The Changhua Journal of Medicine最新文献_第5页

Analysis of Integron-associated Gene Cassettes in Clinical Acinetobacter Calcoaceticus-Baumannii Complex Isolates from Central Taiwan 台湾中部产钙酸不动杆菌-鲍曼复合菌临床分离株整合子相关基因盒分析

The Changhua Journal of Medicine Pub Date : 2015-06-01 DOI: 10.6501/CJM.1302.001

Chang-Hua Chen, Chieh-Chen Huang

{"title":"Analysis of Integron-associated Gene Cassettes in Clinical Acinetobacter Calcoaceticus-Baumannii Complex Isolates from Central Taiwan","authors":"Chang-Hua Chen, Chieh-Chen Huang","doi":"10.6501/CJM.1302.001","DOIUrl":"https://doi.org/10.6501/CJM.1302.001","url":null,"abstract":"Purpose: Acinetobacter calcoaceticus-baumannii complex (ABC) has become a major infectious pathogen in Taiwan, and mobile DNA such as integrons and transposons often contribute to its multiple antibiotic resistance characteristics. Methods: A clinical epidemiological study of the cassette contents of the class 1 integron of ABC isolates in two central Taiwan hospitals was performed. Results: It was found that 78% (39/50) of strains possessed the IntI1 integrase gene, while four major different sizes of class 1 integron cassette arrays were found: 3.0 kb (aacC1-ORF1-ORF2- ORF3-aadA1) (aacC1: aminoglycoside 3'-N-acetyltransferase; aadA1: aminoglycoside 3'-adenyltransferase), 2.5 kb (aacA4- catB8-aadA1) (aacA4: aminoglycoside 6'-N-acetyl-transferase), 2.0 kb (dhfrXII-ORF-aadA2) (dhfrXII: dihydrofolate reductase; aadA2: aminoacyl-adenyltransferase A) and 1.2 kb (dhfrAI-ORF) (dhfrAI: dihydrofolate reductase type AI). Six different combinations of cassette arrays were also noted. The co-relationships between antibiotic-resistant phenotypes and genotypic combinations of cassettes were analyzed. As the 2.5-kb cassette array was found to be the most common in this study, the flanking regions of the specific integron of ABC were also analyzed by inverse PCR. In addition to antibiotic resistance genes, such as aphA1 (kanamycin resistance gene) (AphA1: aminoglycosidephosphotransferase), the transposase gene (tnpIS15/tnpAIS26) was found in the 2.5-kb cassette array flanking regions. Furthermore, PCR-RFLP confirmed that these flanking regions were conserved in all of the examined isolates. Conclusion: The SXT and GM resistance phenotypes of ABC isolates could be used in clinical screening for the IntI1- associated genotype. ABC isolates that carry a 2.5-kb cassette array have become dominant in Central Taiwan, and dissemination of this specific type of integron may derive from the involvement of mobile DNA.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116815405","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}

引用次数: 0

Unsatisfactory LDL-cholesterol Goal Attainment Rate in Type 2 Diabetic Patients 2型糖尿病患者低密度脂蛋白胆固醇目标完成率

The Changhua Journal of Medicine Pub Date : 2015-06-01 DOI: 10.6501/CJM.1302.002

Yung-Sheng Chang, M. Hsieh

{"title":"Unsatisfactory LDL-cholesterol Goal Attainment Rate in Type 2 Diabetic Patients","authors":"Yung-Sheng Chang, M. Hsieh","doi":"10.6501/CJM.1302.002","DOIUrl":"https://doi.org/10.6501/CJM.1302.002","url":null,"abstract":"Background: Type 2 diabetic patients have a higher cardiovascular risk than people without diabetes, and tight lipid level control is recommended to reduce the cardiovascular risk. We attempted to examine the factors associated with the low-density lipoprotein-cholesterol (LDL-C) control attainment rate and the actual LDL-C control attainment rate in type 2 diabetic patients in Taiwan. Methods: This cross-sectional study of LDL-C control in type 2 diabetic patients collected data from 10,000 patients. The LDL-C goal was ＜ 100 mg/dL for all diabetic patients. Multivariate logistic regression was performed to evaluate factors associated with the attainment rate of LDL-C control. Results: 46.63% of the diabetic patients attained the LDL-C goal. Young and female patients were less successful in reaching the LDL-C goal than other participants. 51.07% of the type 2 diabetic patients with cardiovascular comorbidities attained an LDL-C ＜ 100 mg/dL, and nearly 11% of those patients attained an LDL-C ＜ 70 mg/dL. Conclusions: The LDL-C goal attainment rate in type 2 diabetic patients is unsatisfactory in clinical practice, especially in patients with cardiovascular comorbidities. Young and female patients had a lower attainment rate than other participants.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132977300","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}

