Journal of the Formosan Medical Association最新文献

{"title":"Nationwide hepatitis C virus microelimination in uremic patients undergoing maintenance hemodialysis in Taiwan.","authors":"Chung-Feng Huang, Po-Cheng Liang, Yu-Ju Wei, Chao-Chun Wu, Shi-Lun Wei, Li-Ju Lin, Pei-Chun Hsieh, Tsui-Hsia Hsu, Maggie Shu-Mei Hsu, Ya-Xin Luo, Hsi-Chieh Chen, Tsu-Yun Ho, Shao-Hsuan Lin, Chia-Ling Liu, Kuo-Pen Cheng, John W Ward, Ming-Lung Yu","doi":"10.1016/j.jfma.2025.09.016","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.09.016","url":null,"abstract":"<p><p>The anti-hepatitis C virus (HCV) seropositivity rate among hemodialysis patients in Taiwan was reported to be 10.6 %-17.3 % in the last decade. HCV treatment uptake in patients undergoing hemodialysis has tremendously improved with the innovation reimbursement of direct-acting antiviral agents (DAAs) since 2017 in Taiwan. Two successful models of HCV microelimination using DAAs for patients undergoing hemodialysis, one local public health bureau-led strategy (CHIPS-C) and one investigator-initiated campaign (ERASE-C), have been successfully established in Taiwan. Based on data through December 2024, official data of the Ministry of Health and Welfare of Taiwan retrieved from 108,116 patients undergoing hemodialysis indicated that almost all patients undergoing hemodialysis across the country were screened for anti-HCV antibodies (ranging from 99.9 % to 100 % among 22 counties and cities). Among the patients who were anti-HCV seropositive, the HCV RNA diagnostic rate was 97.4 %. Finally, the treatment rate of viremic patients was 97.0 %. With respect to prevention, the seroconversion rate from anti-HCV seronegativity to anti-HCV seropositivity decreased gradually from 0.36 % in 2011 to 0.08 % in 2021 according to the report of the Taiwan Renal Data System (TWRDS). We now believe that Taiwan has achieved HCV microelimination in the hemodialysis population in 2025.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064995","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":"Rethinking the impact of radiation dosing on neoadjuvant chemoradiotherapy efficacy and organ preservation in locally advanced rectal cancer.","authors":"Min Zou, Yansheng Zhang, Feng Gao, Zengqiang Yang","doi":"10.1016/j.jfma.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.09.018","url":null,"abstract":"","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065023","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 \"Prevalent and incident hepatitis C virus infections among participants in a pre-exposure prophylaxis program in Taiwan\".","authors":"Rui Xia, Yun Wang, Huizhen Ma","doi":"10.1016/j.jfma.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.09.012","url":null,"abstract":"","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058491","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":"A comparative analysis of persistence of advanced therapies among patients with inflammatory bowel disease in Taiwan.","authors":"Horng-Yih Chiu, Chia-Jung Kuo, Ming-Wei Lai, Ren-Chin Wu, Chien-Ming Chen, Cheng-Tang Chiu, Yu-Bin Pan, Cheng-Hsun Chiu, Puo-Hsien Le","doi":"10.1016/j.jfma.2025.09.014","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.09.014","url":null,"abstract":"<p><strong>Background/aims: </strong>The prevalence of inflammatory bowel disease (IBD) is rising in Asia. Advanced therapies, defined as biologics and small-molecule drug used for IBD treatment, have improved outcomes for moderate to severe IBD, making treatment selection critical. This is the first study in Taiwan comparing real-world persistence rates of advanced therapies in IBD patients in Taiwan.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on 511 IBD patients from Linkou Chang Gung Memorial Hospital between October 2017 and January 2024. The five therapies evaluated were infliximab (IFX), adalimumab (ADA), vedolizumab (VDZ), ustekinumab (UST), and tofacitinib (TOF). Persistence within 52 weeks was assessed for biologic-naïve and biologic-experienced IBD patients.