Journal of the Chinese Medical Association : JCMA最新文献

{"title":"Comparison of machine learning algorithms for automatic prediction of Alzheimer disease.","authors":"Emrah Aslan, Yildirim Özüpak","doi":"10.1097/JCMA.0000000000001188","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001188","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer disease is a progressive neurological disorder marked by irreversible memory loss and cognitive decline. Traditional diagnostic tools, such as intracranial volume assessments, electroencephalography (EEG) signals, and brain magnetic resonance imaging (MRI), have shown utility in detecting the disease. However, artificial intelligence (AI) offers promise for automating this process, potentially enhancing diagnostic accuracy and accessibility.</p><p><strong>Methods: </strong>In this study, various machine learning models were used to detect Alzheimer disease, including K-nearest neighbor regression, support vector machines (SVM), AdaBoost regression, and logistic regression. A neural network was constructed and validated using data from 150 participants in the University of Washington's Alzheimer's Disease Research Center (Open Access Imaging Studies Series [OASIS] dataset). Cross-validation was also performed on the Alzheimer Disease Neuroimaging Initiative (ADNI) dataset to assess the robustness of the models.</p><p><strong>Results: </strong>Among the models tested, K-nearest neighbor regression achieved the highest accuracy, reaching 97.33%. The cross-validation on the ADNI dataset further confirmed the effectiveness of the models, demonstrating satisfactory results in screening and diagnosing Alzheimer disease in a community-based sample.</p><p><strong>Conclusion: </strong>The findings indicate that AI-based models, particularly K-nearest neighbor regression, provide promising accuracy for the early detection of Alzheimer disease. This approach has potential for further development into practical diagnostic tools that could be applied in clinical and community settings.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":"88 2","pages":"98-107"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451303","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}

{"title":"Incidence and influential factors of postoperative pruritus in morphine-based intravenous patient-controlled analgesia.","authors":"Chung-Yi Liao, Hsiang-Ling Wu, Yu-Ming Wu, Juan P Cata, Jui-Tai Chen, Chien-Wun Wang, Yih-Giun Cherng, Ying-Hsuan Tai","doi":"10.1097/JCMA.0000000000001180","DOIUrl":"10.1097/JCMA.0000000000001180","url":null,"abstract":"<p><strong>Background: </strong>Pruritus is a distressing symptom of systemic opioid analgesia that responds poorly to conventional anti-pruritus treatments. This study aimed to determine the incidence and risk factors for postoperative pruritus using intravenous patient-controlled analgesia (IV-PCA).</p><p><strong>Methods: </strong>Opioid-naïve patients who underwent morphine-based IV-PCA for postoperative pain at a tertiary center between January 1, 2020 and June 30, 2023, were included retrospectively. The primary outcome was pruritus within 72 hours after surgery. Cumulative morphine consumption and pain numerical rating scores were measured to evaluate the potential impact of pruritus on postoperative pain control.</p><p><strong>Results: </strong>A total of 1696 patients were enrolled, of whom 119 (7.0%) developed pruritus during the study period. Five independent factors for pruritus were identified, including intraoperative uses of hydroxyethyl starch solutions (adjusted odds ratio [aOR]: 0.13, 95% CI, 0.04-0.43), lockout interval of IV-PCA (aOR: 0.50, 95% CI, 0.27-0.94, on base-2 logarithmic scale), droperidol addition to morphine solutions (aOR: 0.53, 95% CI, 0.35-0.81), cumulative morphine dose (aOR: 1.76, 95% CI, 1.47-2.12, on base-2 logarithmic scale), and postoperative uses of antihistamines (aOR: 2.90, 95% CI, 1.83-4.60) (c-statistic = 0.745). Patients with pruritus had higher postoperative morphine consumption (median: 67.5 mg, interquartile range: 38.3-94.0 vs 38.0 mg, 21.0-65.4, p < 0.001) but similar pain intensity compared to those without pruritus.</p><p><strong>Conclusion: </strong>Increasing the lockout interval and the droperidol regimen may protect patients from morphine-induced pruritus after IV-PCA. Further studies are warranted to clarify the mechanisms underlying the anti-pruritus effects of hydroxyethyl starch.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"178-187"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960577","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}

