.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537367","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":"Efficacy of ultrasound-guided piriformis muscle corticosteroid injection versus extracorporeal shockwave therapy in patients with piriformis syndrome: A randomized controlled trial.","authors":"Yu-Shan Fu, Kao-Shang Shih, Yu-Ting Lin, Lin-Fen Hsieh, Ya-Fang Liu, Yann-Rong Chen","doi":"10.1016/j.jfma.2025.01.020","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.01.020","url":null,"abstract":"<p><strong>Background: </strong>Piriformis syndrome (PS) is a condition that causes low back pain. Ultrasound-guided injection (USI) has become a popular option for diagnostic block and treatment. Extracorporeal shockwave therapy (ESWT) is widely used for treating musculoskeletal diseases. However, few studies have compared the therapeutic efficacy of local steroid injections and ESWT.</p><p><strong>Objectives: </strong>To compare the therapeutic efficacy of local corticosteroid injections and ESWT against PS.</p><p><strong>Methods: </strong>This prospective randomized controlled trial enrolled 70 patients, who were randomly divided into two groups: the ESWT and USI groups. The ESWT group was subjected to one session of ESWT, and the USI group received one USI. Patients in both groups performed home-based stretching exercises. Evaluations were conducted at baseline and 1 and 5 weeks after the intervention. The outcomes included the patients' pain scores on a visual analog scale (VAS), Oswestry Disability Index (ODI), hip range of motion, side effects, and self-evaluation data.</p><p><strong>Results: </strong>The groups did not vary significantly in terms of demographics. Significant time effects were observed in both groups, indicating post-treatment improvements. Furthermore, significant group effects were discovered in ODI and VAS pain scores. However, determining the superiority of one treatment over the other was challenging because of significant pretreatment differences between the groups in terms of ODI and VAS pain scores. However, no significant between-group difference was noted in the improvement rate.</p><p><strong>Conclusions: </strong>ESWT and USI appear to be effective in the treatment of PS. The levels of efficacy of the two treatment approaches may be similar.</p><p><strong>Clinical trial registration number: </strong>NCT04684537.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523737","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":"The need for caution in assessing the effectiveness of telemedicine services provided to hospitalized patients.","authors":"Hongnan Ye","doi":"10.1016/j.jfma.2025.02.027","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.02.027","url":null,"abstract":"","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523740","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":"Left atrial reservoir strain as a surrogate marker for atrial fibrillation burden in patients with non-valvular atrial fibrillation.","authors":"An-Li Yu, Yen-Bin Liu, Lian-Yu Lin, Hui-Chun Huang, Li-Ting Ho, Kuan-Chih Huang, Ling-Ping Lai, Wen-Jone Chen, Yi-Lwung Ho, Lung-Chun Lin, Chih-Chieh Yu","doi":"10.1016/j.jfma.2025.02.024","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.02.024","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the correlation between atrial fibrillation (AF) burden and two-dimensional LA (left atrium) longitudinal reservoir strain (LARS) to explore the potential clinical utility of this novel parameter in patients with AF.</p><p><strong>Methods: </strong>This cross-sectional study was conducted at the cardiac electrophysiology clinic of a tertiary centre by consecutively enrolling patients with non-valvular AF. The AF burden was evaluated using 14-day patch-based electrocardiography and defined as the percentage of time spent in AF during a 14-day monitoring period. High and low AF burdens were defined based on the median 14-day AF burden. Echocardiographic measurements, including the longitudinal strain of the LA, were performed in all patients.</p><p><strong>Results: </strong>Among 267 patients, LARS was successfully performed in 221 (age 63 ± 11 years, male 71%, paroxysmal AF 71%). After adjusting for age, diabetes mellitus, congestive heart failure, estimated glomerular filtration rate, low-density lipoprotein level, left ventricular ejection fraction, LA dimension, and LA volume in multivariable linear regression analysis, low LARS remained a significant predictor of AF burden in addition to N-terminal pro-B-type natriuretic peptide and sex. Receiver operating curve analysis demonstrated that the best cut-off value for LARS to predict high AF burden (above median 10.49%) was 21.5%, with 75% sensitivity and 83% specificity.</p><p><strong>Conclusions: </strong>LARS is associated with the AF burden in patients with AF. Further studies are needed to determine the role of routine LARS measurements in such patients.