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BACKGROUND: Immune-related enhancer RNAs (eRNAs) have garnered significant attention in cancer metabolism research, yet their specific roles in ccRCC have remained elusive. METHODS: We retrieved eRNA expression profiles from TCGA database and identified immune-related eRNAs (IREs) by assessing their co-expression with immune genes. Utilizing consensus clustering, we organized these IREs into two distinct clusters. The construction of an IREs signature was accomplished through the LASSO and multivariate Cox analysis. Furthermore, we performed Cell Counting Kit-8 and clonogenic assays to assess changes in the proliferative capacity of Caki-1 and 769-P cells. RESULTS: The existence of two clusters of immune-related eRNAs in ccRCC, each with distinctive prognostic and immunological attributes. Cluster B exhibited immunosuppressive properties and displayed a positive correlation with immunosuppressive cells. Functional enrichment analysis unveiled their involvement in several tumor-promoting pathways, metabolic pathways and immune pathways. The IREs signature demonstrated its potential to accurately predict patient immune and prognostic characteristics. AC003092.1, an eRNA strongly associated with patient survival, emerged as a potential oncogene significantly linked to adverse prognosis and the presence of immunosuppressive cells and checkpoints in ccRCC patients. Notably, AC003092.1 displayed marked upregulation in ccRCC tissues and cell lines, and its knockdown substantially inhibited the proliferation of Caki-1 and 769-P cells. CONCLUSION: We established a robust predictive model that played a vital role in determining the prognosis, clinicopathological characteristics and immune cell infiltration patterns of ccRCC patients. IRE, particularly AC003092.1, which was strongly associated with survival, hold promise as novel immunotherapeutic targets for ccRCC.
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Carcinoma de Células Renais , Neoplasias Renais , Humanos , Carcinoma de Células Renais/genética , Prognóstico , Oncogenes , Bioensaio , RNAs Intensificadores , Imunossupressores , Neoplasias Renais/genéticaRESUMO
Clear cell renal cell carcinoma (ccRCC) poses clinical challenges due to its varied prognosis, tumor microenvironment attributes, and responses to immunotherapy. We established a novel Programmed Cell Death-related Signature (PRS) for ccRCC assessment, derived through the Least Absolute Shrinkage and Selection Operator (LASSO) regression method. We validated PRS using the E-MTAB-1980 dataset and created PCD-related clusters via non-negative matrix factorization (NMF). Our investigation included an in-depth analysis of immune infiltration scores using various algorithms. Additionally, we integrated data from the Cancer Immunome Atlas (TCIA) for ccRCC immunotherapy insights and leveraged the Genomics of Drug Sensitivity in Cancer (GDSC) database to assess drug sensitivity models. We complemented our findings with single-cell sequencing data and employed the Clinical Proteomic Tumor Analysis Consortium (CPTAC) and qRT-PCR to compare gene expression profiles between cancerous and paracancerous tissues. PRS serves as a valuable tool for prognostication, immune characterization, tumor mutation burden estimation, immunotherapy response prediction, and drug sensitivity assessment in ccRCC. We identify five genes with significant roles in cancer promotion and three genes with cancer-suppressive properties, further validated by qRT-PCR and CPTAC analyses, showcasing gene expression differences in ccRCC tissues. Our study introduces an innovative PCD model that amalgamates diverse cell death patterns to provide accurate predictions for clinical outcomes, mutational profiles, and immune characteristics in ccRCC. Our findings hold promise for advancing personalized treatment strategies in ccRCC patients.
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Carcinoma de Células Renais , Carcinoma , Neoplasias Renais , Humanos , Carcinoma de Células Renais/genética , Carcinoma de Células Renais/terapia , Proteômica , Morte Celular , Prognóstico , Imunoterapia , Neoplasias Renais/genética , Neoplasias Renais/terapia , Microambiente Tumoral/genéticaRESUMO
OBJECTIVE: To systematically evaluate the association between maternal active smoking during pregnancy and Tourette syndrome (TS), chronic tic disorder (CTD), and developmental coordination disorder (DCD) in children, and to provide evidence-based medical references to reduce the incidence of neurodevelopmental disorders in children. METHOD: We searched PubMed, Web of Science, Embase, and Cochrane Library to obtain relevant articles published before 4 August 2021. Two reviewers independently assessed the articles for eligibility and extracted data. RESULTS: We included eight studies involving a total of 50,317 participants (3 cohort, 3 case-control, and 2 cross-sectional studies). The pooled effect estimates suggested that prenatal maternal active smoking is related to an increased risk of neurodevelopmental disorders (OR = 1.91, 95% CI: 1.30-2.80), especially DCD (OR = 2.25, 95% CI: 1.35-3.75). Maternal active smoking during pregnancy is not associated with TS (OR = 1.07, 95% CI: 0.66-1.73) in children. CONCLUSION: In this meta-analysis, we found evidence for a correlation between active smoking exposure in pregnant women and neurodevelopmental disorders in children. Owing to the differences in sample size, smoking categories and diagnostic methods, further research is needed to validate our results.