</p><p><strong>Results: </strong>Of the 511 patients, 210 had ulcerative colitis (UC) and 301 had Crohn's disease (CD). UST showed the highest 52-week persistence in CD (91.08 %), followed by ADA (81.94 %), IFX (73.76 %), and VDZ (64.35 %), with a statistically significant difference (p < 0.001). In UC, UST also had the highest persistence rate (78.95 %), though this did not reach statistical significance (p = 0.083). IFX had the highest discontinuation rate due to side effects (5.9 %) CONCLUSIONS: UST showed superior 52-week persistence in CD patients, though it also had the highest rate of dose escalation. IFX had the highest rate of discontinuation due to side effects.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058425","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":"Insights and lessons from recent conflicts: A narrative review from the military medicine perspective.","authors":"Shih-Hung Tsai, Wen-I Liao, Ching-Tsung Peng, Zuei-How Young, Chih-Yuan Lin, Yu-Juei Hsu, Chien-Sung Tsai","doi":"10.1016/j.jfma.2025.09.006","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.09.006","url":null,"abstract":"<p><p>The article provides insights and lessons learned from recent conflicts, further elaborating on crucial issues in medical preparedness and medical planning from the perspective of military medicine. It highlights the unique challenges due to its geographical and political situation, predicting scenarios that involve urban casualties and evacuation difficulties. This article describes the evolving nature of warfare, noting the increased frequency of urban combat and the use of advanced weaponry like drones and thermobaric explosives, necessitating enhanced protective equipment and medical protocols to address the new injury patterns. The need for improved civilian-military coordination, advanced medical training, strategic stockpiling of medical supplies, and the blood supply chain is emphasized. The role of Forward Resuscitation and Surgical Detachment is highlighted as crucial for providing urgent surgical care in forward areas. Furthermore, this article emphasizes the importance of realistic medical and operational planning, incorporating simulations and war gaming to estimate medical supply needs. It advocates for the inclusion of advanced airway management kits, burn wound management supplies, and effective pain management protocols in medical stockpiles. The review concludes with a need for continuous training and strategic allocation of medical resources to ensure optimal operational effectiveness and resilience in the face of potential conflicts.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040603","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":"Response to the Letter to the Editor Regarding \"Assessing the link between post-treatment ALT and HCC risk in chronic hepatitis C\".","authors":"Yen-Chun Chen, Ming-Lung Yu","doi":"10.1016/j.jfma.2025.09.007","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.09.007","url":null,"abstract":"","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033542","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":"Risk factors associated with the need for colonoscopic hemostasis for acute lower gastrointestinal bleeding.","authors":"Hao-Che Chang, Li-Chun Chang, Wei-Chih Liao, Hsiu-Po Wang, Han-Mo Chiu, Ming-Shiang Wu, Ping-Huei Tseng","doi":"10.1016/j.jfma.2025.09.009","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.09.009","url":null,"abstract":"<p><strong>Background and purpose: </strong>Colonoscopy is an essential diagnostic and therapeutic tool for lower gastrointestinal bleeding (LGIB), with colonoscopic hemostasis needed in a subset of patients. We aim to identify risk factors associated with colonoscopic hemostasis requirement in acute LGIB patients.</p><p><strong>Methods: </strong>This retrospective study examined consecutive patients who underwent colonoscopy for acute LGIB at a single tertiary hospital between November 2020 and May 2023. Clinical and laboratory profiles were compared between acute LGIB patients who did and did not require colonoscopic hemostasis. Risk factors for hemostasis were determined using regression analysis.