Complications and Mortality after Surgeries in Patients with Prior Stroke Who Received General and Neuraxial Anesthesia: A Propensity-Score Matched Study.

Patients who previously suffered a stroke have increased risks of mortality and complications after surgeries, but the optimal anesthesia method is not fully understood. We aimed to compare the outcomes after surgeries for stroke patients who received general anesthesia (GA) and neuraxial anesthesia (NA). Using health insurance research data, we identified 36,149 stroke patients who underwent surgeries from 1 January 2008 to 31 December 2013. For balancing baseline covariates, the propensity-score-matching procedure was used to select adequate surgical patients who received GA and NA at a case-control ratio of 1:1. Multiple logistic regressions were applied to calculate adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for postoperative mortality and complications between surgical patients with prior stroke who received GA and NA. Among the 4903 matched pairs with prior stroke, patients with GA had higher risks of pneumonia (OR 2.00, 95% CI 1.62-2.46), pulmonary embolism (OR 3.30, 95% CI 1.07-10.2), acute renal failure (OR 3.51, 95% CI 1.13-2.10), intensive care unit stay (OR 3.74, 95% CI 3.17-4.41), and in-hospital mortality (OR 2.02, 95% CI 1.16-3.51) than those who received NA. Postoperative adverse events were associated with GA in patients aged more than 60 years and those who received digestive surgery (OR 3.11, 95% CI 2.08-4.66). We found that stroke patients undergoing GA had increased postoperative complications and mortality after surgery compared with those who received NA. However, these findings need more validation and evaluation by clinical trials.

Risk Assessment of the Dietary Phosphate Exposure in Taiwan Population Using a Total Diet Study.

Phosphorus and calcium are essential nutrients for the human body. However, excessive intake of phosphates and a low calcium:phosphorus ratio can lead to disorders in calcium-phosphorus metabolism, kidney disease, or osteoporosis. In this study, a total diet study (TDS) was used. The total phosphorus concentrations of foods were combined with the average dietary consumption to calculate the estimated daily intake, which was compared with the maximum tolerable daily intake (MTDI) to assess the resulting health risk of total phosphorus exposure. The calcium concentration in food and total calcium intake were also analyzed and estimated to calculate the calcium:phosphorus ratio. In conclusion, the phosphate exposure risks for the Taiwanese population are acceptable. However, the calcium:phosphorus ratio in the Taiwanese population (0.51-0.63) is lower than the reference calcium:phosphorus ratio (1.25).

Polybrominated diphenyl ethers (PBDES) and hexa-brominated biphenyls (Hexa-BBs) in fresh foods ingested in Taiwan.

Polybrominated diphenyl ethers (PBDEs) and hexa-brominated biphenyls (Hexa-BBs) are bioaccumulative and aggregate in the food chain. Therefore, background monitoring and risk assessment for dietary intake are necessary. In present study, a systematic sampling method was first used to collect the high fat content foodstuff such as poultry, livestock, eggs, fish, other seafood, dairy products, and the infant foods and then foodstuff with high consumption in seven categories of 600 food samples. After integrating four years of background surveys of PBDE levels (2010-2013) and one year of that of Hexa-BBs (2013), the highest estimated daily intake (EDI) of PBDEs for Taiwanese food consumption was found in 0- to 3-year-olds (mean = 9.38 ng kg-1 bw d-1, the 95% upper limit of Monte Carlo Simulation (MCS P95) was 21.52 ng kg-1 bw d-1), and the lowest in 16- to 18-year-old girls (mean = 3.35 ng kg-1 bw d-1, MCS P95 was 6.53 ng kg-1 bw d-1). Moreover, the highest of EDI of Hexa-BBs was found in 0-3 years old (mean = 0.007 ng kg-1 bw d-1, MCS P95 = 0.019 ng kg-1 bw d-1), and lowest in 17-18 years old female (mean = 0.002 ng/kg/day, MCS P95 = 0.005 ng kg-1 bw d-1). This study suggests that the large MOEs (>2.5) for the four important congeners BDE-47, -99, -153, and -209, indicate that the dietary exposures are not probably a significant health concern for Taiwanese.

Health risk assessment of the intake of butyltin and phenyltin compounds from fish and seafood in Taiwanese population.

Organotin compounds have been applied as stabilizers for PVCs, fungicides, and pesticides, those can enter water systems through antifouling paints on ships as well as from diverse industrial and agricultural processes. This study aims to monitor the background levels of six organotins in 200 fishery products. In the current study, the high organotin levels are over tolerable average residue levels in Taiwan. Phenyltins (PTs) levels in fish and seafood are higher than butyltins (BTs). Risk assessment showed that 95% upper confidence limits of the hazard index (HI) of organotins were almost all over 1, indicating that there are probability of health impacts for organotin consumption in Taiwanese consumers. Those who consume higher amounts of seafood and fishery may be at a higher risk of health issues, but the data indicate that organotin levels have become controlled in recent years as compared with health risk data published in 2006.

Arsenic speciation in rice and risk assessment of inorganic arsenic in Taiwan population.

This study assessed the total arsenic content and arsenic speciation in rice to determine the health risks associated with rice consumption in various age-gender subgroups in Taiwan. The average total arsenic levels in white rice and brown rice were 116.6 ± 39.2 and 215.5 ± 63.5 ng/g weight (n = 51 and 13), respectively. The cumulative cancer risk among males was 10.4/100,000. The highest fraction of inorganic/total arsenic content in white rice ranged from 76.9 to 88.2 % and from 81.0 to 96.5 % in brown rice. The current study found different arsenic speciation of rice in southern Taiwan, where the famous blackfoot disease has been reported compared with arsenic speciation from other Taiwan areas. Therefore, rice and other grains should be further monitored in southern Taiwan to evaluate whether arsenic contamination is well controlled in this area.

Antiinflammatory activity of Lindera erythrocarpa fruits.

In this study, in vitro and in vivo antiinflammatory activities of fruits from Lindera erythrocarpa Makino were evaluated. The ethyl acetate soluble fraction derived from the ethanol extract of L. erythrocarpa fruits inhibited significantly nitric oxide (NO) production in lipopolysaccharide (LPS) induced NO in the murine macrophage cell line (RAW264.7) assay, the EC(50) being 16.35 microg/mL. Four compounds, including lucidone (1), cis/trans-methylludicone (2), methyl linderone (3) and linderone (4) were identified from the active fraction based on the bioactivity-guided fractionation procedure. Of these lucidone possessed the strongest NO inhibitory activity with an EC(50) value of 4.22 microg/mL. Furthermore, results from the protein expression assay demonstrated that lucidone suppressed iNOS and COX-2 protein expression in a dose-dependent manner. Lucidone also provided antiinflammatory activity in the croton oil-induced ear edema assay. When it was applied topically at a dosage of 0.5 and 1 mg per ear, the percent edema reduction in treated mice was 44% and 25%, respectively. The results obtained in this study indicated that lucidone has a good potential to be developed as an antiinflammation agent.