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1.
Artigo em Inglês | MEDLINE | ID: mdl-30499423

RESUMO

AIM: The study was conducted in order to examine the sex-specific association of serum uric acid (SUA) levels with elevated serum alanine aminotransferase (ALT) in a Taiwanese military cohort. METHODS: We made a cross-sectional examination of the sex-specific relationship using 6728 men and 766 women, aged 18-50 years from a large military cohort in Taiwan. SUA levels within the reference range (<7.0 mg/dL for men and <5.7 mg/dL for women respectively) were divided into quartiles and SUA levels greater than the upper reference limits were defined as hyperuricemia. Elevated ALT levels were defined as ≥40 U/L. Multivariate logistic regression analysis was performed to determine the association between each SUA category and elevated ALT levels in men and women, respectively. RESULTS: The prevalence of hyperuricemia and elevated ALT in men were 18.7% and 12.7%, respectively, and in women were 3.3% and 2.1%, respectively. As compared with the lowest SUA quartile, hyperuricemia was associated with elevated ALT in men (odds ratios (OR): 1.62, 95% confidence intervals (CI): 1.19-2.20) after controlling for age, service specialty, body mass index, metabolic syndrome components, current cigarette smoking, alcohol intake status, and weekly exercise times, but the associations for the other SUA quartiles were null. By contrast, the associations of hyperuricemia (OR: 0.81, 95% CI: 0.10-6.64) and the other SUA quartiles with elevated ALT were null in women. CONCLUSION: Our findings suggest that the relationship between each SUA level and elevated ALT may differ by sex among military young adults. The mechanism for the sex difference requires further investigations.


Assuntos
Alanina Transaminase/sangue , Aptidão Cardiorrespiratória/fisiologia , Militares , Caracteres Sexuais , Ácido Úrico/sangue , Adolescente , Adulto , Biomarcadores/sangue , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
2.
Indian Heart J ; 70(5): 604-607, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30392495

RESUMO

PURPOSE: To investigate the association of preexisting hypertension at admission with the mortality in patients with systolic heart failure (HF). METHOD: We prospectively investigated the association of preexisting hypertension with the mortality among 1351 patients with HF in Taiwan during an average 12 months (range: 8 months-18 months) follow-up period. A multivariate cox regression analysis for the overall cohort and a subgroup analysis by age were performed. RESULTS: After adjustment for all potential risk factors, the associations of preexisting hypertension with cardiovascular mortality were significantly reduced in the overall cohort and those aged less than 65 years (hazard ratios (HR): 0.53, 95% confidence intervals (CI): 0.33-0.84, and 0.28, 95% CI: 0.11-0.67, respectively). However, the associations with all-cause mortality were not significantly different in these two groups (HR: 0.77, 95% CI: 0.54-1.09, and 0.59, 95% CI: 0.32-1.07, respectively). Furthermore, the associations were all nonsignificant in the patients aged older than 65 years. CONCLUSION: Preexisting hypertension have an inverse association with cardiovascular mortality in the Asian patients with systolic HF, particularly for those with younger ages.


Assuntos
Pressão Sanguínea/fisiologia , Insuficiência Cardíaca Sistólica/epidemiologia , Ventrículos do Coração/fisiopatologia , Hipertensão/epidemiologia , Sistema de Registros , Medição de Risco , Idoso , Causas de Morte/tendências , Feminino , Seguimentos , Insuficiência Cardíaca Sistólica/complicações , Insuficiência Cardíaca Sistólica/fisiopatologia , Humanos , Hipertensão/complicações , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Morbidade/tendências , Prognóstico , Estudos Prospectivos , Volume Sistólico/fisiologia , Taxa de Sobrevida/tendências , Taiwan/epidemiologia
3.
Artigo em Inglês | MEDLINE | ID: mdl-29562671

