Medicine
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Observational Study
Dementia Increases Severe Sepsis and Mortality in Hospitalized Patients With Chronic Obstructive Pulmonary Disease.
Dementia increases the risk of morbidity and mortality in hospitalized patients. However, information on the potential effects of dementia on the risks of acute organ dysfunction, severe sepsis and in-hospital mortality, specifically among inpatients with chronic obstructive pulmonary disease (COPD), is limited. The observational analytic study was inpatient claims during the period from 2000 to 2010 for 1 million people who were randomly selected from all of the beneficiaries of the Taiwan National Health Insurance in 2000. ⋯ After controlling for potential confounding factors, dementia was found to significantly increase the odds of severe sepsis and hospital mortality with an adjusted OR (OR) of 1.38 (95% confidence interval [CI] 1.10-1.72) and 1.69 (95% CI 1.18-2.43), respectively. Dementia was also significantly associated with an increased OR of acute respiratory dysfunction (adjusted OR 1.39, 95% CI 1.09-1.77). In hospitalized COPD patients, the presence of dementia may increase the risks of acute respiratory dysfunction, severe sepsis, and hospital mortality, which warrants the attention of health care professionals.
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Comparative Study Observational Study
PET/CT-Based Dosimetry in 90Y-Microsphere Selective Internal Radiation Therapy: Single Cohort Comparison With Pretreatment Planning on (99m)Tc-MAA Imaging and Correlation With Treatment Efficacy.
⁹⁰Y PET/CT can be acquired after ⁹⁰Y-microsphere selective radiation internal therapy (SIRT) to describe radioactivity distribution. We performed dosimetry using ⁹⁰Y-microsphere PET/CT data to evaluate treatment efficacy and appropriateness of activity planning from (99m)Tc-MAA scan and SPECT/CT. Twenty-three patients with liver malignancy were included in the study. (99m)Tc-MAA was injected during planning angiography and whole body (99m)Tc-MAA scan and liver SPECT/CT were acquired. ⋯ Tumor absorbed dose calculated by (99m)Tc-MAA SPECT/CT was not a significant predictor for PFS. Activity planning based on (99m)Tc-MAA scan and SPECT/CT can be effectively used as a conservative method. Post-SIRT dosimetry based on ⁹⁰Y-microsphere PET/CT is an effective method to predict treatment efficacy.
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Treatment against shunt infection by transvenous antimicrobial treatment is difficult, with a high risk of relapse. Consequently, to maintain a sufficient cerebrospinal fluid (CSF) concentration, intraventricular administration is utilized in combination with the transvenous administration of vancomycin (VCM). Few studies have so far investigated the optimum administration dose for newborns and the concentration in the CSF. ⋯ At the same time, in the 5 mg group (n = 5), the concentration in the CSF 24 hours following VCM administration was sufficiently maintained (33.2-62.9 mg/L), with a sufficient trough concentration still maintained at 72 hours (11.7-16.5 mg/L). The concentration in the CSF is prolonged in newborns, thus allowing a sufficient therapeutic range to be maintained even at an intraventricular administration of 5 mg. It is therefore believed that the monitoring of the CSF is very important regarding the administration interval because the VCM concentration in the CSF differs depending on the case.
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Observational Study
A Genetic Susceptibility Mechanism for Major Depression: Combinations of polymorphisms Defined the Risk of Major Depression and Subpopulations.
Major Depression (MD) is a highly inherited psychiatric disorder. The norepinephrine transporter (NET) gene plays important role in pathophysiology of MD. This study attempted to examine the relationship between polymorphisms of NET gene and MD. ⋯ When referenced by TT genotype, the OR value increased gradient from TC to CC genotype; when referenced by T allele, the odds ratio value of C allele also increased. Compared with those having both -182 T/T and 1287 G/G genotypes, in patients with MD, early-onset MD, and MD with suicide concept group, the -182 C/C and 1287 G/A combinatorial genotype has significant risk; yet in patients with MD family history, the -182 C/C and 1287 A/A combinatorial genotype has significant risk. Different combinations of T-182C and the G1287A polymorphisms of NET gene might increase morbidity risk of MD subpopulations.
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Observational Study
Increased Risk of Dementia in Patients With Chronic Obstructive Pulmonary Disease.
Neurodegenerative disease in patients with chronic obstructive pulmonary disease (COPD) was observed. We aim to clarify the risk of dementia in patients with COPD. The study used claims data from Taiwan's National Health Insurance Research Database. ⋯ The study included 8640 patients with COPD and a mean age of 68.76 (±10.74) years. The adjusted hazard ratio of developing dementia (AD or PD) was 1.74 (95% confidence interval = 1.55-1.96) in patients with COPD compared with patients without COPD after adjusting for age, gender, and comorbidities. This nationwide cohort study demonstrates that the risk of dementia, including AD and PD, is significantly increased in patients with COPD compared with individuals in the general population.