{"title":"Predictors of the efficacy of CO 2 laser therapy for female stress urinary incontinence.","authors":"Sheng-Mou Hsiao, Wen-Yih Wu, Ho-Hsiung Lin","doi":"10.1097/JCMA.0000000000001193","DOIUrl":"10.1097/JCMA.0000000000001193","url":null,"abstract":"<p><strong>Background: </strong>Predictors of the efficacy of a single session of CO 2 laser therapy for female stress urinary incontinence are important for pretreatment consultation. Therefore, this study aimed to evaluate these predictors.</p><p><strong>Methods: </strong>All consecutive women who underwent vaginal CO 2 laser therapy for stress urinary incontinence were prospectively enrolled in the obstetrics and gynecology department of a medical center from October 2018 to December 2021. Women with a global response assessment (GRA) ≤0 during follow-up were considered to have subjective failure. A multivariable backward stepwise Cox proportional hazard model was used to identify factors influencing subjective failure.</p><p><strong>Results: </strong>A total of 75 women who underwent single-session vaginal CO 2 laser therapy were evaluated. The median duration of subjective improvement (defined as ≥1 on the GRA) was 18.3 (95% CI, 12.1-18.3 months) months. Multivariable analysis revealed that low voided volume (dL, hazard ratio [HR] = 0.707; area under the curve [AUC] = 0.66, cutoff value of voided volume ≤4.0 dL), high postvoid residual volume (dL, HR = 2.714; AUC = 0.60, cutoff value of postvoid residual volume ≥1.0 dL), and low functional profile length (HR = 0.956; AUC = 0.58, cutoff value of functional profile length ≤2.8 cm) were predictors of subjective failure. Logit(p) was found to predict failure (HR = 1.775; AUC = 0.71, cutoff value of logit(p) ≥0.0). Pad weights decreased at 3- and 6-month follow-up visits (e.g., pad weights: 46.9 ± 62.8 g at baseline, 13.1 ± 29.5 g at 3 months, and 21.0 ± 38.2 g at 6 months, p = 0.006). At 6 months, 8 (21%) women were cured (<1 g pad weight), and 16 (42%) women showed improvement (>50% decrease in pad weight). Overactive bladder symptom improved at 3 and 6 months (ie, Overactive Bladder Symptom Score: 3.2 ± 2.7 at baseline, 2.1 ± 2.2 at 3 months, and 2.0 ± 1.2 at 6 months, p < 0.001). However, no significant change in female sexual function was observed from baseline.</p><p><strong>Conclusion: </strong>Low voided volume and high postvoid residual volume are significant predictors of subjective failure following a single session of transvaginal CO2 laser therapy. However, the subjective therapeutic effects appear to diminish over a median duration of 18 months.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"145-150"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142962561","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}

{"title":"High-intensity interval training attenuates renal injury induced by myocardial ischemia-reperfusion in rats.","authors":"Chang-Chi Lai, Chia-Yu Tang, Szu-Kai Fu, Kuo-Wei Tseng, Chia-Hsien Yu, Chien-Ying Wang","doi":"10.1097/JCMA.0000000000001183","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001183","url":null,"abstract":"<p><strong>Background: </strong>High-intensity interval training (HIIT) has been recognized as an effective form of short-duration exercise. The purpose of this study was to assess whether HIIT could reduce renal injury induced by myocardial ischemia-reperfusion (MIR) in rats.</p><p><strong>Methods: </strong>Male Sprague-Dawley rats were randomly assigned to the Sham (SHAM), coronary artery occlusion (CAO), HIIT, and ischemic precondition (IPC) groups. Rats underwent 40 minutes of left anterior descending CAO under anesthesia, followed by 3 hours of reperfusion, to induce MIR. Postsurgery, rats were sacrificed, and their blood, heart, and kidney tissues were examined. The HIIT group underwent 4 weeks of HIIT training before surgery.</p><p><strong>Results: </strong>HIIT intervention significantly reduced renal injury after MIR and the concentrations of blood urea nitrogen (BUN) and creatinine (CRE) in the serum. Moreover, proinflammatory cytokines, including tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and IL-6, were significantly decreased, while the anti-inflammatory cytokine IL-10 was significantly increased in the serum. Additionally, HIIT intervention suppressed the expression of FoxO1, Bax/Bcl-2 ratio, TNF-α, and cleaved-caspase-3/caspase-3 ratio in kidney tissues, ultimately reducing renal cell apoptosis.</p><p><strong>Conclusion: </strong>This study is the first to demonstrate that HIIT has effects similar to IPC, significantly reducing renal injury after MIR. HIIT regulates the production of proinflammatory and anti-inflammatory cytokines and inhibits renal cell apoptosis, thereby reducing the occurrence of cardiorenal syndrome.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":"88 2","pages":"126-137"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451266","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}