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Transtornos do Neurodesenvolvimento , Fumar , Criança , Humanos , Feminino , Gravidez , Estudos Transversais , Fumar/epidemiologia , Fumar/efeitos adversos , Transtornos do Neurodesenvolvimento/epidemiologia , Transtornos do Neurodesenvolvimento/etiologia , Fumar Tabaco , FamíliaRESUMO
Bladder cancer (BC), as a genitourinary system tumor, is a highly prevalent tumor type. Ferroptosis is an iron-dependent oxidative cell death mechanism that is becoming increasingly recognized as a promising avenue for cancer therapy. However, further determination of the prospective prognostic value of ferroptosis for BC and investigation of the underlying mechanisms is required. The mRNA expression profiles and associated clinical data were downloaded from public databases such as The Cancer Genome Atlas, Gene Expression Omnibus and the IMvigor210 database. To construct a predictive formula, the least absolute shrinkage and selection operator Cox regression algorithm was used. In addition, a prognostic multigene signature was constructed using previously selected ferroptosis-related genes (FRGs). A total of 28 FRGs were differentially expressed between tumor and normal samples with |log2 fold change| >1 and adjusted P<0.05. A prognostic model was then established and it was validated in the GEO cohort using six genes: Glutamate-cysteine ligase modifier subunit, crystallin α-B, transferrin receptor, zinc finger E-box binding homeobox 1, squalene epoxidase and glucose-6-phosphate dehydrogenase (G6PD). Numerous important pathways involved in the development of the immune system and cancer were indicated to be significantly different between the two risk groups. In addition, it was discovered that G6PD expression subgroups that were associated with immunotherapy response in patients with BC had similar prognostic features to risk score subgroups. In the present study, a gene signature with a prognostic value for ferroptosis in BC was successfully developed and the potential value of G6PD was identified for future research.
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BACKGROUND AND OBJECTIVES: Comorbid attention deficit hyperactivity disorder (ADHD) symptoms are highly prevalent among heroin-dependent patients. We aim to investigate differences in dependence severity, depression, and quality of life between heroin-dependent patients with and without ADHD-screened positive. METHODS: Heroin-dependent participants (n = 447) entering methadone maintenance treatment were divided into ADHD-screened positive (ADHD-P) and ADHD-screened negative (ADHD-N) groups according to scores of Adult ADHD Self-Report Scale (ASRS). Mini-International Neuropsychiatric Interview was used to identify current and lifetime depressive episodes and suicidality. Substance use disorder, depression, family support, and quality of life in two groups were also assessed. RESULTS: About 7.8% (n = 35) scored 24 or higher of ASRS indicating highly likely Adult ADHD. More heroin-dependent patients of ADHD-P had a current depressive episode (p = .02). They had higher Center for Epidemiological Studies Depression (CESD) scores (p = .003), and more severe heroin dependence (p = .006). Poorer family support and quality of life in physical, and psychological domains were found in patients of ADHD-P compared to ADHD-N. DISCUSSION AND CONCLUSIONS: Heroin-dependent patients of ADHD-P represent a vulnerable minority. They were comorbid with regard to depression, greater substance dependence severity, and poorer quality of life. SCIENTIFIC SIGNIFICANCE: Assessment for ADHD symptoms in heroin-dependent patients may be indicated for the effective management of the complex problems of these patients. (Am J Addict 2017;26:26-33).