引用次数: 0

Successful Endoscopic Therapy for Delayed Esophageal Perforation after Endoscopic Removal of Ingested Duck Bone 内镜下成功治疗误食鸭骨取出后迟发性食管穿孔

The Changhua Journal of Medicine Pub Date : 2015-06-01 DOI: 10.6501/CJM.1302.006

Yuchen Dong, H. Yen, F. Siao

{"title":"Successful Endoscopic Therapy for Delayed Esophageal Perforation after Endoscopic Removal of Ingested Duck Bone","authors":"Yuchen Dong, H. Yen, F. Siao","doi":"10.6501/CJM.1302.006","DOIUrl":"https://doi.org/10.6501/CJM.1302.006","url":null,"abstract":"Ingestion of a dietary foreign body is an emergency condition that requires prompt diagnosis and treatment. Delayed recognition of ingested esophageal foreign bodies can cause esophageal perforation, leading to potentially fatal complications such as mediastinitis and aortoesophageal fistula. Currently, endoscopy is the diagnostic tool of choice because it allows accurate diagnosis of the characteristics of the ingested foreign body and permits endoscopic removal. Computed tomography (CT) can help to both determine the location of the foreign body and assess any associated complications. We report the case of a 42-year-old female who presented to the hospital with chest pain and dysphagia after eating ginger duck 2 days prior. An endoscopic evaluation revealed an impacted duck bone in the mid-esophagus, which we subsequently removed. Although no immediate perforations were found during endoscopy and subsequent CT, the patient experienced worsening chest pain two days after removal of the impacted bone. Esophagography revealed an esophageal perforation and we started the patient on parenteral nutrition. Repeated endoscopy revealed esophageal perforation, and we applied two endoclips to close the wound. Repeated esophagography 14 days later revealed complete healing of the esophageal perforation and the patient was discharged on day 18 of hospitalization. This case highlights that delayed esophageal perforation may occur and clinicians should be aware of this rare complication to allow for early treatment.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127950103","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}

引用次数: 0

Pleomorphic Adenoma of the Hard Palate: A Case Report 硬腭多形性腺瘤1例报告

The Changhua Journal of Medicine Pub Date : 2015-06-01 DOI: 10.6501/CJM.1302.003

T. Chi, C. Yuan, S. Chien

引用次数: 1

Penetrating Fish Bone in the Stomach: A Rare Cause of Acute Abdomen Diagnosed Early Using Ultrasound 胃穿透鱼骨:早期超声诊断急腹症的罕见病因

The Changhua Journal of Medicine Pub Date : 2015-06-01 DOI: 10.6501/CJM.1302.007

Lisa Wu, F. Siao, Maw-Soan, H. Yen

{"title":"Penetrating Fish Bone in the Stomach: A Rare Cause of Acute Abdomen Diagnosed Early Using Ultrasound","authors":"Lisa Wu, F. Siao, Maw-Soan, H. Yen","doi":"10.6501/CJM.1302.007","DOIUrl":"https://doi.org/10.6501/CJM.1302.007","url":null,"abstract":"Abdominal ultrasound is a widely-used tool for screening various abdominal emergencies. Common abdominal emergencies, such as cholecystitis, pancreatitis, appendicitis, aortic aneurysm, and intra-abdominal bleeding, can be easily diagnosed using ultrasound. Foreign body ingestion is another common emergency that requires timely diagnosis and treatment to prevent delayed complications. Diagnosis of foreign body ingestion is easy when its typical history is reported. However, diagnosis of clinically-unsuspected fish bone ingestion is difficult and is usually only possible after complications develop. Here, we report a 66-year-old woman with a history of hypertension who presented to our emergency department with abdominal pain after a meal for 1 day. She did not remember having any discomfort during swallowing or ingestion of any abnormal material by mistake during the previous 1 week. Abdominal ultrasound examination suggested the presence of a penetrating fish bone in the gastric antrum without local complications. Upper endoscopy was performed immediately and the fish bone was successfully removed. Although fish bone ingestion can be easily diagnosed by computed tomography, previous studies using ultrasound for diagnosis of fish bone ingestion are limited, and all cases were diagnosed after complications had occurred. To the best of our knowledge, this is the first case of clinically-unsuspected fish bone ingestion diagnosed using ultrasound before any complications developed.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130957209","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}

