Publications by authors named "An-Fu Lee"

Article Synopsis
  • * Conducted as a cluster randomised controlled trial in Taipei City, Taiwan, with participation from advanced life support ambulance teams between July 2020 and June 2023, excluding a temporary halt due to the covid-19 pandemic.
  • * Results showed no significant difference in survival rates; 10.7% of intraosseous patients and 10.3% of intravenous patients were discharged alive, with similar outcomes for return of spontaneous circulation and neurological recovery.
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Introduction: The optimal vascular access for patients with out-of-hospital cardiac arrest (OHCA) remains controversial. Increasing evidence supports intraosseous (IO) access due to faster medication administration and higher first-attempt success rates compared to intravenous (IV) access. However, the impact on patient outcomes has been inconclusive.

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Article Synopsis
  • Empyema is a rare but serious condition that can arise even with antibiotics, and it may present with unusual symptoms like persistent hiccups accompanied by fever.
  • A case study highlighted a patient who experienced persistent hiccups, abdominal pain, and fever, leading to a diagnosis of empyema just days later.
  • The case emphasizes the need for clinicians to investigate empyema when encountering patients with both unexplained fever and persistent hiccups, suggesting the use of chest CT scans for diagnosis.
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This review assessed the development of Taiwan's emergency medical services (EMS) and focused on the optimizing initiatives of the EMS systems, the current state of Taiwan's EMS system, EMS benchmarks in different regions of Taiwan, EMS response during the coronavirus disease 2019 (COVID-19) pandemic, and future design. In the past decade, there has been a noticeable increase in prehospital services, numerous optimizing initiatives to improve patient prognosis, and the medical oversight model. Taiwan's current EMS system, including the dispatch system, out-of-hospital cardiac arrest (OHCA) patient management, time-sensitive critical illness in prehospital settings, and disaster response, has undergone significant improvements.

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Article Synopsis
  • This study examines the impact of point-of-care ultrasound (PoCUS) on hospital length of stay (LOS) and mortality rates in stable patients experiencing chest pain or dyspnea between June 2020 and May 2021.
  • Out of 465 patients, findings showed that PoCUS had minimal influence on LOS and mortality for those with ST-segment elevation (STE) but significantly reduced LOS and improved survival in non-STE patients, especially when administered within 90 minutes of arrival.
  • The study concluded that while PoCUS is beneficial for non-STE cases and helps identify unforeseen conditions, its effects on STE patients were limited despite a high overall diagnostic accuracy of 96.6%.*
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Autosomal Dominant polycystic kidney disease (ADPKD) is the most common inherited adult kidney disease. Although ADPKD is primarily caused by PKD1 and PKD2, the identification of several novel causative genes in recent years has revealed more complex genetic heterogeneity than previously thought. To study the disease-causing mutations of ADPKD, a total of 920 families were collected and their diagnoses were established via clinical and image studies by Taiwan PKD Consortium investigators.

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The efficacy of ultrasound (US) in real-time differential diagnosis and guiding further treatment decisions has been well demonstrated in prearrest conditions and during resuscitation. Evidence is limited regarding the application of US in postresuscitation care. Most of the patients following resuscitation remain comatose, and the requirement for transportation to other examination rooms increases their risk of injury.

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Background: The effects of early integration of point-of-care ultrasound (PoCUS) into patient care are uncertain. This study aims to investigate the effects of early PoCUS on patients with acute flank pain.

Methods: Adult non-traumatic patients with acute flank pain receiving PoCUS were enrolled.

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Importance: Prehospital advanced airway management with either initial endotracheal intubation (ETI) or initial supraglottic airway (SGA) insertion in patients with out-of-hospital cardiac arrest (OHCA) remains controversial.

Objective: To compare the effectiveness of ETI and SGA in patients with nontraumatic OHCA.

Design, Setting, And Participants: The Supraglottic Airway Device vs Endotracheal intubation (SAVE) trial was a multicenter cluster randomized clinical trial conducted in Taipei City, Taiwan.

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Background: Opioids have been shown to increase risk of pneumonia among susceptible population. However, the effect of opioid abuse on the outcome of pneumonia has not been evaluated at the population level. We aimed to compare the outcomes of pneumonia among patients with opioid use disorder and patients without substance use disorder using a large population database.

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Study Objective: We compare effectiveness of different airway interventions during cardiopulmonary resuscitation for patients with out-of-hospital cardiac arrest.

Methods: We systematically searched the PubMed and EMBASE databases from their inception through August 2018 and selected randomized controlled trials or quasi randomized controlled trials comparing intubation, supraglottic airways, or bag-valve-mask ventilation for treating adult out-of-hospital cardiac arrest patients. We performed a network meta-analysis along with sensitivity analyses to investigate the influence of high intubation success rate on meta-analytic results.

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Tyrosine kinase inhibitors (TKIs) are currently the first-line treatment for non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR) mutations. These patients receive platinum-based chemotherapy as the second-line treatment after they develop resistance to TKIs. Many patients regain sensitivity to the TKIs used in the first-line treatment after the failure of chemotherapy.

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