{"title":"Real‑world therapeutic strategies and survival outcomes in advanced HER2-mutant non-small cell lung cancer.","authors":"Ruei-Lin Sun, Pei-Ya Liao, Ying-Ting Liao, Yi-Chen Yeh, Chi-Lu Chiang, Yuh-Min Chen, Kuo-Hsuan Hsu, Jeng-Sen Tseng, Hsu-Ching Huang, Chia-I Shen, Yen-Han Tseng, Yen-Hsiang Huang, Yung-Hung Luo, Tsung-Ying Yang","doi":"10.1097/JCMA.0000000000001212","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001212","url":null,"abstract":"<p><strong>Background: </strong>Limited information is available regarding the clinical features and outcomes of advanced human epidermal growth factor receptor 2 (HER2)-mutant non-small cell lung cancer (NSCLC) in Taiwan, despite expanding treatment options for this distinct subtype. The present study explored the clinical features and outcomes of HER2-mutant NSCLC in a real-world setting.</p><p><strong>Methods: </strong>Relevant data were collected from patients with advanced or recurrent HER2-mutant NSCLC who received systemic therapy between 2011 and 2021 and were followed up until 2022 at two medical centers in Taiwan. Clinical features, treatment responses, and survival-associated factors were analyzed.</p><p><strong>Results: </strong>This study included 45 patients (median age: 59.7 [range: 41.3-78.7] years). A775_G776insYVMA was the most common NSCLC subtype (57.8%), followed by G778_P780dup (11.1%). Approximately 53.3% of the patients received first-line platinum-based chemotherapy (PC) alone, whereas 13.3% received PC combined with an immune checkpoint inhibitor (ICI). The median overall survival (OS) and progression-free survival (PFS) after first-line therapy were 25.8 and 4.4 months, respectively. The objective response rate was generally higher in patients receiving first-line PC + ICI than in those receiving PC alone (33.3% vs. 12.5%; p = 0.269). Furthermore, patients receiving PC + ICI had longer PFS than did those receiving PC alone (9.5 vs. 4.4 months; p = 0.131) and those receiving tyrosine kinase inhibitor/ICI monotherapy (9.5 vs. 0.5 months; p = 0.015). Compared with patients having other NSCLC subtypes, those carrying HER2 exon 20 insertion mutations had shorter median PFS (17.3 vs. 2.9 months; p = 0.043) and OS (not reached vs. 19 months; p = 0.031).</p><p><strong>Conclusion: </strong>This study highlights the clinical features and outcomes of advanced HER2-mutant NSCLC in Taiwan. PC + ICI may be more effective than other regimens as first-line therapy. The prognostic role of HER2 exon 20 insertion mutations warrants further investigation.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049166","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}

{"title":"Potential risk factors for delayed neurological sequelae and myocardial injury following acute carbon monoxide poisoning: A retrospective study.","authors":"Min-Po Ho, Yuan-Hui Wu, Tsan-Chi Chen, Kuang-Chau Tsai, Chen-Chang Yang","doi":"10.1097/JCMA.0000000000001208","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001208","url":null,"abstract":"<p><strong>Background: </strong>Acute carbon monoxide poisoning (COP) has been a common cause of emergency hospital visits over the past decade. Besides the immediate symptoms of poisoning, carbon monoxide exposure can cause various long-term complications, especially delayed neurological sequelae (DNS) and myocardial injury (MI).</p><p><strong>Methods: </strong>This study retrospectively enrolled 502 patients with COP, including complete collection data, from the Taiwan National Poison Control Center between January 1, 2000, and December 31, 2015. After collecting the relevant clinical and laboratory data, multivariate logistic regression analysis was performed to investigate the associations between potential predictors and risk factors, hazard ratio (HR), and confidence intervals (CI).</p><p><strong>Results: </strong>The cumulative incidence rates were 12.0% and 19.7% for DNS and MI, respectively. A Glasgow Coma Scale (GCS) score of <9 (HR 2.55; 95% CI: 1.52-4.27) and rhabdomyolysis (HR 2.68; 95% CI: 1.59-4.53) were identified as individual indicators of DNS in patients with COP. However, a greater risk for MI was associated with a GCS score of <9 (HR 2.50; 95% CI: 1.67-3.74), rhabdomyolysis (HR 4.91; 95% CI: 3.28-7.35), acute renal impairment (HR 2.43; 95% CI: 1.59-3.71), and leukocytosis (HR 9.55; 95% CI: 3.88-23.50). Hyperbaric oxygen therapy for patients with COP was more beneficial for DNS (HR 0.64; 95% CI: 0.34-1.20) than for MI (HR 1.94; 95% CI: 0.94-4.01).</p><p><strong>Conclusion: </strong>Early differentiation of risk factors between DNS and MI contributes to an effective evaluation of patients with acute COP and the provision of appropriate therapy.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019006","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}