引用次数: 0

An Elderly Patient with Frontotemporal Dementia Masquerading as Mania Detected by Single Photon Emission Computed Tomography 用单光子发射计算机断层扫描检测冒充狂躁的老年额颞叶痴呆患者

The Changhua Journal of Medicine Pub Date : 2015-03-01 DOI: 10.6501/CJM.1301.007

Ta-Wei Lin, Cheng-Chen Chang

引用次数: 0

Hepatic Portal Venous Gas Associated with Emphysematous Gastritis: an Unusual Cause of Acute Abdomen with a Benign Course 肝门静脉气体与肺气肿性胃炎相关:一种罕见的急性腹部良性病因

The Changhua Journal of Medicine Pub Date : 2015-03-01 DOI: 10.6501/CJM.1301.004

Lisa Wu, Chia‐Wei Yang, M. Soon, H. Yen

引用次数: 0

Decreased Hyperintense Cerebral Arteries on Susceptibility-Weighted Imaging in Reversible Cerebral Vasoconstriction Syndrome 可逆性脑血管收缩综合征的敏感性加权成像显示高强度脑动脉减少

The Changhua Journal of Medicine Pub Date : 2015-03-01 DOI: 10.6501/CJM.1301.005

C. Hsueh, Hung-Wen Kao, Wei-Liang Chen, Chi‐Kuang Liu, Kwo-whei Lee

引用次数: 0

Hemobilia: A Fatal Cause of Obscure Gastrointestinal Bleeding Diagnosed by Abdominal Computed Tomography 胆道出血:腹部计算机断层扫描诊断的消化道隐蔽性出血的致命原因

The Changhua Journal of Medicine Pub Date : 2015-03-01 DOI: 10.6501/CJM.1301.006

Chi-Hsien Lin, F. Siao

引用次数: 0

The Perceptions of Palliative Care Among Family Caregivers of Non-Cancer Patients 非癌症患者家属照护者对缓和疗护的认知

The Changhua Journal of Medicine Pub Date : 2015-03-01 DOI: 10.6501/CJM.1301.003

Y. Kuo, Mei-Yu Kang, L. Chiang, Jiann-Der Lee

{"title":"The Perceptions of Palliative Care Among Family Caregivers of Non-Cancer Patients","authors":"Y. Kuo, Mei-Yu Kang, L. Chiang, Jiann-Der Lee","doi":"10.6501/CJM.1301.003","DOIUrl":"https://doi.org/10.6501/CJM.1301.003","url":null,"abstract":"Family caregivers play an important role in providing palliative care for patients with chronic life-threatening illnesses. Understanding the experience of family caregivers regarding palliative care can identify areas in which to improve the quality of care at the end of life. The purpose of this study was to explore the perceptions of palliative care among family caregivers of non-cancer patients. This research was conducted using a qualitative descriptive design with content analysis. A total of 10 family caregivers with a mean age of 53.6 years were recruited from a home healthcare organization of a medical center in central Taiwan. Data were collected from the family caregivers using semi-structured interviews from April 2008 to December 2008. The findings revealed 6 main themes: unfamiliar labels for a layperson, palliative care is linked to cancer, palliative care is to give up, palliative care is waiting to die, the decision to provide palliative care is made by healthcare professionals, and palliative care is to let it be. Family caregivers provide long-term home care for chronically ill patients. When they were unable to find a good solution for care, they relied on the ＂let it be＂ philosophy of Taoism. Our findings suggested that healthcare providers should recognize that dealing with palliative care in the home is a continuing care process, and that they can be the best advocates and instructors for patients and family caregivers to enhance the quality of long-term palliative care.","PeriodicalId":404480,"journal":{"name":"The Changhua Journal of Medicine","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2015-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126279996","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}

引用次数: 0