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Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Depressão/epidemiologia , Dependência de Heroína/epidemiologia , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Comorbidade , Estudos Transversais , Feminino , Dependência de Heroína/diagnóstico , Dependência de Heroína/psicologia , Humanos , Masculino , Qualidade de Vida , Autorrelato , Índice de Gravidade de Doença , Taiwan/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Few studies have investigated the relationship between the use of different generations of antipsychotics and mortality with contradictory results. The aim of this study is to compare mortality among patients suffering schizophrenia taking different generations of antipsychotics in a nationwide population-based cohort study in Taiwan. METHODS: A total of 812 patients suffering newly diagnosed schizophrenia under monotherapy of second generation antipsychotics (SGAs) comprised the group of cases. The matched controls were under monotherapy of first generation antipsychotics (FGAs). Each case was matched individually with their initial antipsychotics prescription calendar year and month, gender, and age. Cox regression analyses were applied to estimate survival time, adjusting for gender, age, residence, insurance premium, Charlson comorbidity index, hospital admission days, and hospital admission times. An analysis including the number of antipsychotic prescriptions, a proxy indicator of adherence, into the fully adjusted model to reveal the effect of adherence on survival of patients served as a sensitivity analysis. RESULTS: Subjects receiving SGAs had lower admission times and inpatient days, more antipsychotic prescriptions, and longer follow-up time than FGAs. Compared with the FGAs group, the adjusted hazard ratio of mortality was 0.58 (95% confidence interval =0.34-0.96, p=.034) for SGAs group. After controlling for the number of antipsychotic prescriptions, the difference in mortality between antipsychotic generations was non-significant. CONCLUSIONS: The results of this study suggest that SGAs were better than FGAs in mortality among patients suffering schizophrenia. The difference in mortality can be explained by the better medication adherence of SGAs.
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Antipsicóticos/uso terapêutico , Esquizofrenia/tratamento farmacológico , Esquizofrenia/mortalidade , Resultado do Tratamento , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Análise de Sobrevida , Taiwan , Adulto JovemRESUMO
INTRODUCTIONS: This study aims to evaluate the validity and reliability of the Chinese version of the Sheehan Disability Scale (SDS-C) among depression patients in Taiwan. METHODS: To validate the SDS-C, two samples were selected: Sample 1 (n = 78) consisted of patients diagnosed with Depressive Disorder, while sample 2 (n = 63) consisted of a nondepressive population. Sample 1 was evaluated with SDS twice with 7-14 days interval to measure test-retest reliability. Both samples were also evaluated with The Centre for Epidemiologic Studies Depression Scale (CESD), Family APGAR (adaptation, partnership, growth, affection, resolve) score, the Global Assessment of Functioning (GAF), and brief questionnaire of the World Health Organization Quality of Life instrument (WHOQOL-BREF) and by a psychiatrist. The two samples were combined to measure validity. RESULTS: In concurrent validity, SDS-C scores were significantly correlated with the total score of GAF. The discriminative validity was carried out by comparing the score of SDS-C between subjects with and without current depressive disorder (t = 12.32, df = 139, P < 0.001). Another discriminative validity by receiver-operating characteristic analysis showed the optimal cut-point was >11 (sensitivity: 82.1, specificity: 93.7). The area under the curve was 0.93 (±0.02). For the factor validity, principal components analysis showed that a single factor solution was the best solution accounting for 88.9% of the variance. Regarding the construct validity, SDS-C scores were significantly correlated with CESD, WHOQOL-BREF, and the Family APGAR score. For test-retest reliability, the intra-class correlation coefficient for the total SDS-C score was 0.89 (95% confidence interval 0.82-0.93) and internal consistency Cronbach's alpha was 0.94. DISCUSSION: The SDS-C was found to be a valid and reliable instrument for current depressive disorder patients in Taiwan.
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Transtorno Depressivo/diagnóstico , Avaliação da Deficiência , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Adulto , Povo Asiático , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e QuestionáriosRESUMO
Evidence supports an association between metabolic syndrome (MetS) and schizophrenia. However, specific risk factors for MetS and gender differences in patients with schizophrenia taking second-generation antipsychotics (SGAs) have not been well explored. A cross-sectional cohort of 329 Han Chinese patients was recruited in a psychiatric hospital in central Taiwan. Using the definitions of the International Diabetes Federation for Chinese, the prevalence of MetS was 23.7% (men: 25.7%; women: 21.2%). Logistic regression analyses showed that patients with a BMI ≥ 24 and an abnormal non-high-density lipoprotein cholesterol (non-HDL-C) were significantly (p < 0.001) more likely to develop MetS. A BMI ≥ 24 was a significant risk factor in men (OR: 6.092, p < 0.001) and women (OR: 5.886, p < 0.001). An abnormal non-HDL-C was a significant specific risk factor for men with MetS (OR: 4.127, p < 0.001), but not for women. This study supports a greater prevalence of MetS in patients with schizophrenia taking SGAs than in the general population. Abnormal BMI and non-HDL-C were significantly associated with developing MetS, and an abnormal non-HDL-C was a specific risk factor for men. Future development of specific interventions and regular monitoring for MetS is imperative for early identification and prevention.
