Systematic Screening for SARS-CoV-2 to Detect Asymptomatic Infections: An Epitome of Taiwan's Outbreak.

BACKGROUND: Increased studies have revealed that asymptomatic carriers substantially impact the epidemic and that asymptomatic transmission is very common. Therefore, the asymptomatic transmission threat to the spread of the pandemic should not be neglected. METHODS: The local outbreak in Taiwan, especially in Taipei City, is unprecedented and paramount and has claimed hundreds of lives, tens of thousands of cases, and enormous economic costs. As care providers and gatekeepers of infectious diseases, Taipei City Hospital has to perform regular polymerase chain reaction (PCR) results of admitted patients and healthcare workers (HCWs) to achieve these goals. RESULTS: In this study, the results revealed a low positive rate of less than 1%, but the asymptomatic proportions could range from 42% to 46%, which bolsters that systematic screening was effective in controlling coronavirus disease-19 (COVID-19) of Novel Coronavirus or Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) and might be an exemplar to other similar scenarios. Universal screening of admitted patients may be important and necessary, especially in asymptomatic patients. CONCLUSIONS: Regular screening for healthcare providers is also important during this pandemic, and it is recommended that admitted patients and healthcare providers undergo systemic PCR testing.

CC12 Induces Apoptotic Cell Death and Cell Cycle Arrest in Human Glioblastoma Cell Lines and Mouse Xenograft Model.

Among central nervous system tumors, glioblastoma (GBM) is the most common and the most malignant type. Even under current standard treatments, the overall survival rate is still low and the recurrence rate is high. Therefore, developing novel and effective therapy is urgently needed. CC12, a synthesized small molecule, was evaluated for the potential anti-GBM effects in two GBM cell lines, U87MG and U118MG. The observations of cell morphology, MTT assay, flow cytometry-based apoptosis after CC12 treatment, were conducted. Western blot was performed for the investigation of the apoptotic mechanism. Positron emission tomography scan analysis and bioluminescent imaging assay using a mouse xenograft model were performed for the effect of CC12 in vivo. After treated by 10 µM CC12 for 24 h, both U118MG and U87MG cells showed tumor cell death. MTT assay results showed that the survival rates decreased when the CC12 concentrations or the treatment periods increased. Ki-67 expression and flow cytometry results indicated that the proliferation was inhibited in GBM cells, and G1 phase arrest was shown. The results of 7-AAD, Br-dUTP, and JC-1 staining all showed the apoptosis of GBM cells after CC12 treatment. Increased γH2AX, caspase-3, and poly (ADP-ribose) polymerase (PARP) levels meant the DNA damage, and increased Bcl2 family proteins after CC12 treatment indicated the intrinsic apoptotic pathway was involved in CC12 induced apoptosis. Furthermore, CC12 can induce the decrease of tumor prognostic marker DcR3. In vivo experiment results showed the effect of CC12 on tumor size reduction of CC12. In addition, the ability to cross the brain-blood barrier of CC12 was also confirmed. CC12 may have anti-tumor ability through the regulation of cell cycle and apoptosis in vitro and in vivo.

Outcomes of necrotic immature open-apex central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh as an apical barrier.