RESUMO

The association of metabolic syndrome (MetS) components with elevated serum alanine aminotransferase (ALT) levels, a marker of hepatic injury, may differ between men and women. However, the sex-specific association in a military young population which has a low prevalence of MetS was unclear. We conducted a cross-sectional examination in 6738 men and 766 women, aged 18-50 years, from the cardiorespiratory fitness study in armed forces (CHIEF) in eastern Taiwan. The components of MetS were defined according to the updated International Diabetes Federation (IDF) ethnic criteria for Asians. Elevated ALT levels were defined as ≥40 U/L for both sexes and ≥30 U/L for women alternatively. Multivariate logistic regression analysis was performed to determine the sex-specific association between MetS components and elevated ALT. The prevalence of MetS and elevated ALT in men were 11.9% and 12.7% respectively, and in women were 3.5%, and 3.8% respectively. In men, high-density lipoprotein < 40 mg/dL, blood pressures ≥ 130/85 mmHg, serum triglycerides ≥ 150 mg/dL, and waist size ≥ 90 cm were associated with elevated ALT (odds ratios (OR) and 95% confidence intervals: 1.59 (1.34-1.90), 1.40 (1.19-1.65), 2.00 (1.68-2.39), and 1.68 (1.38-2.04); all p < 0.001); whereas in women, only fasting plasma glucose ≥ 100 mg/dL was associated with elevated ALT ≥ 40 U/L (OR: 7.59 (2.35-24.51), p = 0.001) and ALT ≥ 30 U/L (2.67 (0.89-7.95), p = 0.08). Our findings suggest that the relationship between metabolic abnormalities and elevated ALT may differ by sex, possibly due to the MetS more prevalent in young adult men than in women.


Assuntos
Alanina Transaminase/sangue , Síndrome Metabólica/sangue , Militares , Adolescente , Adulto , Grupo com Ancestrais do Continente Asiático , Biomarcadores/sangue , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Caracteres Sexuais , Taiwan/epidemiologia , Adulto Jovem
4.
Indian Heart J ; 69(6): 720-724, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29174248

RESUMO

OBJECTIVE: To investigate the 12-lead surface electrocardiographic (ECG) findings in young male patients with left primary spontaneous pneumothorax (PSP) estimated by the Collins equation. METHODS: From 2003 through 2008, 60 young male patients who had left PSP and 61 age-matched unaffected males were included for 12-lead ECG analyses. The PSP size was estimated by the Collins equation. Those with left PSP were divided into two groups: 1) large PSP ≥30% (n=37), and 2) small PSP <30% (n=23). The ECG in the unaffected was used as the normal control. Baseline demographic, anthropometric, and electrocardiographic findings including heart rate, P-QRS-T axes, wave intervals, and RS voltages were compared among three groups. RESULTS: As compared to the unaffected, patients with left PSP had faster heart rate, longer QTc interval, greater QRS and T axes. With regard to RS amplitudes, greater R in lead aVR and V1, and deeper S in lead II indicating predominant rightward forces, and smaller R in lead I and V3-V6 indicating inferior leftward forces were present in patients with left PSP. Of these ECG findings, heart rate, S voltage in lead II and R voltage in V1 in the large PSP but not in the small PSP had greater values than that in the unaffected group. CONCLUSION: Among young male patients with left PSP estimated by the Collins method, the ECG showed faster heart beat and predominant rightward forces especially for those with large PSP.


Assuntos
Eletrocardiografia/métodos , Sistema de Condução Cardíaco/fisiopatologia , Pneumotórax/fisiopatologia , Estudos de Casos e Controles , Seguimentos , Frequência Cardíaca , Humanos , Masculino , Pneumotórax/diagnóstico , Radiografia Torácica , Estudos Retrospectivos , Adulto Jovem
5.
World J Gastroenterol ; 23(25): 4587-4594, 2017 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-28740347

RESUMO

AIM: To investigate the association of chronic hepatitis B and nonalcoholic steatohepatitis with physical fitness in a Taiwanese military male cohort. METHODS: We made a cross-sectional examination of this association using 3669 young adult military males according to cardiorespiratory fitness and hospitalization events recorded in the Taiwan Armed Forces study. Cases of chronic hepatitis B (n = 121) were defined by personal history and positive detection of hepatitis B surface antigen. Cases of nonalcoholic steatohepatitis (n = 129) were defined by alanine transaminase level > 60 U/L, liver ultrasound finding of steatosis, and absence of viral hepatitis A, B or C infection. All other study participants were defined as unaffected (n = 3419). Physical fitness was evaluated by performance in 3000-m run, 2-min sit-ups, and 2-min push-ups exercises, with all the procedures standardized by a computerized scoring system. Multiple linear regression analysis was used to determine the relationship. RESULTS: Chronic hepatitis B negatively correlated with 2-min push-up numbers (ß = -2.49, P = 0.019) after adjusting for age, service specialty, body mass index, systolic and diastolic blood pressures, current cigarette smoking, alcohol intake status, serum hemoglobin, and average weekly exercise times. Nonalcoholic steatohepatitis was borderline positively correlated with 3000-m running time (ß = 11.96, P = 0.084) and negatively correlated with 2-min sit-up numbers (ß = -1.47, P = 0.040). CONCLUSION: Chronic hepatitis B viral infection and nonalcoholic steatohepatitis affects different physical performances in young adult military males, and future study should determine the underlying mechanism.