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Antipsicóticos/uso terapêutico , Colesterol/sangue , Hipercolesterolemia/sangue , Síndrome Metabólica/sangue , Esquizofrenia/sangue , Fatores Sexuais , Adulto , Antropometria , Antipsicóticos/efeitos adversos , Antipsicóticos/classificação , Antipsicóticos/farmacologia , China/epidemiologia , Comorbidade , Estudos Transversais , Feminino , Humanos , Hipercolesterolemia/epidemiologia , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Esquizofrenia/tratamento farmacológico , Esquizofrenia/epidemiologia , Aumento de Peso/efeitos dos fármacosRESUMO
Second-generation antipsychotics (SGAs) have been associated with an increased liability for weight gain and metabolic side effects. Among SGAs, clozapine and olanzapine had great liability to induce weight gain and metabolic adverse reactions. Leptin, adiponectin, and total ghrelin play important roles in energy homeostasis and are suggested to be biomarkers of metabolic disturbances. The purpose of the present study was to investigate the differential effects of antipsychotics (olanzapine and clozapine) on the levels of adipocytokines (leptin and adiponectin) and total ghrelin. Three hundred and thirty-three patients with schizophrenia under clozapine or olanzapine monotherapy were recruited. Control participants were recruited from a healthy community population based on a health investigation (N=119). Fasting blood samples for glucose, cholesterol, triglycerides, leptin, adiponectin, and total ghrelin were analyzed. There were significant differences in the levels of cholesterol, triglycerides, and glucose between these three groups. Post hoc comparisons showed that the olanzapine group had the highest levels of cholesterol and triglycerides. The levels of leptin, adiponectin, and total ghrelin were also significantly different between the three groups after controlling age and body mass index (BMI). Post hoc comparisons showed that the olanzapine group had the lowest levels of adiponectin and total ghrelin. The present study found that the uses of olanzapine and clozapine were associated with changes in adipocytokines and total ghrelin, even after adjusting potential confounding factors. Olanzapine had greater influences on adiponectin and total ghrelin than clozapine. The changes in adipocytokines and total ghrelin were a direct effect of antipsychotics on hormonal pathways of energy homeostasis, rather than the result of weight gain.
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Adipocinas/sangue , Antipsicóticos/uso terapêutico , Benzodiazepinas/uso terapêutico , Clozapina/uso terapêutico , Grelina/sangue , Esquizofrenia/tratamento farmacológico , Adulto , Envelhecimento/sangue , Envelhecimento/efeitos dos fármacos , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Índice de Massa Corporal , Colesterol/sangue , Jejum/sangue , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Olanzapina , Esquizofrenia/sangue , Triglicerídeos/sangueRESUMO
This study examined the impact of inattention and hyperactivity symptoms in children and mothers, opposition problems in children, maternal depression, and perceived family support on the quality of life (QOL) of mothers. Mothers of children in one elementary school were contacted. The relationship between sociodemographic variables, the levels of inattention and hyperactivity symptoms in children and mothers, oppositional symptoms in children, maternal depression, perceived family support, and maternal QOL were examined. Three hundred and eighty-two participants were included in this study. Consistent factors related to the mother's QOL in the four domains were maternal depression, perceived family support, and housing status after controlling for several family, maternal, and child variables. Maternal QOL was more related to her own and family factors including maternal inattention, hyperactivity and depression symptoms, perceived family support, and housing status, instead of parent-rated inattention and hyperactivity symptoms of the child. Screening for maternal inattention, hyperactivity and depression symptoms, and mental health services for these mothers are warranted based on these findings.