{"title":"Potential beneficial impacts of tadalafil on cardiovascular diseases.","authors":"Tien-Yun Lan, Chih-Hung Chiang, Jaw-Wen Chen, Ting-Ting Chang","doi":"10.1097/JCMA.0000000000001205","DOIUrl":"https://doi.org/10.1097/JCMA.0000000000001205","url":null,"abstract":"<p><p>Tadalafil is a selective phosphodiesterase type 5 (PDE5) inhibitor commonly used for the treatment of erectile dysfunction and benign prostatic hyperplasia. Its mechanism of action involves the inhibition of PDE5, leading to increased levels of nitric oxide and cyclic guanosine monophosphate in the corpus cavernosum, which facilitates smooth muscle relaxation. This article reviews studies using tadalafil in the treatment of cardiovascular diseases and emphasizes its potential advantages in conditions such as pulmonary arterial hypertension, atherosclerosis, coronary artery disease, myocardial infarction, heart failure, stroke, diabetic ulcers, and cardiomyopathy. Although tadalafil shows potential efficacy in treating cardiovascular disease, further experimental studies are needed to clarify its pharmacological effects on cardiovascular protection beyond PDE5 inhibition.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142960738","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}

{"title":"Anti-inflammatory and anticancer effects of polysaccharides from Antrodia cinnamomea : A review.","authors":"Zhi-Hu Lin, Sang-Nguyen-Cao Phan, Diem-Ngoc-Hong Tran, Mei-Kuang Lu, Tung-Yi Lin","doi":"10.1097/JCMA.0000000000001186","DOIUrl":"10.1097/JCMA.0000000000001186","url":null,"abstract":"<p><p>Antrodia cinnamomea ( Ac ), also known as \"Niu-Chang-Chih\" in Chinese, is a valuable fungus that has been widely used as medicine and food among indigenous people in Taiwan. Ac is rich in polysaccharides ( Ac -PS), making it a promising candidate for adjunctive therapy in cancer and inflammation conditions. There are two types of Ac -PS: general (non-sulfated) PS ( Ac -GPS) and sulfated PS ( Ac -SPS). This review highlights that both Ac -GPS and Ac -SPS possess immunomodulatory, anti-inflammatory, and anticancer properties. Each type influences interleukin signaling pathways to exert its anti-inflammatory effects. Ac -GPS is particularly effective in alleviating inflammation in the brain and liver, while Ac -SPS shows its efficacy in macrophage models. Both Ac -GSP and Ac -SPS have demonstrated anticancer effects supported by in vitro and in vivo studies, primarily through inducing apoptosis in various cancer cell lines. They may also synergize with chemotherapy and exhibit antiangiogenic properties. Notably, Ac -SPS appears to have superior anticancer efficacy, potentially due to its sulfate groups. Furthermore, Ac -SPS has been more extensively studied in terms of its mechanisms and effects on lung cancer compared with Ac -GPS, highlighting its significance in cancer research. In addition, Ac -SPS is often reported for its ability to activate macrophage-mediated responses. Clinically, Ac -GPS has been used as an adjunctive therapy for advanced lung cancer, as noted in recent reports. However, given the numerous studies emphasizing its anticancer mechanisms, Ac -SPS may exhibit greater efficacy, warranting further investigation. This review concludes that Ac -derived Ac -GPS or Ac -SPS have the potential to be developed into functional health supplements or adjunctive therapies, providing dual benefits of anti-inflammatory and anticancer effects.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523999","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}