Assuntos
Vírus da Hepatite B/imunologia , Hepatite B Crônica/fisiopatologia , Militares/estatística & dados numéricos , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Aptidão Física/fisiologia , Adulto , Alanina Transaminase/sangue , Índice de Massa Corporal , Estudos Transversais , Exercício Físico , Hepacivirus/isolamento & purificação , Vírus da Hepatite A Humana/isolamento & purificação , Antígenos de Superfície da Hepatite B/isolamento & purificação , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/virologia , Humanos , Fígado/patologia , Masculino , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Prevalência , Estudos Retrospectivos , Taiwan/epidemiologia , Ultrassonografia , Adulto Jovem
6.
Cardiovasc Diagn Ther ; 7(3): 244-251, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28567350

RESUMO

BACKGROUND: The Cornell and Sokolow-Lyon electrocardiography (ECG) criteria have been widely used for diagnosing left ventricular hypertrophy (LVH) in patients with hypertension. However, the correlations of these ECG criteria with LVH were rarely compared in military members who received rigorous training, particularly of the Asian male population. METHODS: We compared the Cornell voltage and product criteria with the Sokolow-Lyon criteria for the echocardiographic LVH in 539 military male members, ages 18-50 years and free of hypertension in the Cardiorespiratory fitness and HospItalization Events in armed Forces (CHIEF) study in Taiwan. Pearson's correlation coefficient was used to determine the association of each ECG criterion with the index of left ventricular mass (LVM, g)/height (m)2.7. The sensitivities and specificities were estimated using a receiver-operating characteristics (ROC) curve in relation to the echocardiographic LVH which was defined as LVM index ≥49 g/m2.7. RESULTS: The correlations of the Cornell voltage and product criteria (r=0.24 and 0.26 respectively, both P<0.0001) were stronger than that of the Sokolow-Lyon criteria (r=0.049 and 0.095, and P=0.26 and 0.03 respectively) with the LVM index. Similarly the performances of the Cornell voltage and product criteria for the echocardiographic LVH [area under curve (AUC): 0.66 and 0.68, both P<0.0001] were superior to that of the Sokolow-Lyon criteria (AUC: 0.54 and 0.53, both P>0.1) in the area under the ROC curve analysis. CONCLUSIONS: The Cornell ECG criteria for the echocardiographic LVH had better performance than the Sokolow-Lyon criteria in a young military male cohort in Taiwan.

7.
Int J Infect Dis ; 54: 18-24, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27836794

RESUMO

OBJECTIVE: To analyze 48 cases the risk factors of vancomycin-resistant Enterococcus (VRE) infections, the antibiotic costs after infection, and the survival conditions. DESIGN: 1:3 matched case-control study a medical center in the eastern Taiwan area. The case group, patients with VRE bacterial strains detected at the sterile sites, and the control group were randomly selected from invasive vancomycin-sensitive Enterococcus (VSE) infected patients at the nearest time point by taking the occurrence time of each VRE infection case as the reference time. Fisher exact tests were conducted in order to verify the existence of differences between the case and control groups; survival analysis was applied to explore the prognoses of the VRE infection cases. RESULTS: The mortality rate of the invasive VRE infection cases was 64.6%, which is obviously higher than that of the invasive VSE infection cases (39.4%); the fact of taking chemotherapy during a hospital stay as well as the use of third-generation cephalosporin, glycopeptides, and medicines of the metronidazole category before the infections, are the risk factors of future invasive VRE infections. Moreover, the antibiotic costs after the infections of invasive VRE infection cases are much higher than those of the VSE infection cases (the average daily cost is 3,433 new Taiwan dollars (NTD) vs. 1,742 NTD). CONCLUSIONS: The history of receiving chemotherapy, the use of third-generation cephalosporin, glycopeptides, and medicines of the metronidazole category before the infections are the risk factors of VRE infections. The antibiotic costs after the infections of invasive VRE infection cases are much higher than those of the VSE infection cases.


