Publications by authors named "Yu-Mu Chen"

Purpose: This study aimed to investigate the impact of body composition variables on hospital mortality compared to other predictive factors among patients with severe pneumonia. Additionally, we aimed to monitor the dynamic changes in body composition variables over the course on days 1, 3, and 8 after intensive care unit (ICU) admission for each patient.

Methods: We conducted a prospective study, enrolling patients with severe pneumonia admitted to the medical intensive care unit at Kaohsiung Chang Gung Memorial Hospital from February 2020 to April 2022.

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Background: Among patients with chronic obstructive pulmonary disease (COPD), some have features of both asthma and COPD-a condition categorized as asthma-COPD overlap (ACO). Our aim was to determine whether asthma- or COPD-related microRNAs (miRNAs) play a role in the pathogenesis of ACO.

Methods: A total of 22 healthy subjects and 27 patients with ACO were enrolled.

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Article Synopsis
  • - The study analyzes patients with influenza-related acute respiratory distress syndrome (ARDS) who required prolonged mechanical ventilation (PMV), identifying factors that contribute to PMV and challenges in weaning off ventilation.
  • - Conducted at eight medical centers in Taiwan, the research involved 263 patients, revealing that 78 experienced PMV, with a mortality rate of 39.7% and a weaning rate of 68.8% during a 60-day observation period.
  • - Key risk factors for PMV included a body mass index (BMI) over 25, the use of extracorporeal membrane oxygenation (ECMO), bacterial pneumonia, and prolonged neuromuscular blockade; while ECMO usage and bacteremia were linked
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Altered expressions of pro-/anti-oxidant genes are known to regulate the pathophysiology of obstructive sleep apnea (OSA).We aim to explore the role of a novel long non-coding (lnc) RNA FKSG29 in the development of intermittent hypoxia with re-oxygenation (IHR)-induced endothelial dysfunction in OSA. Gene expression levels of key pro-/anti-oxidant genes, vasoactive genes, and the FKSG29 were measured in peripheral blood mononuclear cells from 12 subjects with primary snoring (PS) and 36 OSA patients.

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Background: Despite the well-established efficacies of tyrosine kinase inhibitors (TKIs) in epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC), there is limited real-world evidence comparing their effectiveness according to patients' clinical characteristics. This network meta-analysis (NMA) compared survival outcomes among first-line EGFR-TKIs in different subgroups of East Asian patients with advanced NSCLC.

Methods: This NMA included real-world observational studies reporting outcomes with TKIs in patients aged >65 years, with baseline brain metastasis, with different Eastern Cooperative Oncology Group (ECOG) statuses, or with different common EGFR mutation types.

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Background: The comparative efficacies of different generation tyrosine kinase inhibitors (TKIs) in epidermal growth factor receptor (EGFR)-mutated advanced non-small cell lung cancer (NSCLC) remain largely unknown. Moreover, whether one EGFR-TKI confers superior survival remains unclear, especially in East Asians. We conducted a network meta-analysis (NMA) comparing the survival outcomes of East Asian patients with advanced NSCLC treated with first-line EGFR-TKIs.

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Background: The expression of programmed death-ligand 1 (PD-L1), tumor-infiltrating lymphocytes (TILs), E-cadherin, and vimentin in lung cancer tumor microenvironment is known to impact patient survival or response to therapy. The expression of these biomarkers may also differ between primary lung tumors and brain metastatic tumors. In this study, we investigated the interaction between these biomarkers in lung tumors with or without concomitant brain metastasis and the interaction with paired brain metastatic tumors.

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Background: Autophagy is a catabolic process that recycles damaged organelles and acts as a pro-survival mechanism, but little is known about autophagy dysfunction and epigenetic regulation in patients with obstructive sleep apnea (OSA).

Methods: Protein/gene expressions and DNA methylation levels of the autophagy-related genes (ATG) were examined in blood leukocytes from 64 patients with treatment-naïve OSA and 24 subjects with primary snoring (PS).

Results: LC3B protein expression of blood monocytes, and ATG5 protein expression of blood neutrophils were decreased in OSA patients versus PS subjects, while p62 protein expression of cytotoxic T cell was increased, particularly in those with nocturia.

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Both hypernatremia and an abnormal immune response may increase hospital mortality in patients with sepsis. This study examined the association of hypernatremia with abnormal immune response and mortality in 520 adult patients with sepsis in an intensive care unit (ICU). We compared the mortality and ex vivo lipopolysaccharide (LPS)-induced inflammatory response differences among patients with hyponatremia, eunatremia, and hypernatremia, as well as between patients with acquired hypernatremia on ICU day 3 and those with sustained eunatremia over first three ICU days.

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Article Synopsis
  • The study investigates acute exacerbations (AEs) in male patients with chronic obstructive pulmonary disease (COPD) to find independent markers that could predict these episodes.
  • It included data from 149 patients, categorizing them into high and low AE groups based on their exacerbation history, using various clinical parameters.
  • Key findings show that different markers like white blood cell count and FEV were linked to AEs in different years, highlighting the importance of ongoing monitoring for better management of COPD.
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Background: We aimed to determine whether septic patients with liver cirrhosis (LC) had worse survival than septic patients without liver cirrhosis (WLC). We also investigated the survival of septic patients with compensated liver cirrhosis (CLC) and decompensated liver cirrhosis (DLC). Methods: This study enrolled 776 consecutive adult patients with sepsis admitted to the medical intensive care units of a tertiary referral hospital.