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Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Mães , Qualidade de Vida , Instituições Acadêmicas , Adulto , Criança , Demografia , Feminino , Humanos , Masculino , Análise de RegressãoRESUMO
We investigated the prevalence and correlated factors of human immunodeficiency virus (HIV) among heroin users attending methadone maintenance treatment (MMT) programs in Central Taiwan, and explored the degree of risk perception of HIV infection among the participants. Our study participants were 781 heroin users seeking treatment at the MMT program at Tsaotun Psychiatric Center in Taiwan. The presence of HIV antibodies was identified by microparticle enzyme immunoassay and confirmed by western blot. Multivariate logistic regression was used to identify the independent correlates of HIV infection. The mean age of the sample was 36.1 years [standard deviation (SD) = 7.6]; of the patients, 710 (90.9%) were men. The prevalence of HIV infection among our study population was 20.7%. Multivariate logistic regression analysis revealed that HIV infection was independently associated with the age of the patients of initial heroin use, heroin injection use, nondrug-related criminal convictions, needle-sharing behaviors, and sharing injection paraphernalia. A strong agreement existed between self-reported HIV serostatus and the results of laboratory analyses, with 88.8% of patients reporting their condition correctly. We found a high rate of HIV infection among patients in the MMT program. Factors associated with HIV infection were mostly related to drug-use behaviors. These findings stress the importance of education regarding drug-risk behaviors.
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Infecções por HIV/epidemiologia , Heroína/efeitos adversos , Transtornos Relacionados ao Uso de Opioides/complicações , Adulto , Western Blotting , Feminino , Anticorpos Anti-HIV/sangue , Infecções por HIV/complicações , Humanos , Técnicas Imunoenzimáticas , Masculino , Prevalência , Taiwan/epidemiologiaRESUMO
OBJECTIVE: Most research on the Illness Management and Recovery (IMR) program for people with severe mental illnesses has focused on individuals with stable symptoms living in the community, with less attention to persons being treated in an inpatient setting. We evaluated the feasibility and effects of an IMR program adapted for individuals with schizophrenia who were awaiting discharge into the community. METHOD: A randomized controlled trial was conducted at 2 hospitals in Taiwan to compare the adapted IMR program with treatment as usual (TAU). Ninety-seven individuals with schizophrenia were randomized to the adapted IMR program or TAU. Four outcome indicators including illness-management knowledge, attitudes toward medication, insight, and symptoms were assessed at baseline, posttreatment, and at a 1-month follow-up following discharge from the hospital. RESULTS: Participants in the adapted IMR group showed significantly greater improvements at posttreatment and 1-month follow-up in illness-management knowledge, attitudes toward medication, insight, and negative symptoms on the Brief Psychiatric Rating Scale (BPRS) than individuals in the TAU group. There were no significant differences between the 2 groups on other subscales of the BPRS. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This is the first controlled evaluation of a version of the IMR program in an East Asian culture, and the first to evaluate it in an acute care inpatient setting. Our findings support the feasibility and potential benefits of implementing an adapted IMR program, focused on the prevention of relapses and rehospitalizations, during the discharge period of an inpatient treatment stay to prepare individuals to reenter the community.
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Conhecimentos, Atitudes e Prática em Saúde , Hospitais Psiquiátricos , Educação de Pacientes como Assunto/métodos , Esquizofrenia/reabilitação , Psicologia do Esquizofrênico , Adulto , Escalas de Graduação Psiquiátrica Breve/estatística & dados numéricos , Feminino , Seguimentos , Objetivos , Humanos , Pacientes Internados/psicologia , Modelos Lineares , Masculino , Avaliação de Resultados em Cuidados de Saúde/estatística & dados numéricos , Alta do Paciente , Avaliação de Programas e Projetos de Saúde , Prevenção Secundária , TaiwanRESUMO
BACKGROUND: Accumulated evidence supports the effectiveness of equipping chronically ill patients with illness management knowledge and skills. The Illness Management and Recovery (IMR) program developed by the United States government has been widely adopted for persons with mental illness. However, few studies support its effectiveness in patients with schizophrenia. PURPOSE: This pilot study developed a culturally adapted and abbreviated version of the IMR for Taiwanese patients with schizophrenia who were ready for discharge from the hospital. Furthermore, we investigated the impact of the program in terms of illness knowledge, drug attitude, insight, and psychopathology. METHODS: The original IMR was condensed and modified for implementation during participants' preparation for hospital discharge. Using a preexperimental design, pretest and posttest assessments for a single group of 26 participants received the new IMR twice a week for 3 weeks on the four outcome indicators of illness knowledge, drug attitude, insight, and psychopathology. RESULTS: Participants improved in terms of treatment-related illness knowledge, insight, and affective-domain psychopathology (p < .01) after intervention completion. Average participant attendance was 5.45 sessions out of 6 total sessions. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The intensive symptom and medication-focused IMR model for soon-to-be-discharged patients with schizophrenia had positive impacts on illness management. In the future, studies using a two-group randomized controlled design and extended follow-up should be conducted to determine the long-term effects of IMR.