Assuntos
Antibacterianos/uso terapêutico , Infecção Hospitalar/mortalidade , Enterococcus/efeitos dos fármacos , Infecções por Bactérias Gram-Positivas/mortalidade , Resistência a Vancomicina , Vancomicina/uso terapêutico , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/microbiologia , Enterococcus/classificação , Enterococcus/genética , Enterococcus/isolamento & purificação , Feminino , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/epidemiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Lactente , Tempo de Internação , Masculino , Fatores de Risco , Análise de Sobrevida , Taiwan/epidemiologia
8.
World J Cardiol ; 8(8): 464-71, 2016 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-27621774

RESUMO

AIM: To investigate the association between cardiorespiratory fitness and hospitalization events in a cohort of large voluntary arm forces in Taiwan. METHODS: The cardiorespiratory fitness and hospitalization events in armed forces (CHIEF) is a retrospective cohort consisting of more than 4000 professional military members aged 18-50 years in Eastern Taiwan. All participants received history taking, physical examination, chest radiography, 12-lead electrocardiography, blood tests for cell counts and fasting glucose, lipid profiles, uric acid, renal function and liver function in the Hualien Armed Forces General Hospital during 2014. In addition, participants were required to undergo two indoor resistant exercise tests including 2-min push-up and 2-min sit-up, both scored by infrared sensing, and one outdoor endurance 3000-m none weight-bearing running test, the main indicator of cardiorespiratory fitness in the Military Physical Training and Testing Center in Eastern Taiwan in 2014. RESULTS: Hospitalization events for cardiovascular disease, acute kidney injury, rhabdomyolysis, severe infectious disease, acute psychiatric illness, diabetes, orthopedic surgery and mortality will be identified in the National Insurance Research Database for 10 years. CONCLUSION: CHIEF will be among the largest Eastern Asian armed forces cohort, in which physical status was strictly evaluated to follow up the hospitalization events for severe illness.

9.
Am J Cardiol ; 118(7): 1011-8, 2016 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-27521221

RESUMO

A global heart failure (HF) registry suggested that the inverse association between body mass index (BMI) and all-cause mortality differed by race, particularly stronger in Japanese patients at 1-year follow-up. Whether this finding was consistent across all East Asian populations was unknown. In a multicenter prospective study in Taiwan, we enrolled 1,301 patients hospitalized for systolic HF from 2013 to 2014 and followed up the mortality after their discharge for a median of 1-year period. Cox proportional hazard regression analyses were used to assess the association of BMI with all-cause mortality. The results showed that BMI was inversely associated with all-cause mortality (hazard ratio and 95% CI per 5-kg/m(2) increase: 0.75 [0.62 to 0.91]) after adjusting for demographics, traditional risk factors, HF severity, and medications at discharge. Subsequently, we sought previous studies regarding the BMI association with mortality for East Asian patients with HF from Medline, and a random-effect meta-analysis was performed by the inverse variance method. The meta-analysis including 7 previous eligible studies (3 for the Chinese and 4 for the Japanese cohorts) and the present one showed similar results that BMI was inversely associated with all-cause mortality (hazard ratio 0.65 [0.58 to 0.73], I(2) = 37%). In conclusion, our study in Taiwan and a collaborative meta-analysis confirmed a strong inverse BMI-mortality association consistently among East Asian patients with HF.


Assuntos
Insuficiência Cardíaca Sistólica/epidemiologia , Mortalidade , Obesidade/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Causas de Morte , Estudos de Coortes , Comorbidade , Extremo Oriente/epidemiologia , Feminino , Seguimentos , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/mortalidade , Insuficiência Cardíaca Sistólica/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Proteção , Índice de Gravidade de Doença , Taiwan/epidemiologia
10.
Cardiovasc Diagn Ther ; 6(2): 109-19, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27054100