BACKGROUND/PURPOSE: Although unset mineral trioxide aggregate (MTA) has some cytotoxicity, MTA is still a biocompatible material suitable for doing apexification. This study assessed the outcomes for 8 necrotic immature open-apex permanent maxillary central incisors treated by MTA apexification using poly(ε-caprolactone) fiber mesh (PCL-FM) as an apical barrier (so-called PCL-FM/MTA apexification) to prevent extrusion of MTA materials into the periapical tissues of open-apex teeth. METHODS: Eight necrotic immature open-apex permanent maxillary central incisors with the open apices measuring 2.5 mm-3.5 mm in diameter in 8 patients (6 boys and 2 girls; age range, 8-10 years) were first cleaned using ultrasonic activated irrigation with 2.5% sodium hypochlorite solution and then treated by PCL-FM/MTA apexification procedure. RESULTS: All the 8 permanent maxillary central incisors showed successful outcomes after PCL-FM/MTA apexification procedure. The mean duration for apical hard tissue barrier formation of the 8 incisors was 6.8 ± 0.5 weeks (range 6-7 weeks). The mean increased root length was 1.8 ± 0.7 mm (range 1-3 mm) at 7 weeks and 3.1 ± 0.6 mm (range 2-4 mm) at 3 months. The mean increased dentinal wall thickness at the most apical portion of the root was 1.3 ± 0.5 mm (range 1-2 mm) at 7 weeks and 2.4 ± 0.6 mm (range 1.5-3 mm) at 3 months. None of the teeth treated by PCL-FM/MTA apexification showed tooth discoloration after a follow-up period of 3 months. CONCLUSION: PCL-FM/MTA apexification is an excellent technique for treatment of necrotic immature open-apex permanent maxillary central incisors.

Bacteria in the apical root canals of teeth with apical periodontitis.

BACKGROUND/PURPOSE: Bacteria in the tooth root canal may cause apical periodontitis. This study examined the bacterial species present in the apical root canal of teeth with apical periodontitis. Antibiotic sensitivity tests were performed to evaluate whether these identified bacterial species were susceptible to specific kinds of antibiotics. METHODS: Selective media plating and biochemical tests were used first to detect the bacterial species in samples taken from the apical portion of root canals of 62 teeth with apical periodontitis. The isolated bacterial species were further confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry. RESULTS: We found concomitant presence of two (32 teeth) or three species (18 teeth) of bacteria in 50 (80.6%) out of 62 tested teeth. However, only 34 bacterial species were identified. Of a total of 118 bacterial isolates (83 anaerobes and 35 aerobes), Prophyromonas endodontalis was detected in 10; Bacteroides, Dialister invisus or Fusobacterium nucleatum in 9; Treponema denticola or Enterococcus faecalis in 8; Peptostreptococcus or Olsenella uli in 6; and Veillonella in 5 teeth. The other 25 bacterial species were detected in fewer than five teeth. Approximately 80-95% of bacterial isolates of anaerobes were sensitive to ampicillin/sulbactam (Unasyn), amoxicillin/clavulanate (Augmentin), cefoxitin, and clindamycin. For E. faecalis, 85-90% of bacterial isolates were sensitive to gentamicin and linezolid. CONCLUSION: Root canal infections are usually caused by a mixture of two or three species of bacteria. Specific kinds of antibiotic can be selected to control these bacterial infections after antibiotic sensitivity testing.

A Randomized, Double-Blind Clinical Study on Blood Pressure Reduction and Blood Lipid Profile Amelioration on Treatment with Ankascin 568.

Hypertension and cardiovascular complications are the leading causes of death worldwide. Antihypertensive drugs often cause various side effects, and improper use of antihypertensive medications can result in irreparable damage. Edible fungi of the Monascus species have been used as traditional Chinese medicines in Southeast Asia for several centuries. The fermented products of Monascus purpureus NTU 568 (ANKASCIN 568) possess a number of functional secondary metabolites including the anti-inflammatory pigments monascin (MS) and ankaflavin (AK). In this study, a double-blind, placebo-controlled clinical trial was performed in which patients with mild to moderate hypertension were randomly assigned to receive placebo or two 500-mg capsules of Ankascin 568 for 8 weeks. The effects of this treatment on the regulation of blood pressure (BP) were then examined. The results showed that systolic blood pressure (SBP) decreased from 141.6 ± 12.0 to 133.9 ± 14.4 mmHg (P < 0.05), and diastolic blood pressure (DBP) decreased from 91.7 ± 8.1 to 84.8 ± 7.4 mmHg (P < 0.05). Moreover, Ankascin 568 treatment effectively reduced serum triglycerides and total cholesterol (TC), increased high-density lipoprotein cholesterol (HDL-C), and reduced low-density lipoprotein cholesterol (LDL-C) levels, thereby improving the serum lipid profile. Additionally, administration of Ankascin 568 did not cause significant rhabdomyolysis nor impaired the metabolic or physiological functions of the liver or kidney. In conclusion, patients administered Ankascin 568 for 8 weeks exhibited significant in reduction of SBP, serum TC and LDL-C levels, which should contribute to better cardiovascular health.