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501617","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":"Loss of the second molar, masticatory ability, and oral health-related quality of life.","authors":"Haili Lu, Na Kang","doi":"10.1016/j.jfma.2025.02.029","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.02.029","url":null,"abstract":"","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501620","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":"Animation-assisted learning enhances caregivers' knowledge of anticipatory guidance for children during a well-child clinical visit: A prospective study.","authors":"Yu-Tsun Su, Hsiang-Hao Chao, Jieh-Neng Wang, Iwen Huang, Chian-Heng Su, Chyi-Her Lin","doi":"10.1016/j.jfma.2025.02.022","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.02.022","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether animation-assisted learning (AAL) enhances caregiver's knowledge of anticipatory guidance (AG) for children and determine the influence of the socioeconomic status during a well-child clinical visit.</p><p><strong>Methods: </strong>We prospectively enrolled caregivers who presented for well-child checkups at a tertiary care center. Participants completed a pre-test, watched a 25-min animation on specific AG topics, and then completed a post-test. We collected information on the caregivers' gender, parity number, educational level, age, and employment status and then analyzed test accuracy relative to select socio-demographic factors.</p><p><strong>Results: </strong>We enrolled 150 caregivers (75 in the ≤3-month group, and 75 in the >3-month-to-7-year group). The pre- and post-AAL accuracy rates were 68.7% ± 14.5% vs. 88.2% ± 9.9% for the ≤3-month and 75.9% ± 13.1% vs. 92.3% ± 10.0% for the >3-month-to-7-year groups. Women, non-primipara caregivers, and college graduates in the ≤3-month group had better pre-test accuracy than their counterparts (p = 0.002, 0.002, and 0.004, respectively). Irrespective of socio-demographic factors, all caregivers demonstrated significantly improved AG knowledge post-AAL. Furthermore, college graduates or unemployed caregivers in the ≤3-month group showed improvements with AAL (p = 0.001 and 0.006, respectively).</p><p><strong>Conclusions: </strong>Caregiver's knowledge level further improved post-AAL regardless of their socio-demographic backgrounds, highlighting AAL's effectiveness across diverse populations. The most substantial improvements were observed among higher-educated or unemployed caregivers with infants aged ≤3 months.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492580","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":"Cogstate Brief Battery performance in assessing cognitive impairment in Taiwan: A prospective, multi-center study.","authors":"Yi-Chun Kuan, Kai-Ming Jhang, Wen-Fu Wang, Yi-Chun Yeh, Cheng-Sheng Chen, Cheng-Chang Yang, Chaur-Jong Hu","doi":"10.1016/j.jfma.2025.02.025","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.02.025","url":null,"abstract":"<p><strong>Background: </strong>Early detection and accessible monitoring of dementia are crucial for timely intervention. However, traditional neuropsychological assessments are resource-intensive, and with the growing aging population, scheduling delays increased. The Cogstate Brief Battery (CBB) offers a promising, rapid screening tool, though its validation in Mandarin-speaking populations has been limited.</p><p><strong>Methods: </strong>This prospective, multi-center study assessed the validity of the CBB in distinguishing between mild cognitive impairment (MCI) and dementia compared to healthy controls (HC) in Taiwan. Participants from three tertiary medical centers underwent comprehensive cognitive evaluation using the CBB, including the Learning/Working Memory Brain Performance Index (Lrn/WM BPI), Attention/Psychomotor Brain Performance Index (Attn/Psychomotor BPI), combined BPI, and Brain Age.</p><p><strong>Results: </strong>Of 192 participants (mean age 68.7 ± 8.2 years, mean education level 11.0 ± 3.9 years, 59.9% female), the CBB showed strong discriminatory power across groups. The combined BPI demonstrated the highest AUC (0.95) for distinguishing dementia from HC, followed by 0.92 for Lrn/WM BPI, 0.91 for Brain Age difference, and 0.88 for Attn/Psychomotor BPI. A combined BPI cut-off score of 41.25 effectively differentiated between HC and cognitive impairment groups.</p><p><strong>Conclusion: </strong>This first validation of the CBB in Mandarin-speaking populations highlights its utility as a reliable screening tool for early cognitive impairment detection. Its use could enhance timely diagnoses, helping to streamline clinical pathways and improve patient outcomes, addressing a critical gap in dementia care in Taiwan's healthcare system.