RESUMO

BACKGROUND: The obesity paradox phenomenon has been found in different populations, such as heart failure and coronary heart disease, which suggest that patients with established cardiovascular disease (CVD) and with normal weight had higher risk of mortality than those with overweight or obesity. However, the obesity paradox is controversial among patients with diabetes which has been considered as the coronary heart disease equivalent. The aim of our study was to summarize current findings on the relationship between body mass index (BMI) and all-cause mortality in patients with diabetes and make a meta-analysis. METHODS: We searched previous studies from MEDLINE, EMBASE, and the Cochrane databases using the keywords: BMI, mortality, diabetes, and obesity paradox or reverse epidemiology. Finally, sixteen studies were identified and 385,925 patients were included. Patients were divided into five groups based on BMI (kg/m(2)) levels: underweight (<18.5), normal weight (18.5-24.9), overweight (25-29.9), mild obesity (30-34.9), and morbid obesity (>35). A random effect meta-analysis was performed by the inverse variance method. RESULTS: As compared with the normal weight, the underweight had higher risk of mortality [hazard ratio (HR): 1.59, 95% confidence interval (CI): 1.32-1.91]. In contrast, the overweight and the mild obesity had lower risk of mortality than the normal weight (HR: 0.86, 95% CI: 0.78-0.96, and 0.88, 95% CI: 0.78-1.00, respectively), but the morbid obesity did not (HR: 0.99, 95% CI: 0.84-1.16). In addition, the subgroup analysis by sex showed that the overweight had the lowest mortality as compared with the normal weight (HR: 0.82, 95% CI: 0.74-0.90) and the obesity in males, but the risk of mortality did not differ among groups in females. Notably, the heterogeneity was significant in most of group comparisons. CONCLUSIONS: Our meta-analysis showed a U-shaped relationship between BMI and all-cause mortality in patients with diabetes. The significant heterogeneity among studies suggested that many confounders such as sex difference may affect the association.

12.
Knee Surg Sports Traumatol Arthrosc ; 24(5): 1547-54, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26860100

RESUMO

PURPOSE: To compare the recurrence risk of parameniscal cysts between arthroscopic meniscectomy with open cystectomy (arthroscopic excision) and entirely arthroscopic techniques with intra-articular cyst decompression (arthroscopic decompression). METHODS: A retrospective longitudinal study was conducted at a medical centre in Taiwan between 2002 and 2012. Patients with symptomatic parameniscal cysts undergoing either arthroscopic excision or arthroscopic decompression were included. Parameniscal cyst recurrence was evaluated every 3 months after surgery. The recurrence risk associated with treatment group, cyst volume, and meniscal tear circumference was investigated. RESULTS: This study included 241 young to middle-aged men and women. Of these, 112 underwent arthroscopic excision and 129 underwent arthroscopic decompression. During an average 26-month follow-up period, the arthroscopic decompression group had a sixfold higher recurrence risk [prevalence: 4 and 21 %, respectively; hazard ratio, HR 6.0 (95 % confidence interval, CI 2.3-15.6); p < 0.001] than the arthroscopic excision group. Furthermore, meniscal tears >12 mm in circumference and a cyst volume >2.4 cm(3) conferred a fivefold higher recurrence risk than both lesions of smaller dimensions, both in the overall population and in the arthroscopic decompression group [HRs 5.3 (95 % CI 2.3-12.2) and 5.35 (95 % CI 2.2-13.3), respectively; p values <0.001 for both]. CONCLUSIONS: The suggestion of our study is that the recurrence of parameniscal cysts may be strongly related to large cystic lesions and large meniscal tears. Arthroscopic excision is preferable for treating parameniscal cysts, which are large cystic lesions with large meniscal tears, to reduce the recurrence risk. LEVEL OF EVIDENCE: III.


Assuntos
Artroscopia/métodos , Cistos/epidemiologia , Descompressão Cirúrgica/métodos , Adulto , Feminino , Humanos , Articulação do Joelho/cirurgia , Imagem por Ressonância Magnética , Masculino , Auditoria Médica , Meniscos Tibiais/cirurgia , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Medição de Risco , Taiwan/epidemiologia
14.
Acta Cardiol ; 70(4): 479-86, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26455252