Di-(2-ethylhexyl) phthalate accelerates atherosclerosis in apolipoprotein E-deficient mice.

Di-(2-ethylhexyl) phthalate (DEHP) is associated with atherosclerosis-related cardiovascular disease complications, but we lack direct evidence of its unfavorable effect on atherogenesis. In this study, we aimed to clarify in vivo and in vitro the contribution of DEHP to the development of atherosclerosis and its underlying mechanisms. Apolipoprotein E-deficient (apoE(-/-)) mice chronically treated with DEHP for 4 weeks showed exacerbated hyperlipidemia, systemic inflammation, and atherosclerosis. In addition, DEHP promoted low-density lipoprotein (LDL) oxidation, which led to inflammation in endothelial cells as evidenced by increased protein expression of pro-inflammatory mediators. Furthermore, chronic DEHP treatment increased hepatic cholesterol accumulation by downregulating the protein expression of key regulators in cholesterol clearance including LDL receptor, cholesterol 7α-hydrolase, ATP-binding cassette transporter G5 and G8, and liver X receptor α. Moreover, the adiposity and inflammation of white adipose tissues were promoted in DEHP-treated apoE(-/-) mice. In conclusion, DEHP may disturb cholesterol homeostasis and deregulate the inflammatory response, thus leading to accelerated atherosclerosis.

Comparison of clinical outcomes for 40 necrotic immature permanent incisors treated with calcium hydroxide or mineral trioxide aggregate apexification/apexogenesis.

BACKGROUND/PURPOSE: Traumatic injury often results in pulp necrosis of immature permanent incisors in children. This study compared clinical outcomes for 40 necrotic immature permanent incisors treated with calcium hydroxide [Ca(OH)2] or mineral trioxide aggregate (MTA) apexification/apexogenesis. METHODS: Forty necrotic open-apex incisors from 40 children aged 6.5-10 years were divided evenly into four groups with each group containing teeth of similar type and similar root apex width in patients of similar age. Group 1 incisors were treated with ultrasonic filing and MTA placement; Group 2 were treated with ultrasonic filing and Ca(OH)2 medication; Group 3 were treated with hand filing and MTA placement; and Group 4 were treated with hand filing and Ca(OH)2 medication. RESULTS: Group 1 incisors needed the shortest mean duration (5.4 ± 1.1 weeks) for apical hard tissue barrier formation, followed by Group 3 incisors (7.8 ± 1.8 weeks), Group 2 incisors (11.3 ± 1.3 weeks), and Group 4 incisors (13.1 ± 1.5 weeks). Group 1 incisors had a significantly shorter mean elongated root length (2.1 ± 0.2 mm) after treatment than Group 2 incisors (3.5 ± 0.3 mm, p < 0.001), and Group 3 incisors had a significantly shorter mean elongated root length (2.1 ± 0.1 mm) after treatment than Group 4 incisors (3.7 ± 0.3 mm, p < 0.001). CONCLUSION: Necrotic open-apex incisors treated with ultrasonic filing plus MTA placement need the shortest mean duration for apical hard tissue barrier formation. For elongation of apical root length, Ca(OH)2 apexification/apexogenesis is better than MTA apexification/apexogenesis, regardless if either ultrasonic or hand filing are used.

Quantitative assessment of post-operative recurrence of chronic subdural haematoma using mean haematoma density.