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Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto , Esquizofrenia/terapia , Autocuidado/psicologia , Adulto , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Alta do Paciente , Projetos Piloto , Avaliação de Programas e Projetos de Saúde , Escalas de Graduação Psiquiátrica , Esquizofrenia/reabilitação , Psicologia do Esquizofrênico , Taiwan , Resultado do TratamentoRESUMO
BACKGROUND: Antipsychotics have been regarded as the most effective therapy for schizophrenia; however, Taiwan's non-adherence rate for prescribed antipsychotics of 50-80% is an important issue that relates directly and significantly to schizophrenia patient relapse rates. PURPOSE: This study examines the correlational and predictive relationships between medication adherence and rehospitalization in schizophrenia patients discharged from an acute ward. METHODS: This study used a prospective research design. Schizophrenia patients discharged from a psychiatric acute ward who stated their plan to live in the community were recruited as participants. Participant medication adherence was assessed via home visits during the 6-month follow-up period using scales including the Medication Adherence Questionnaire (MAQ), drug attitudes, and regimen knowledge. Rehospitalization data were retrieved from electronic medical records. Relationships between medication adherence and rehospitalization were analyzed using t-tests and regression analysis. RESULTS: Seventy-seven patients with schizophrenia discharged from the acute ward were recruited in accordance with sampling criteria. The majority were male, young, unmarried, had poorer global function, had 12 years of education, and were not rehospitalized during the past 6-month period. Using binomial regression analysis, we found the relative risk for number of rehospitalizations during the 6-month period to be significantly less and the average scores for the total scale, attitude subscale, and knowledge subscale of medication adherence to have increased (0.194-0.79 times). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Our findings support that better medication adherence in people with schizophrenia decreases rehospitalization risk. We urge clinicians to develop sensitive interventions to promote antipsychotics adherence in this population.
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Antipsicóticos/uso terapêutico , Adesão à Medicação , Esquizofrenia/tratamento farmacológico , Adulto , Feminino , Hospitalização , Humanos , Masculino , Alta do Paciente , Estudos ProspectivosRESUMO
BACKGROUND: This study investigates the prevalence and correlates of hepatitis C virus (HCV) infections among heroin dependent individuals who received methadone maintenance therapy in Taiwan. Also, we investigate users' awareness of HCV. METHODS: Participants were 773 heroin users entering the methadone maintenance treatment (MMT) program at Tsaotun Psychiatric Center in Taiwan. The presence of HCV antibodies was detected. Multivariate logistic regression was used to identify the relationship between HCV infection and correlates. RESULTS: The prevalence of HCV infection was 90.8%. All participants who were HIV-positive were also infected with HCV. Multivariate logistic regression analysis showed that the route of heroin administration (injection), HIV-infection, and criminal records were significantly related to HCV infection. Few (34.8%) HCV positive heroin users were aware of their infection. CONCLUSION: An extremely high prevalence of HCV infection but low awareness of their infection status was found among MMT patients in Taiwan. These findings highlight the importance of education regarding risky behaviors and the necessity for HCV treatment for this population in Taiwan.
