Coprescription Trends in Western Medicine, Chinese Herbal Medicine and Dental Medicine among Older Adults in Taiwan from 1997 to 2013.

BACKGROUND: Coprescription is a potential medical problem for older adults that could induce polypharmacy and subsequent complications. In Taiwan, Chinese herbal medicine (CHM) is popular among the older adults. Investigating the coprescription trends in Western medicine, CHM and dental medicine is important to avoid possible polypharmacy. METHODS: We analyzed data from the Longitudinal Health Insurance Database 2000 (LHID 2000) in Taiwan. Patients ≥ 60 years old who received coprescription of Western medicine, CHM and drugs for dental care from 1997 to 2013 were included. The odds ratio (OR) and 95% confidence interval (95% CI) were estimated by a logistic regression model for evaluating the correlation between baseline characteristics and coprescription. RESULTS: A total of 266,034 patients were included for the analysis. Most patients receiving coprescriptions lived in the northern Taiwan and with a monthly income lower than 20,000 new Taiwan dollars. The trends in older adults using Western medicine alone or CHM alone decreased over time, but the cohort using dental medicine alone had the opposite result. Decreased trends in coprescription with age were noted. The trends in the proportion of coprescription and the number of days of coprescription increased with the calendar year. Increased trends in the proportion of patients with coprescription were also found, except for the cohort of patients who used both Western medicine and CHM. Patients who were female, and aged 70-79 years were prone to receive coprescription. CONCLUSIONS: Coprescription in older patients is not uncommon in Taiwan. Healthcare providers and policymakers should be aware of the complex coprescription pattern in the older adults.

Low incidence of complications from endoscopic gastric variceal obturation with butyl cyanoacrylate.

BACKGROUND & AIMS: Endoscopic variceal obturation with tissue adhesive is used to control gastric variceal bleeding. We investigated the prevalence of serious complications from this therapy. METHODS: We performed a retrospective analysis of complications that occurred in 753 patients with gastric variceal hemorrhages who were hospitalized in 2 tertiary referral hospitals. All patients received N-butyl-2-cyanoacrylate as therapy for endoscopic variceal obturation. RESULTS: Complications occurred in 51 patients. Thirty-three patients experienced rebleeding because of early-onset (within 3 months) extrusion of the N-butyl-2-cyanoacrylate glue cast (4.4%), 10 patients developed sepsis (1.3%), and 5 patients developed distant embolisms (0.7%; 1 pulmonary, 1 brain, and 3 splenic). One patient had major gastric variceal bleeding after endoscopic variceal obturation (0.1%), 1 developed a large gastric ulcer (0.1%), and 1 had mesentery hematoma, hemoperitoneum, and infection in the abdominal cavity (0.1%). The complication-related mortality was 0.53% (3 deaths from sepsis and 1 death from rebleeding after early-onset glue cast extrusion). CONCLUSIONS: The occurrence of complications after endoscopic variceal obturation with N-butyl-2-cyanoacrylate in gastric varices treatment is rare.

[Short and Long Term Clinical Efficacy of IMRT and CRT for Treatment of Patients with ENKTL].

OBJECTIVE: To compare the short and long term clinical efficacy for treatment of patients with extranodal nasal-type NK/T-cell lymphoma(ENKTL) by intensity modulated radiotherapy(IMRT) and conventional radiotheraphy(CRT). METHODS: Sixty-three cases of early ENKTL were divided into the IMRT group of (33 cases) and CRT group(30 cases). The short effects, overall survival(OS) of 3 years, progression free survival(PFS) of 3 years, acute radiation injury and late adverse reactions to radiation were compared between 2 group. RESULTS: The rate of overall response rate(ORR) were not significantly between the 2 groups(P>0.05); the OS of 3 years and PFS of 3 years were not different significantly between the 2 groups(P>0.05); the OS of 3 years and PFS of 3 years were not different significantly between the chemotherapy and non-chemotherapy group(P>0.05); the incidence and severity of oral mucosa reaction, myelosuppression, skin reaction and dry mouth were not significantly different between the 2 groups(P>0.05); the incidence of late dry mouth and swallowing obstruction feeling in the IMRT group were significantly lower than those in CRT group (P<0.05); the rate of late hearing loss, visual loss and mouth openin restriction were not different between the 2 groups(P>0.05). CONCLUSION: The short and long term clinical efficacy of IMRT and CRT for the patients with ENKTL is the same; however, the adverse radiation reactions of IMRT are lower, showing a positive significance for improvment of prognosis improving.

Experimental study on the osseointegration of foam TiC/Ti composites.

Macroporous ceramics have demonstrated osteoconductive properties because of their biocompatibility and 3D macroporous structure, and these materials have recently been widely studied as bone replacement materials. The foam TiC/Ti composites discussed in this study have good mechanical properties, balancing out metallic toughness and ceramic strength. Furthermore, because of the high porosity and pore connectivity of these TiC/Ti composites, they have the potential to be a new bone replacement material. The purpose of this study was to evaluate the osseointegration of foam TiC/Ti composites, preliminarily discuss the TiC/Ti ossification mechanism, and to obtain reliable data on the use of foam TiC/Ti composites as bone replacement materials. The foam TiC/Ti composites were sited in 40 Japanese white rabbits for 4, 8, 12 and 24 weeks. The foam TiC/Ti composites were compared to foam SiC. M-CT (micro-computed tomography) analysis, histological analysis, SEM (scanning electron microscopy) observation and EDS (energy-dispersive x-ray spectrometer) analysis were conducted to estimate the osseointegration of the materials. The histological observations and quantitative analysis exhibited significantly more ossification area (volume), trabeculae maturity, and calcium and phosphorus content in the foam TiC/Ti composites compared to the foam SiC (p < 0.05). The results from this study suggest that the foam TiC/Ti composites possess good osseointegration capacity and have the potential to be a new bone replacement material.