PURPOSE: The purpose of this study was to establish a quantitative method with which to assess the post-operative recurrence of chronic subdural haematoma (CSDH). METHODS: CT scans were reviewed from 44 consecutive patients with CSDHs who underwent burr hole drainage between July 2008 and January 2012. The area of the haematoma was quantified according to the mean haematoma density (MHD) using computer-based image analysis of pre-operative brain CT scans. MHD as well as other variables of patients with and without post-operative recurrences was statistically compared. RESULTS: Post-operative recurrence was noted in six of the 44 patients that underwent surgical procedures. Among these variables, high MHD, separated type and bilateral and skull base involvement of CSDHs were shown to be significantly related to post-operative recurrence (p < 0.05). Controlling for separated type in logistic regression analysis revealed the OR of MHD as statistically significant indicators with a p value of less than 0.05 (OR = 1.243; 95% CI = 1.003-1.54). CONCLUSION: This study provides statistical proof that MHD is a significant, independent, prognostic factor for the post-operative recurrence of CSDH. As such, consideration of MHD could aid in the prediction of post-operative prognosis of CSDHs.

Clinical treatment outcomes for 40 patients with bisphosphonates-related osteonecrosis of the jaws.

BACKGROUND/PURPOSE: Bisphosphonates (BPs) are used to treat osteoporosis and bone metastases from malignancy. They may result in BPs-related osteonecrosis of the jaws (BRONJ) in a subset of patients receiving BPs. This study examined whether conservative or aggressive surgical approach could result in successful treatment of BRONJ lesions and assessed whether concomitant steroid administration or tobacco smoking habit might hinder the remission of BRONJ lesions. METHODS: The 40 BRONJ patients were evenly divided into four different groups. Group 1 contained 10 patients with concomitant corticosteroid medication but without smoking habit. Group 2 contained 10 patients with smoking habit but without concomitant corticosteroid medication. Groups 3 and 4 each consisted of 10 patients without concomitant corticosteroid medication and smoking habit. To avoid bias, each group contained equal number of patients with different stages of BRONJ. Patients in Groups 1, 2, and 3 received conservative treatment, including antibiotic coverage, antibacterial solution irrigation, and minor surgical debridement. Patients in Group 4 were treated with aggressive surgical excision of necrotic bone segment. RESULTS: The mean duration to achieve complete remission of BRONJ lesion was 19.7±0.6, 18.2±0.5, 13.0±1.0, and 7.6±1.1 months for patients in Groups 1, 2, 3 and 4, respectively. Student's t-test showed significant differences in the mean duration to achieve complete remission of BRONJ lesion between Groups 1 and 3, between Groups 2 and 3, between Groups 3 and 4, between Groups 1 and 4, and between Groups 2 and 4 (all p values < 0.001). CONCLUSION: Although both conservative and aggressive surgical approaches can result in successful treatment of BRONJ lesions, aggressive surgical treatment needs a shorter mean duration to achieve complete remission of BRONJ lesion than conservative treatment. Concomitant corticosteroid administration or tobacco smoking may prolong the duration for complete remission of BRONJ lesion.

Real world fracture prediction of fracture risk assessment tool (FRAX), osteoporosis self-assessment tool for Asians (OSTA) and one-minute osteoporosis risk test: An 11-year longitudinal study.

Introduction: Fractures affect people's quality of life especially in the elders. One of the most important risk factors is osteoporosis. There are many screening tools to predict osteoporosis and fractures. We aimed to compare the predictive validity of three commonly used screening tools: fracture risk assessment tool (FRAX), osteoporosis self-assessment tool for Asians (OSTA) and one-minute osteoporosis risk test. Among them, OSTA and one-minute osteoporosis risk test were originally developed to predict osteoporosis risks and FRAX was to predict fracture risks. Methods: This is an 11-year longitudinal study. We enrolled 708 senior people from health examinees in Taiwan in 2010. A standardized questionnaire and blood tests were provided. Annual telephone interview was conducted to assess the real fracture status. We calculated risk scores of FRAX, OSTA, and one-minute osteoporosis risk test and compared with real-world fracture records. Results: The mean age of the participants were 74.9 (SD 6.4). There were 356 (50.3 %) men. From 2010 to 2020, a total of 105 (14.8 %) persons suffered from fractures. Compared to people without fractures, people with fractures had higher FRAX major osteoporotic fracture risk scores (14.0 % ± 7.6 % vs.11.3 % ± 5.7 %), higher hip fracture risk scores, and higher OSTA risk (5.9 % ± 1.4 % vs. 5.3 % ± 1.3 %). Cox regression analysis showed that hazard ratios for fracture of high FRAX risk was 1.53 (95 % confidence interval (CI) 1.05-2.21), and for high OSTA risk was 1.37 (95 % CI 1.04-1.82). Conclusions: Only OSTA and FRAX scores were satisfactory in predicting 10-year fractures.