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Conhecimentos, Atitudes e Prática em Saúde , Hepatite C/epidemiologia , Dependência de Heroína/epidemiologia , Adulto , Analgésicos Opioides/uso terapêutico , Criminosos/estatística & dados numéricos , Feminino , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Hepatite C/psicologia , Dependência de Heroína/tratamento farmacológico , Humanos , Modelos Logísticos , Masculino , Metadona/uso terapêutico , Pessoa de Meia-Idade , Tratamento de Substituição de Opiáceos , Prevalência , Assunção de Riscos , Abuso de Substâncias por Via Intravenosa/epidemiologia , Taiwan/epidemiologiaRESUMO
Increasing attention has been paid recently to the potential diabetogenic effect of second-generation antipsychotics (SGAs). The objective of this prospective study was to evaluate the effects of quetiapine treatment on pancreatic beta-cell function in SGA-naïve schizophrenic patients. Seventeen schizophrenic subjects completed an eight-week trial. The metabolic parameters were assessed at weeks 0, 2, 4, and 8. We measured glucose homeostasis with the intravenous glucose tolerance test. After the eight-week treatment, body weight and body mass index showed to be significantly increased compared to those at baseline. No significant changes were found in serum levels of fasting glucose, insulin, total cholesterol, and high-density lipoprotein. Insulin resistance and insulin secretion were significantly increased. Incidences of clinically significant weight gain and treatment-emergent metabolic syndrome were 11.8% and 11.8%, respectively. This study result confirms the association of quetiapine treatment and impairment of glucose homeostasis in schizophrenic patients.
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Antipsicóticos/efeitos adversos , Glicemia/efeitos dos fármacos , Dibenzotiazepinas/efeitos adversos , Teste de Tolerância a Glucose , Homeostase/efeitos dos fármacos , Esquizofrenia/sangue , Esquizofrenia/complicações , Adolescente , Adulto , Antipsicóticos/uso terapêutico , Glicemia/metabolismo , Índice de Massa Corporal , Peso Corporal/efeitos dos fármacos , Dibenzotiazepinas/uso terapêutico , Relação Dose-Resposta a Droga , Feminino , Humanos , Lipídeos/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fumarato de Quetiapina , Esquizofrenia/tratamento farmacológico , Caracteres Sexuais , Adulto JovemRESUMO
Background Children with oppositional defiant symptoms (ODS) are highly related to parental stress, especially in mothers. This study is the first to investigate the quality of life (QOL) of mothers of children with ODS in a community sample.Methods Randomly selected mothers of children attending an elementary school were contacted, and 387 who completed the questionnaire participated in this study. The children's ODS status was determined by the maternal rating of the Chinese Swanson, Nolan, and Pelham rating scale, version IV. The mothers' QOL was estimated by maternal reports from the World Health Organization Quality of Life - BREF (WHOQOL-BREF) instrument. The relationship between the children's ODS status and maternal QOL was examined by analysis of covariance (ANCOVA) with the participants' sociodemographic factors as covariables.Results Sixty-three children, mostly boys, met the screening criteria for ODS. The positive screening rate for ODS was 16.49%. The children's ODS status was a significant predictor for the maternal physical capacity, psychological wellbeing and environment domains of QOL. Mothers of children with ODS who rented a house were younger and had lower education levels and worse QOL in all domains.Conclusion A high positive screening rate for ODS children in the elementary school and a relationship between poor maternal QOL and children's ODS were found in this study. Routine screening for ODS in children and mental health services for these children and their mothers are warranted.
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AIMS AND OBJECTIVES: The purpose of this study was to explore the lived experiences of brokered brides who have attempted suicide in Taiwan. BACKGROUND: There has been a significant rise in number of brokered brides since the 1970s in Western world and since the 1990s in several Asian countries. However, there is a great lack of research on brokered brides' suicide around the world. DESIGN: A descriptive phenomenological study was used to explore the lived experiences of brokered brides who have attempted suicide. METHODS: Purposive sampling, one-on-one, in-depth with semi-structural interviews were conducted to collect data. Narratives were analysed by Colaizzi's (1978) seven-step method. RESULTS: Data saturation was achieved after interviewing 12 brokered brides. The study group was comprised of females whose average age was 33. Three themes and the sub-themes were: being a chrysalis (loss of support, loneliness, suffering abused experience, loss of self-esteem), death of a chrysalis (loss of hope and seeking salvation) and birth of a chrysalis (regaining hope and sense of self-worth). CONCLUSIONS: These brokered brides suffered from numerous pressures and difficulties in life. Their hopelessness led to suicidal behaviours as a way to get out of trouble. Hence, the need to provide brokered brides with substantial assistance and support in their lives is an issue that cannot be neglected. The results of this study could be used as a reference to provide professionals and the public with a deeper understanding of suicide in this vulnerable group, and provide more appropriate help and care. Relevance to clinical practice. The suffering may be alleviated by giving brokered brides a reliable support system that they so obviously need. Several recommendations have been made, including amendments in terms of policy, society and the services offered by healthcare professionals.