</p><p><strong>Results: </strong>The study cohort included 409 acute LGIB patients. The most common cause of acute LGIB among the 212 patients with overt bleeding was inflammatory lesions (n = 120; 56.60 %), followed by neoplastic (n = 38; 17.92 %) and vascular lesions (n = 26; 12.26 %). Hypotension was significantly more common among patients with overt bleeding than those without (11.32 % vs. 1.52 %; P = 0.0001). Patients who required colonoscopic hemostasis (n = 53) had a significantly lower hemoglobin level (9.3 vs. 10.0 g/dL; P = 0.039), higher rate of red blood cell transfusion (52.83 % vs. 36.52 %; P = 0.023), and more significant hypotension (18.87 % vs. 4.78 %; P = 0.0001) compared to those who did not. Significant hypotension was an independent risk factor for colonoscopic hemostasis (adjusted odds ratio, 3.64; 95 % confidence interval, 1.43-9.30; P = 0.007).</p><p><strong>Conclusions: </strong>Acute LGIB patients with significant hypotension are at higher risk of requiring colonoscopic hemostasis and may benefit from early colonoscopic evaluation.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029665","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":"Comparative performance of machine learning and conventional scoring systems for neuroprognostication in out-of-hospital cardiac arrest survivors.","authors":"Chi-Hsin Chen, Edward Pei-Chuan Huang, Cheng-Yi Fan, Yi-Chien Kuo, Yi-Ju Ho, Ching-Yu Chen, Sih-Shiang Huang, Chun-Hsiang Huang, Chien-Tai Huang, Chun-Ju Lien, Chien-Hua Huang, Wei-Tien Chang, Chih-Wei Sung","doi":"10.1016/j.jfma.2025.09.003","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.09.003","url":null,"abstract":"<p><strong>Background: </strong>Accurately predicting the neurological outcomes in out-of-hospital cardiac arrest (OHCA) survivors is crucial. Conventional prediction scores should be validated across different settings. Additionally, machine learning (ML) models may provide improved predictive performance. This study aimed to externally validate these conventional scores and compare their performance with the developed ML model.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study included non-traumatic, adult OHCA survivors from the National Taiwan University Hospital Hsinchu and Yunlin Branch Out-of-Hospital Cardiac Arrest Research Database between January 2016 and July 2021. The primary outcome was neurological outcomes at discharge. We externally validated four conventional prediction scores-OHCA, SWAP, PROLOGUE and CAHP-by performing a receiver-operating characteristic (ROC) analysis and using calibration plots. A new ML model was developed using the XGBoost algorithm. The area under the ROC (AUROC) of the conventional scores and ML model was compared using DeLong's test.</p><p><strong>Results: </strong>This study included 1253 non-traumatic adult OHCA survivors, of whom 279 (22.3 %) achieved a favorable neurological outcome. Among the conventional scores, PROLOGUE had the highest AUROC of 0.89, followed by CAHP, OHCA and SWAP (0.84, 0.78, and 0.78, respectively) on the complete dataset. The ML model outperformed the conventional scores, with AUROC slightly higher than the best performing conventional score PROLOGUE (0.94 vs. 0.88, p = 0.032).</p><p><strong>Conclusions: </strong>PROLOGUE was the best performing conventional score. CAHP, although slightly less accurate, used simpler variables. The ML model outperformed the conventional scores, but its advantage over PROLOGUE was not substantial. Clinicians should select predictive tools based on the clinical context.</p>","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023518","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":"Assessing the link between post-treatment ALT and HCC risk in chronic hepatitis C.","authors":"Weiyi Jiang, Ye Li, YongSheng Wang, Tingsu Zhang","doi":"10.1016/j.jfma.2025.09.004","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.09.004","url":null,"abstract":"","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008336","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 \"Controlling nutritional status score as a survival prognosticator in patients with head and neck cancer\".","authors":"Xiaocen Wang","doi":"10.1016/j.jfma.2025.09.002","DOIUrl":"https://doi.org/10.1016/j.jfma.2025.09.002","url":null,"abstract":"","PeriodicalId":17305,"journal":{"name":"Journal of the Formosan Medical Association","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006344","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}