646 results match your criteria: "National Taiwan University Hospital Yun-Lin Branch[Affiliation]"

Secondary hypertension in the elderly poses many challenges and requires a comprehensive diagnostic and management approach. This review explores the prevalence, diagnostic strategies, and treatment modalities for secondary hypertension in elderly patients, focusing on etiologies including primary aldosteronism, renal vascular disease, renal parenchymal disease, obstructive sleep apnea, thyroid disorders, Cushing's syndrome, pheochromocytomas and paragangliomas, and drug-induced hypertension. Key considerations include age-related changes in physiology and atypical presentations of underlying conditions necessitating thorough screening with a combination of clinical evaluation, laboratory tests, and imaging studies.

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  • This study looked at women with a health issue called atypical endometrial hyperplasia (AEH) who didn't get better after 3 months of treatment with a hormone called progestin.
  • Most of the women who continued the treatment improved after about a year, especially if they took higher doses of progestin.
  • However, some women had the problem come back later, and being overweight was linked to a higher chance of this happening. Overall, the study suggests that continuing treatment can still help these patients.
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  • - Ambulance-based telestroke evaluations using mobile phones with 5G technology were tested for feasibility and reliability with standardized patients in urban settings.
  • - The study involved independent raters assessing stroke scenarios via videoconferencing, finding no significant differences in NIHSS scores between face-to-face and remote evaluations, with a very high correlation (0.994).
  • - Results indicate that using mobile technology for stroke assessment in ambulances is practical and effective, showing that both neurologists and emergency physicians achieved similar results in stroke evaluations.
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Background: Spontaneous intracerebral hemorrhage (ICH) accounts for up to 20% of all strokes and results in 40% mortality at 30 days. Although conservative medical management is still the standard treatment for ICH patients with small hematoma, patients with residual hematoma ≤15 mL after surgery are associated with better functional outcomes and survival rates. This study reported our clinical experience with using Robotic Stereotactic Assistance (ROSA) as a safe and effective approach for stereotactic ICH aspiration and intra-clot catheter placement.

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Hypogonadism among HIV-positive men who have sex with men in Taiwan: Prevalence and associated factors.

J Microbiol Immunol Infect

October 2024

Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan; Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan; Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address:

Background: Male hypogonadism is not uncommon in people with HIV (PWH), with estimated prevalence ranging from 9% to 16%. Existing data are limited on the serum testosterone levels in PWH in Asian populations.

Methods: We enrolled HIV-positive men who have sex with men (MSM) and had been on stable antiretroviral therapy and MSM without HIV between February 2021 and November 2022.

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Objectives: Following current cardiopulmonary resuscitation (CPR) guidelines, which recommend chest compressions at "the center of the chest," ~50% of patients experiencing out-of-hospital cardiac arrest (OHCA) undergo aortic valve (AV) compression, obstructing blood flow. We used resuscitative transesophageal echocardiography (TEE) to elucidate the impact of uncompressed vs. compressed AV on outcomes of adult patients experiencing OHCA.

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  • This study aimed to validate a simplified radiological scoring system for evaluating clinical symptoms and outcomes in Taiwanese patients with noncystic fibrosis bronchiectasis (NCFB).
  • It involved analyzing data from 2,753 patients, assessing their bronchiectasis type and severity using a modified Reiff score derived from high-resolution CT scans, and correlating these with clinical features such as lung function and hospitalization rates.
  • The findings indicated that as the severity of bronchiectasis increased, patients experienced worse symptoms and lung function, and identified factors like age and pneumonia as independent predictors of mortality, suggesting the scoring system's utility in clinical assessments.
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Purpose: Mycobacterium abscessus complex (MABC) commonly causes lung disease (LD) and has a high treatment failure rate of around 50%. In this study, our objective is to investigate specific CT patterns for predicting treatment prognosis and monitoring treatment response, thus providing valuable insights for clinical physicians in the management of MABC-LD treatment.

Methods: We retrospectively assessed 34 patients with MABC-LD treated between January 2015 and December 2020.

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Do cardiac causes predominate in the etiological classification of out-of-hospital cardiac arrest (OHCA)?

Resuscitation

June 2024

Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan; Department of Emergency Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address:

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Background: High-risk emergency department (ED) revisit is considered an important quality indicator that may reflect an increase in complications and medical burden. However, because of its multidimensional and highly complex nature, this factor has not been comprehensively investigated. This study aimed to predict high-risk ED revisit with a machine-learning (ML) approach.

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Background: Concomitant atrial fibrillation and end-stage renal disease is common and associated with an unfavorable prognosis. Although oral anticoagulants have been well established to prevent thromboembolism, the applicability in patients under long-term dialysis remains debatable. The study aimed to determine the efficacy and safety of anticoagulation in the dialysis-dependent population.