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Body mass index (BMI) influences the prognosis of patients with non-small cell lung cancer (NSCLC), including both early-stage and late-stage NSCLC patients that are undergoing chemotherapies. However, earlier research on the relationship between BMI and survival in patients taking epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) yielded contradictory results. These publications either had a limited number of patients or were getting TKIs in various lines of therapy, which might explain why the outcomes were contradictory.

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  • This study compares the effectiveness of prone positioning versus ECMO as rescue therapies for severe ARDS related to influenza pneumonia.
  • It analyzed 263 patients from eight hospitals in Taiwan, finding that those who received prone positioning had a significantly lower 60-day mortality rate (28% vs. 60%).
  • The results suggest that prone positioning may be a better initial treatment option for these patients, although the exact relationship between prone positioning and improved outcomes remains unclear.
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  • - The study explored the optimal timing for the National Early Warning Score 2 (NEWS2) in predicting outcomes for patients with severe sepsis in the ICU, comparing its effectiveness with the Sequential Organ Failure Assessment (SOFA) score for mortality risk assessment.
  • - Researchers included 699 adult patients in a derivation cohort from 2013 to 2017 and a validation cohort from early 2020, finding that the 72-hour NEWS2 performed well in predicting 7 to 28-day mortality rates and was comparable to SOFA scores.
  • - A new combined NESO tool showed significant risk stratification for mortality, indicating higher hazard ratios for intermediate and high-risk groups, and demonstrated its utility in assessing mortality risk over
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  • Researchers investigated how changes in acute kidney injury (AKI) from day 1 to day 3 in sepsis patients could predict hospital mortality, focusing on patients in the ICU.
  • They analyzed data from 523 sepsis patients, categorizing them into normal, improved, and deteriorated AKI groups based on their AKI stages over the first three days.
  • Results indicated that patients whose AKI worsened had significantly higher mortality rates and abnormal inflammatory responses compared to those whose AKI remained stable or improved.
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Nutritional status affects the survival of patients with sepsis. This retrospective study analyzed the impact of body mass index (BMI) and modified nutrition risk in critically ill (mNUTRIC) scores on survival of these patients. Data of 1291 patients with sepsis admitted to the intensive care unit (ICU) were extracted.

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Article Synopsis
  • * Among these, 34 patients developed acute kidney injury (AKI) needing RRT, showing significantly higher 30- and 60-day mortality rates compared to those not requiring RRT (50% vs. 19.8% and 58.8% vs. 27.2%).
  • * Key predictors for needing RRT included chronic liver disease and C-reactive protein levels, while mortality predictors for those needing RRT involved pneumonia severity index and tidal volume.
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Purpose: Circadian clock is synchronized to the 24-hour day by the daily light-dark cycle and proper function of circadian rhythm is essential for many physiological processes. Disruption of circadian rhythm can affect disease processes and influence disease severity, treatment responses, and even survivorship. In this retrospective case-controlled study, we tried to explore whether expression of circadian clock genes was disturbed in patients with bronchial asthma.

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Objective: Multimorbidity in elderly patients increases complications and retards the recovery of pulmonary function after coronary artery bypass grafting (CABG) surgery. We aimed to evaluate the impact of multiple-intervention pulmonary rehabilitation (PR) on respiratory muscle strength and dyspnea scores after CABG in adult patients aged ≥65 years who had multimorbidity.

Methods: A cohort study was retrospectively conducted with 95 adults aged ≥65 years who underwent CABG surgery and completed a multiple-intervention PR program.

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We hypothesized that Ventilator-Associated Event (VAE) within 28 days upon admission to medical intensive care units (ICUs) can be a predictor for poor outcomes in sepsis patients. We aimed to determine the risk factors and associated outcomes of VAE. A total of 453 consecutive mechanically ventilated (MV) sepsis patients were enrolled.

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Background: Patients with severe influenza-related acute respiratory distress syndrome (ARDS) have high morbidity and mortality. Moreover, nosocomial lower respiratory tract infection (NLRTI) complicates their clinical management and possibly worsens their outcomes. This study aimed to explore the clinical features and impact of NLRTI in patients with severe influenza-related ARDS.

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The association between sepsis and segmented neutrophil-to-monocyte (SeMo) ratio is unclear. We postulated that an increase in dynamic SeMo ratio measurement can be applied in risk stratification. This retrospective study included 727 consecutive sepsis patients in medical intensive care units (ICUs), including a subpopulation of 153 patients.

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Objective: The aim of this study was to determine whether do-not-resuscitate (DNR) orders affect outcomes in patients with sepsis admitted to intensive care unit (ICU).

Design: This is a retrospective observational study.

Participants: We enrolled 796 consecutive adult intensive care patients at Kaohsiung Chang Gung Memorial Hospital, a 2700-bed tertiary teaching hospital in southern Taiwan.

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Article Synopsis
  • The study investigated the effectiveness of a new tool called dynamic pulse pressure and vasopressor (DPV) in predicting mortality risk for patients with severe sepsis, comparing it to traditional methods.
  • After analyzing 757 adult patients with sepsis from an ICU, the findings showed that the DPV tool was better at predicting 7-day mortality, with an area under the curve (AUC) of 0.70.
  • The research suggests that the DPV tool is a viable option for predicting both 7-day and 28-day mortality in sepsis patients, contributing valuable insights into patient management.
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Immune dysfunction is seen both in sepsis patients and in those with malnutrition. This study aimed to determine whether insufficient nutrition and immune dysfunction have a synergistic effect on mortality in critically ill septic patients. We conducted a prospective observational study from adult sepsis patients admitted to intensive care units (ICUs) between August 2013 and June 2016.

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