{"title":"Clinical outcomes in ventilator-associated pneumonia patients with and without chronic obstructive pulmonary disease.","authors":"Caiden Taowei Lu, Tien-Pei Fang, Ming-Szu Hung, Yi-Tsung Lin","doi":"10.1097/JCMA.0000000000001176","DOIUrl":"10.1097/JCMA.0000000000001176","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Critically ill patients with COPD exacerbations may require invasive mechanical ventilation (IMV). Ventilator-associated pneumonia (VAP) commonly occurs in the intensive care unit (ICU) and is usually associated with high mortality. Current studies on the association between COPD and VAP are limited. This work compared the causes and clinical outcomes of VAP in patients with and without COPD in Taiwan.</p><p><strong>Methods: </strong>This retrospective observational study was conducted at the Chiayi Chang Gung Memorial Hospital. Patients diagnosed with VAP were enrolled between January 2015 and December 2019. The COPD diagnosis was based on postbronchodilator pulmonary function tests. We compared the bacterial cause, ICU and hospital stay length, IMV duration and mortality rates in patients with and without COPD.</p><p><strong>Results: </strong>A total of 175 patients with VAP were enrolled, 44% of whom presented had preexisting COPD. The disease severity on the day of admission was similar in both groups. Microorganisms were identified in 83 (47%) patients, with Pseudomonas aeruginosa , Acinetobacter spp., and Klebsiella pneumoniae being the most common pathogens. The proportion of multidrug resistant isolates showed no significant differences between groups. Most patients underwent antibiotic treatment before VAP onset. The length of ICU and hospital stays and IMV duration after VAP onset were similar between the two groups, as well as ICU mortality, in-hospital mortality, and 14-day mortality.</p><p><strong>Conclusion: </strong>Our study revealed that COPD was not associated with worse clinical outcomes in patients with VAP. No significant differences in bacterial cause were observed between the two groups.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"65-70"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335324","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}

{"title":"The neuropsychological impacts of coronavirus disease 2019 in nonhospitalized patients with long coronavirus disease and brain fog.","authors":"Yu-Chen Chuang, Yu-Hsiang Cheng, Meng-Ju Tsai, Yi-Jiun Lu, Jong-Ling Fuh","doi":"10.1097/JCMA.0000000000001175","DOIUrl":"10.1097/JCMA.0000000000001175","url":null,"abstract":"<p><strong>Background: </strong>Coronavirus disease 2019 (COVID-19) causes persistent symptoms, including brain fog. Based on limited research on the long-term consequences of mild COVID-19, which has yielded inconsistent results, we investigated which cognitive functions were most affected by COVID-19 in nonhospitalized Asian patients with long-term COVID and subjective cognitive complaints.</p><p><strong>Methods: </strong>Fifty-five nonhospitalized patients with subjective cognitive complaints after COVID infection (24 males and 31 females, mean age: 45.6 ± 14.6 years, mean duration of education: 14.4 ± 3.0 years) finished the study. Neuropsychological assessments included screening tests for overall cognition, and comprehensive tests for memory, executive function, processing speed, and subjective emotional and disease symptoms. Cognitive test scores were converted into Z -scores. Moreover, principal component analysis (PCA) was used to define cognitive domains across subtest scores.</p><p><strong>Results: </strong>Comprehensive assessments revealed cognitive impairment in 69.1% of patients (<1.5 SD in at least one test). The processing speed (27.3%), memory recall (21.8%), memory learning (20.0%), and inhibitory control (18.2%) were the most affected areas. Self-reported anxiety and depression were observed in 35% and 33% of patients, respectively. Furthermore, the degree of anxiety was predictive of learning performance.</p><p><strong>Conclusion: </strong>Nearly 70% of patients with subjective cognitive complaints and long COVID had objective cognitive impairments. A comprehensive evaluation is essential for these patients, even when they present with mild symptoms.</p>","PeriodicalId":94115,"journal":{"name":"Journal of the Chinese Medical Association : JCMA","volume":" ","pages":"58-64"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335325","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}