Post-acute care for frail older people decreases 90-day emergency room visits, readmissions and mortality: An interventional study.

BACKGROUND: To evaluate the effects of post-acute care (PAC) on frail older adults after acute hospitalization in Taiwan. METHODS: This was a multicenter interventional study. Frail patients aged ≥ 75 were recruited and divided into PAC or control group. The PAC group received comprehensive geriatric assessment (CGA) and multifactorial intervention including exercise, nutrition education, and medicinal adjustments for two to four weeks, while the control group received only CGA. Outcome measures included emergency room (ER) visits, readmissions, and mortality within 90 days after PAC. RESULTS: Among 254 participants, 205 (87.6±6.0 years) were in the PAC and 49 (85.2±6.0 years) in the control group. PAC for more than two weeks significantly decreased 90-day ER visits (odds ratio [OR] 0.21, 95% confidence interval [CI] 0.10-0.43; p = 0.024), readmissions (OR 0.30, 95% CI 0.16-0.56; p < 0.001), and mortality (OR 0.20, 95% CI 0.04-0.87; p = 0.032). Having problems in self-care was an independent risk factor for 90-day ER visits (OR 2.11, 95% CI 1.17-3.78; p = 0.012), and having problems in usual activities was an independent risk factor for 90-day readmissions (OR 2.69, 95% CI 1.53-4.72; p = 0.001) and mortality (OR 3.16, 95% CI 1.16-8.63; p = 0.024). CONCLUSION: PAC program for more than two weeks could have beneficial effects on decreasing ER visits, readmissions, and mortality after an acute illness in frail older patients. Those who perceived severe problems in self-care and usual activities had a higher risk of subsequent adverse outcomes. TRIAL REGISTRATION: ClinicalTrials.gov NCT Identifier: NCT05452395.

Therapeutic effects of methimazole on 3,4-methylenedioxymethamphetamine-induced hyperthermia and serotonergic neurotoxicity.

3,4-methylenedioxymethamphetamine (MDMA) is a popular recreational drug, however over 200 studies demonstrate that acute (e.g. hyperthermia, rhabdomyolysis) and chronic (e.g. neurotoxicity) toxicity effects of MDMA were observed in different animals. Methimazole (MMI), an inhibitor of thyroid hormone synthesis, was found to significantly reduce the HSP72 expression of heat stress induced in fibroblasts. Hence, we attempted to understand the effects of MMI on MDMA induced changes in vivo. Male SD rats were randomly divided into four groups as follows:(a) water-saline (b) water-MDMA (c) MMI-saline and (d) MMI-MDMA group. In the temperature analysis test, MMI was found to alleviate MDMA-induced hyperthermia and increase the heat loss index (HLI), revealing its peripheral vasodilation effect. PET experiment suggested that MDMA induced elevated glucose uptake by skeletal muscles, which was resolved by MMI pretreatment. IHC staining (serotonin transporter, SERT) showed the evidence of neurotoxicity caused by MDMA (serotonin fiber loss), which was alleviated by MMI. Furthermore, the animal behaviour test (forced swimming test, FST) showed higher swimming time but lower immobility time in MMI-MDMA and MMI-saline groups. Taken together, treatment of MMI shows benefits such as lowered body temperature, alleviation of neurotoxicity and excited behaviour. However, further investigations should be conducted in the future to provide in-depth evidence for its clinical use.