RESUMO

BACKGROUND: The body mass index (BMI)-mortality paradox has been well known in patients with obstructive coronary artery disease (CAD). However, this phenomenon has rarely been described among elderly patients over a 5-year follow-up. METHODS: We studied a cohort of 722 elderly patients (age 65 years) with angiographic CAD from the ET-CH D registry during 1997-2003 in eastern Taiwan. To evaluate the BMI effect on mortality, the elderly subjects were categorized into 5 groups by BMI (kg/m2): underweight and normal-low weight (< 21), normal-high weight (21-23.9) overweight (24-26.9), mild obesity (27-29.9) and moderate/severe obesity (30). At a maximal 10-year follow-up, cardiac and all-cause deaths were the primary end points. RESULTS: After multivariate analysis, patients from the category of under weight and normal-low weight in reference to those from the normal-high weight category had a significantly higher risk of cardiac and all-cause mortality (hazard ratio (HR): 1.68 (95% CI: 1.04-2.70) and 2.02 (95% CI: 1.42-2.87), respectively) following a median of 5.4 years. Obese elderly patients tended to have the lowest risk of all-cause death across all the study BMI categories in the early stage. However, after 5 years, mortality increased in the obese patients surviving beyond 5 years, and was higher than that in overweight patients. CONCLUSIONS: The obesity-mortality paradox was present in elderly patients with angiographic CAD in Taiwan and the risk of death was significantly higher in those with a BMI < 21 kg/n2. However, a J-shaped relationship between mortality and BMI developed after 5 years of follow-up.


Assuntos
Índice de Massa Corporal , Doença da Artéria Coronariana , Obesidade , Idoso , Causas de Morte , Estudos de Coortes , Angiografia Coronária/métodos , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/mortalidade , Feminino , Humanos , Masculino , Mortalidade/tendências , Análise Multivariada , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/mortalidade , Sistema de Registros , Fatores de Risco , Índice de Gravidade de Doença , Taiwan/epidemiologia , Fatores de Tempo
19.
Chin J Cancer ; 33(5): 256-8, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24417876

RESUMO

Muscular dystrophies (MD) comprise a heterogeneous group of hereditary myopathic diseases. In this group, myotonic MD is associated with an increased cancer risk. However, the cancer risk in other types of MD is unclear. To address this gap in knowledge, we assessed data obtained from the Taiwan Health Insurance Program database. A total of 1,272 patients with MD diagnosed between 1997 and 2009 were enrolled. They were followed up for cancer during the same period by record linkage with the cancer certification in Taiwan. Age- and sex-standardized incidence ratios (SIRs) of overall and site-specific cancers were calculated. For congenital and progressive hereditary MD, there were 685 and 505 cases (males: 69.5% and 80.6%), the median ages at diagnosis were 16 and 13 years, and the mean follow-up durations were 7.12 and 5.06 years, respectively. In addition, cancers were developed in 10 patients with congenital MD and 3 patients with progressive hereditary MD. Female MD patients exhibited an increased cancer risk, yielding an SIR of 3.37 [95% confidence interval (CI) = 1.38-8.25] in congenital MD and 2.95 (95% CI = 0.95-9.19) in hereditary progressive MD. Site-specific cancer SIRs were not powered to be significantly different. In conclusion, genetic defects in hereditary MD may increase cancer risks in females and a sex difference should be further investigated.


Assuntos
Distrofias Musculares , Neoplasias , Fatores Sexuais , Idoso , Intervalos de Confiança , Bases de Dados Factuais , Feminino , Humanos , Incidência , Masculino , Fatores de Risco , Taiwan
20.
Acta Cardiol Sin ; 30(2): 157-64, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27122783

RESUMO

BACKGROUND: Typical electrocardiographic (ECG) changes associated with left primary spontaneous pneumothorax (PSP) have previously been well-described. However, there were no reports in the literature about the characteristic of ECG in estimating the severity of pneumothorax. METHODS: From 2003 through 2008, 63 male patients who had left PSP were divided into two groups: 1) large PSP, Light index ≥ 20% (n = 43), and 2) small PSP, Light index < 20% (n = 20). The ECGs of 64 age-matched disease-free men were used as the normal control. Those medical records reviewed that provided data for this study included patient backgrounds, severity of PSP, and 12-lead ECG characteristics. RESULTS: As compared to the normal controls, left PSP patients had lower body mass index, more rapid heart beat rate and lower voltages in V3R-V6R. In analyzing QRS voltages, the amplitudes of V2S and V3S were significantly different. As with both V2S < 12 mm and V3S < 9 mm, the sensitivity, specificity and positive predictive value to predict patients who had large left PSP area were estimated at 42% (18/43), 100% (20/20) and 100% (18/18), respectively. CONCLUSIONS: Using the criteria of V2S < 12 mm, V3S < 9 mm and electrical alternans could predict pneumothorax size exceeding 20% in patients who already had left PSP. KEY WORDS: 12-lead electrocardiogram; Male; Primary spontaneous pneumothorax.

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