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472618","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":"Preoperative thoracic epidural analgesia with and without erector spinae plane block for thoracotomy: A retrospective study.","authors":"Tzu-Jung Wei, Hsin-An Hsu, Ping-Yan Hsiung, Ping-Ju Chen, Chen-Tse Lee, Chun-Yu Wu","doi":"10.1016/j.jfma.2025.02.021","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.02.021","url":null,"abstract":"<p><strong>Background: </strong>Thoracotomy is a highly painful surgical procedure, with thoracic epidural analgesia (TEA) serving as the gold standard for postoperative pain management. However, TEA can induce significant hypotension, especially when combined with general anesthesia. The ultrasound-guided erector spinae plane block (ESPB) has emerged as a complementary technique for enhancing analgesia while minimizing side effects. This study compares the analgesic efficacy and intraoperative hemodynamic outcomes of preoperative TEA with and without ESPB in patients undergoing thoracotomy.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted at a tertiary university hospital, including patients who underwent thoracotomy for tumor resection between March 2017 and March 2023. Patients receiving ESPB prior to TEA were compared with those receiving TEA alone. Postoperative pain intensity and intraoperative hemodynamic stability were assessed. The primary outcome was postoperative pain scores, while secondary outcomes included intraoperative mean arterial pressure and postoperative outcomes such as length of hospital stay.</p><p><strong>Results: </strong>A total of 64 patients were enrolled in the study, including 43 who received TEA alone and 21 who received a combination of TEA and ESPB. After propensity score matching, 21 patients were matched 1:1 in each group for comparative analysis. Patients who received ESPB in addition to TEA had significantly lower pain scores at 1 h and 24 h postoperatively (p < 0.001). Additionally, they demonstrated higher intraoperative mean arterial pressures (p = 0.036) compared to the TEA-only group. However, there were no significant differences in postoperative outcomes.</p><p><strong>Conclusions: </strong>The combination of preoperative ESPB and TEA provides superior early postoperative pain control and enhances intraoperative hemodynamic stability in thoracotomy patients compared to TEA alone.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468354","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":"Ablative margin assessment for recurrence prediction in patients with hepatocellular carcinoma receiving radiofrequency ablation.","authors":"Geeng-Jia Hu, Quan-Yin Zheng, Feng-Guang Tsai, Chiueng-Fang Wu, Yi-Cheng Hsiao, Chih-Kai Chang, Po-Chin Liang, Chih-Horng Wu","doi":"10.1016/j.jfma.2025.02.023","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.02.023","url":null,"abstract":"<p><strong>Background/purpose: </strong>To predict outcomes for patients with hepatocellular carcinoma (HCC) after radiofrequency ablation (RFA) by assessing the ablative margin.</p><p><strong>Methods: </strong>We retrospectively analyzed 163 HCC patients with complete RFA treatment at National Taiwan University Hospital (NTUH) from 2015 to 2020. Local tumor progression (LTP) is defined as the reappearance of HCC around the ablative zone. Various ablative margins (AM) are measured on post-RFA computed tomography (CT), including the minimal and maximal AM covering or not covering the liver surfaces (AMCLSmin, AMCLSmax, AMULSmin, AMULSmax). Average ablative margins (AMCLSavg, AMULSavg) are calculated from the minimal and maximal AM. Tumors at high-risk locations, including subdiaphragmatic, subcapsular, and perivascular regions, were further analyzed. The Kaplan-Meier method was utilized to analyze the recurrence-free survival (RFS) of different groups of patients. Patients were grouped by their ablative margin width with a cutting-off value of 3 mm or 5 mm.</p><p><strong>Results: </strong>Of the 163 HCC patients enrolled, 29 had LTP within two years, and 20 had LTP after two years. AMULSmin and AMULSavg were shown to be significant factors contributing to local tumor recurrences. Patients with AMULSmin≧3 mm had significantly better RFS than those with AMULSmin<3 mm (p = 0.0236). In high-risk locations, AMULSavg ≧5 mm had better RFS in subdiaphragmatic and subcapsular regions, and AMULSavg ≧3 mm had better RFS in perivascular region.</p><p><strong>Conclusion: </strong>Measuring the ablative margin without covering the liver surface (especially AMULSmin, AMULSavg) in the post-RFA CT may be helpful prognosis indicators of LTP and RFS in HCC patients.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468353","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":"Reply to commentary on \"Fluid intake impact on heart failure: Systematic review and meta-analysis with trial sequential analysis\".","authors":"Suh-Meei Hsu, Ying-Chun Lin, Chung-Lieh Hung, Tsae-Jyy Wang","doi":"10.1016/j.jfma.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.02.001","url":null,"abstract":"","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457914","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}