Effect of far-infrared radiation on inhibition of colonies on packaging during storage of sterilised surgical instruments.

The sterilisation of surgical instruments is a major factor in infection control in the operating room (OR). All items used in the OR must be sterile for patient safety. Therefore, the present study evaluated the effect of far-infrared radiation (FIR) on the inhibition of colonies on packaging surface during the long-term storage of sterilised surgical instruments. From September 2021 to July 2022, 68.2% of 85 packages without FIR treatment showed microbial growth after incubation at 35 °C for 30 days and at room temperature for 5 days. A total of 34 bacterial species were identified, with the number of colonies increasing over time. In total, 130 colony-forming units were observed. The main microorganisms detected were Staphylococcus spp. (35%) and Bacillus spp. (21%) , Kocuria marina and Lactobacillus spp. (14%), and mould (5%). No colonies were found in 72 packages treated with FIR in the OR. Even after sterilisation, microbial growth can occur due to movement of the packages by staff, sweeping of floors, lack of high-efficiency particulate air filtration, high humidity, and inadequate hand hygiene. Thus, safe and simple far-infrared devices that allow continuous disinfection for storage spaces, as well as temperature and humidity control, help to reduce microorganisms in the OR.

Ten-year trends in lifestyle habits among community-dwelling older people in Taiwan.

OBJECTIVE: Different lifestyles may contribute to chronic diseases or a health condition. We aimed to study trends in lifestyle habits among community-dwelling older people. METHODS: This retrospective time-trend study enrolled 429 108 participants from the Senior Citizen Health Examination in Taiwan over ten years (2001-2010). We analysed lifestyle habits including smoking, alcohol, betel nut chewing, milk drinking, fruit and vegetable intake, car driving and motorcycle riding. Joinpoint regression was used to identify changes in trend. RESULTS: The overall rate of smoking, alcohol and betel nut chewing was 8.2%, 18.1% and 0.3%, respectively. Smoking rates decreased gradually, but alcohol and betel nut chewing increased. We found that milk drinking, fruit and vegetable intake and car driving initially increased and then later decreased. The change in the trend was in 2003. CONCLUSIONS: There were significant turning points in milk drinking, fruit and vegetable intake and car driving. Implementation of strategies to change the behaviors of citizens about the intake of fruit and vegetable and milk drinking is important.

Persistent Depressive Disorder-Related Effect of Sleep Disorder on the Highest Risk of Suicide in Taiwan, 2000-2015.

OBJECTIVE: to investigate whether persistent depressive disorder (PDD) affects sleep disorders (SDs) and increased suicide risk. METHODS: in this study, we used the National Health Insurance Research Database (NHIRD) to select 117,033 SD patients, of whom 137 died by suicide, and 468,132 non-SD patients, of whom 118 died by suicide, and analyzed gender, age, and co-existing diseases. Hazard ratios (HRs) and 95% confidence intervals (CI) were calculated using a multivariate Cox proportional hazards model. RESULTS: the hazard ratio of suicide in SD patients was 1.429 times that of non-SD patients. The hazard ratio of suicide in female patients was 1.297 times higher than in males. Compared with people without PDD, people with PDD had a 7.195 times higher hazard ratio for suicide than those without PDD. PDD patients with SDs had a 2.05 times higher hazard ratio for suicide than those with no SDs. CONCLUSIONS: suicide risk was increased in SD patients, and the maximum suicide risk was greater in SD patients with PDD than in non-PDD patients. PDD affected SDs and increased suicide risk. Clinicians should be aware of the possibility that PDD affects patients with SDs and contributes to suicide risk.

Erythropoietin suppresses the formation of macrophage foam cells: role of liver X receptor alpha.