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  • Heart failure with preserved ejection fraction (HFpEF) is a complex condition affecting the heart and other organs, leading to significant health issues, especially in younger patients in Asia with high rates of diabetes and kidney disease.
  • The diagnosis involves a 2-step algorithm focusing on symptoms, ejection fraction, natriuretic peptide levels, and tests for heart abnormalities; if uncertain, additional stress testing may be required.
  • Management includes controlling comorbidities, lifestyle changes like weight loss and exercise, and pharmacological treatments such as diuretics and SGLT2 inhibitors to improve patient outcomes.
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Background: Tourniquets (TQ) have been increasingly adopted in pre-hospital settings recently. This study examined the effectiveness and safety of applying TQ in the pre-hospital settings for civilian patients with traumatic vascular injuries to the extremities.

Materials And Methods: We systematically searched the Ovid Embase, PubMed, and Cochrane Central Register of Controlled Trials databases from their inception to June 2023.

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Background: Congestive heart failure (CHF) as a risk of stroke in patients with atrial fibrillation (AF) mainly referred to patients with left ventricular systolic dysfunction. Whether this should include patients with preserved ejection fraction is debatable.

Objective: The study aimed to investigate the variation in stroke risk of AF patients with heart failure with preserved ejection fraction (HFpEF), heart failure with mid-range ejection fraction (HFmrEF), and heart failure with reduced ejection fraction (HFrEF) for enhancing risk assessment and subsequent management strategies.

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Background: Primary aldosteronism (PA) has been associated with atherosclerosis beyond the extent of essential hypertension, but the impact of albuminuria remains unknown.

Objective: To investigate the effect of concomitant albuminuria on arterial stiffness in PA.

Design: Prospective cohort study.

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Background: Out-of-hospital cardiac arrest (OHCA) is a significant public health issue worldwide and is associated with low survival rates and poor neurological outcomes. The generation of optimal coronary perfusion pressure (CPP) via high-quality chest compressions is a key factor in enhancing survival rates. However, it is often challenging to provide adequate CPP in real-world cardiopulmonary resuscitation (CPR) scenarios.

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Background: Rapid recognition of frailty in older patients in the ED is an important first step toward better geriatric care in the ED. We aimed to develop and validate a novel frailty assessment scale at ED triage, the Emergency Department Frailty Scale (ED-FraS).

Methods: We conducted a prospective cohort study enrolling adult patients aged 65 years or older who visited the ED at an academic medical center.

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Low physical activity has been associated with poor prognosis in hemodialysis (HD) patients. Interventions to maintain healthy lifestyle in this population are important to reduce mortality. This study aimed to evaluate the effectiveness of digital health interventions (DHIs) for improving the physical activity and health-related quality of life (HRQoL) in HD patients.

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Association of exosomes in patients with compromised myocardial perfusion on functional imaging.

J Formos Med Assoc

September 2024

Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Dou-Liu City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Background: Exosomes are membrane vesicles that are actively secreted in response to microenvironmental stimuli. In this study, we quantified the amount of exosomes in patients with significant coronary artery disease (CAD) and evaluated its relationship with myocardial perfusion imaging (MPI) results.

Methods: Patients who underwent both MPI and coronary angiography were recruited.

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Background: Studies have established that sex and age influence outcomes following out-of-hospital cardiac arrest (OHCA). However, a knowledge gap exists regarding their interaction. This study aimed to investigate the interaction of age and sex and how they cooperatively influence OHCA outcomes.

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Modified physiologic criteria for the field triage scheme: Efficacy of major trauma recognition in different age groups in Asia.

Am J Emerg Med

March 2024

Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital Yun-Lin Branch, Douliu City, Taiwan. Electronic address:

Article Synopsis
  • Major trauma is a leading cause of unexpected deaths worldwide, and while current field triage schemes (FTSs) help identify proper care facilities, they can be inefficient and time-consuming.* -
  • A simplified field triage scheme (sFTS) using only physiological and anatomical criteria was evaluated to determine its effectiveness in identifying high-risk trauma patients across different age groups in Asia.* -
  • The study found that while the initial sFTS had moderate sensitivity and specificity, modifications like adjusting criteria and including the shock index improved its ability to identify severely injured patients.*
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Objective: Hyperaldosteronism has adverse effects on cardiovascular structure and function. Laparoscopic adrenalectomy is the gold standard for patients with unilateral primary aldosteronism. For unilateral primary aldosteronism patients unable or unwilling to undergo surgery, the effects of mineralocorticoid receptor antagonists (MRAs) on the reversibility of arterial stiffness and other clinical data remain unclear.

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Introduction: Sarcopenia is an adverse prognostic factor in patients with liver cirrhosis and hepatocellular carcinoma (HCC). Image-based sarcopenia assessment allows a standardized method to assess abdominal skeletal muscle. However, which is an index muscle for sarcopenia remains unclear.

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Objective: This study aims to describe out-of-hospital cardiac arrest (OHCA) characteristics and trends before and during the coronavirus disease-2019 (COVID-19) pandemic in Taiwan.

Methods: We conducted a retrospective cohort study using a 5-year interrupted time series analysis. Eligible adults with non-traumatic OHCAs from January 2017 to December 2021 in 3 hospitals (university medical center, urban second-tier hospital, and rural second-tier hospital) were retrospectively enrolled.

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