BACKGROUND: In addition to the hematopoietic effect of erythropoietin, increasing evidence suggests that erythropoietin also exerts protective effects for cardiovascular diseases. However, the role of erythropoietin and its underlying mechanism in macrophage foam cell formation are poorly understood. METHODS AND RESULTS: Compared with wild-type specimens, erythropoietin was increased in atherosclerotic aortas of apolipoprotein E-deficient (apoE(-/-)) mice, mainly in the macrophage foam cells of the lesions. Erythropoietin levels in culture medium and macrophages were significantly elevated in response to oxidized low-density lipoprotein in a dose-dependent manner. Furthermore, erythropoietin markedly attenuated lipid accumulation in oxidized low-density lipoprotein-treated macrophages, a result that was due to an increase in cholesterol efflux. Erythropoietin treatment significantly increased ATP-binding cassette transporters (ABC) A1 and ABCG1 mRNA and protein levels without affecting protein expression of scavenger receptors, including scavenger receptor-A, CD36, and scavenger receptor-BI. The upregulation of ABCA1 and ABCG1 by erythropoietin resulted from liver X receptor alpha activation, which was confirmed by its prevention on expression of ABCA1 and ABCG1 after pharmacological or small interfering RNA inhibition of liver X receptor alpha. Moreover, the erythropoietin-mediated attenuation on lipid accumulation was abolished by such inhibition. Finally, reduced lipid accumulation and marked increase in ABCA1 and ABCG1 were demonstrated in erythropoietin-overexpressed macrophages. CONCLUSIONS: Our data suggest that erythropoietin suppresses foam cell formation via the liver X receptor alpha-dependent upregulation of ABCA1 and ABCG1.

The relationship between anthropometric factors and hyperuricemia in adolescent athletes.

PURPOSE: Hyperuricemia has been increasingly prevalent and linked to future cardio-metabolic risks in adolescent population. The study aims to explore the relationship between anthropometric indices and hyperuricemia among adolescent athletes. METHODS: This was a cross-sectional study of 387 student athletes (218 males and 169 females; mean age, 17.4 ± 1.3 years) in Northern Taiwan in 2013-2015. We exhibited the prevalence of hyperuricemia among this population, and tested the association of serum uric acid levels with different anthropometric parameters in males and females respectively. RESULTS: A total of 59 (27.1%) male and 37 (21.8%) female adolescent athletes had hyperuricemia. Both in male and female adolescents, several obesity-related anthropometric parameters were significantly higher in hyperuricemia groups than in non-hyperuricemia groups. The odds of having hyperuricemia significantly increased with increasing BMI, BMI z-score, waist circumference and waist-to-height ratio in logistic regression analysis. There was a U-shaped association between uric acid level and body fat percentage (BF%) in both genders. Subjects whose BF% in lowest-body-fat-percentage quintile (quintile 1) and highest-body-fat-percentage quintile (quintile 5) had higher mean serum uric acid level than subjects whose BF% in the middle three quintiles. In both genders, the odds ratio (OR) of having hyperuricemia in subjects whose BF% in quintile 1 remained significantly higher than the OR in the middle three quintiles (the reference) after adjusting for age and BMI z-score. CONCLUSIONS: In addition to the positive association between obesity and hyperuricemia, there is a U shape association between BF% and prevalence of hyperuricemia among adolescent athletes of both genders.

The effect of home visits on healthcare resource utilisation.

BACKGROUND AND OBJECTIVES: Home visits may change patients' healthcare resource utilisation, including hospital admission, medications, outpatient and emergency room visits. The aim of the present study was to report changes in healthcare resource utilisation after the provision of home healthcare services. METHOD: This was a multicentre follow-up study. Data on health and functional statuses were collected during home visits. Electronic medical records of 12 medical institutions were retrieved (outpatient visits, emergency care use, hospital admissions and prescription medications). The researchers analysed healthcare utilisation and medications before and after enrolment. RESULTS: There were 246 participants. The mean age was 85.5 years (52% men). There was an increase in annual outpatient visits and a decrease in hospital admission days after enrolment (13.7-15.3 visits/year and 17.5-15 days/year, respectively). The number of medical institutions visited increased, but specialties and doctors visited decreased. Oral medications also increased (3.3-4.3 types). DISCUSSION: Home visits help decrease days of hospital admission, but not medications or outpatient or emergency room visits.

Duration for apical barrier formation in necrotic immature permanent incisors treated with calcium hydroxide apexification using ultrasonic or hand filing.

BACKGROUND/PURPOSE: Traumatic injury usually results in pulp necrosis of immature permanent incisors in children aged 7-10 years. Calcium hydroxide apexification is the most common treatment for necrotic, immature permanent teeth. This study compared the duration for apical barrier formation in necrotic immature permanent incisors treated with calcium hydroxide apexification using ultrasonic or hand filing. METHODS: Thirty-two trauma-induced necrotic immature permanent incisors with or without a periapical lesion (PL) were selected from children aged 7-10 years. They were evenly divided into four groups. Teeth in groups 1 (with PL) and 2 (without PL) were treated with ultrasonic filing, and teeth in groups 3 (with PL) and 4 (without PL) were treated with hand filing. The canals were cleaned with 0.2% chlorhexidine solution during treatment and then compactly filled with calcium hydroxide. The patients were followed up once every 1-3 weeks to change the intracanal medication and to detect when the apical barrier formed. RESULTS: The mean duration for apical barrier formation was 11.1 +/- 1.1 weeks, 11.8 +/- 1.0 weeks, 13.3+/-0.9 weeks and 13.4 +/- 0.7 weeks for groups 1, 2, 3 and 4, respectively. Student's t test showed significant differences in the mean duration for apical barrier formation between groups 1+2 and 3 + 4 (p = 0.000), groups 1 and 3 (p = 0.000), and groups 2 and 4 (p = 0.002). These results indicated that teeth treated with ultrasonic filing required a shorter mean duration for apical barrier formation than teeth treated with hand filing regardless of the presence of PL or not. CONCLUSION: Ultrasonic filing with 0.2% chlorhexidine as an irrigant is effective for disinfection of the root canal and can shorten the duration for apical barrier formation in necrotic permanent incisors treated with calcium hydroxide apexification.

Utilization of emergency ophthalmology services in Taiwan: a nationwide population study.

The aim of this study was to conduct a nationwide survey of the use of emergency ophthalmology services using a sub-dataset of one million beneficiaries sampled from Taiwan's National Health Insurance Research Database (NHIRD) for the years 2008 through 2012. By analyzing this population dataset, the study illustrates the disease landscape of emergency eye care services. The five-year, one-million-person NHIRD sub-dataset for 2008 through 2012 was used to explore emergency visits and ophthalmology specialty visits and to analyze the associated demographics and diagnosis codes based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Diagnoses were categorized into three groups: urgent, non-urgent, and intermediate. A total of 2454 emergency eye care visits were identified. The mean age of the patients who made these visits was 34.6 years old, and their sex ratio was 1.36 men to women. The percentages of urgent, non-urgent, and intermediate eye care visits in this study were 48.2%, 30.9%, and 20.9%, respectively. The leading diagnoses in the urgent category were corneal abrasions, foreign bodies in the eyes, eye burns, and blunt eye injuries. The leading diagnoses for the non-urgent visits were conjunctivitis, subconjunctival hemorrhages, trichiasis, and dry eye disease. Those for the intermediate category were superficial punctate keratitis, corneal opacity and degeneration, and lid, orbital, and lacrimal drainage infections. The urgent visit category accounted for nearly half of all the visits identified in this study. Compared to outpatient department visitors, the emergency ophthalmology service patients were younger and more predominantly male. These results were consistent with those of previous reports. Low copays have made emergency ophthalmology services highly accessible in Taiwan. However, future policies can be designed to more effectively allocate resources to urgent cases.