Association Between Type I and II Diabetes With Gallbladder Stone Disease

Objective: To assess the association of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) with the subsequent development of gallbladder stone disease (GSD).Setting: Cohort Study.Participants: We identified two study cohort groups to evaluate the association of T1DM and T2DM with the development of GSD. The first group comprised a T1DM cohort of 7015 patients aged ≤ 40 years and a non-diabetes cohort randomly matched with the study cohort (4:1). The second group comprised a T2DM cohort of 51,689 patients aged ≥20 years and a non-diabetes cohort randomly matched with the study cohort (1:1). All patients were studied from 1996 to the end of 2011 or withdrawal from the National Health Insurance program to determine the incidence of GSD.Results: Compared with patients without diabetes, those with T1DM had a decreased risk of GSD [adjusted hazard ratios (aHR) = 0.48, 95% confidence interval (CI) = 0.25–0.92]. Those with T2DM had an increased risk of GSD (aHR = 1.55, 95% CI = 1.41–1.69), after adjustment for age, sex, comorbidities, and number of parity. The relative risk of GSD in the T2DM cohort was higher than that in the non-diabetes cohort in each group of age, sex, and patients with or without comorbidity. However, the relative risk of GSD in the T1DM cohort was lower than that in the non-diabetes cohort only in the age group of 20–40 years.Conclusion: Our population-based cohort study reveals a strong association between T2DM and GSD. However, an inverse relationship exists between T1DM and GSD in patients aged 20–40 years

Trogodišnji trend promjena tjelesne pripremljenosti i indeksa tjelesne mase u učenika u dobi od 12 do 16 godina s ekstremnim indeksima tjelesne mase

The aim of this study was to investigate a three-year development in BMI and physical fitness of schoolchildren aged 12-16 years with extreme weight status. Taiwan Physical Fitness Test Battery, assessing aerobic fitness (1600-meter walk/run test), power (standing long jump), muscular endurance (sit-up), and flexibility (sit-and-reach) in 16,945 boys, was implemented in September from the year 2006 till 2008. Overweight and underweight were defined by the baseline BMI data values that fall within the highest and lowest 5% of their age population, whereas the BMI data values that fall within one standard deviation of the mean was considered “normal” in this study. The results showed that BMI of schoolchildren in 2006 was ~2–3 kg/m2 above the national average reported in 1993. All physical fitness components in the overweight group were substantially poorer than those in the normal group. Yet, these fitness parameters were improved over the three years in all groups. BMI in the underweight group increased at a faster rate than that in the normal and overweight groups. No difference was found in the jumping distance between the underweight and normal groups. Aerobic fitness in the underweight group was superior but flexibility and muscular endurance were slightly lower than those in the normal group. BMI of Taiwan schoolchildren increased substantially from 1993 to 2006 but leveled off from 2006 to 2008. Underweight schoolchildren during the growing period should not a priori be considered as physically weaker or unfit individuals.Cilj je ovog istraživanja bio ustanoviti trogodišnji trend razvoja indeksa tjelesne mase (ITM) i tjelesne pripremljenosti u učenika, u dobi između 12 i 16 godina, s ekstremnim vrijednostima tjelesne težine. Tajvanski sklop testova za tjelesnu pripremljenosti (Taiwan Physical Fitness Test Battery), koja uključuje procjenu aerobne pripremljenosti (test hodanja/ trčanja na 1600 metara), eksplozivne snage (skok u dalj s mjesta), mišićne izdržljivosti (podizanje trupa iz ležanja na leđima) i fleksibilnosti (sjed-i-dohvat), primijenjen je od 2006 do 2008 godine u mjesecu rujnu na uzorku od 16.945 dječaka. Preteški (overweight) i prelagani (underweight) ispitanici bili su definirani prema inicijalnoj vrijednosti ITM-a za dobnu skupinu populacije ispitanika kao oni koji se ubrajaju među 5% s najvišim odnosno najnižim vrijednostima ITM. Ispitanici koji su se nalazili unutar jedne standardne devijacije smatrali su se „normalnima“. Rezultati su pokazali da je ITM tajvanskih učenika u 2006. godini bio za ~2–3kg/m2 veći od nacionalnog prosjeka objavljenog 1993. godine. Sve varijable tjelesne pripremljenosti u grupi prekomjerno teških bile su značajno lošije u odnosu na rezultate koje su postigli ispitanici u normalnoj grupi. Ipak, rezultati su se u svim mjerenim varijablama u svim grupama poboljšali tijekom 3 godine mjerenja. ITM je u grupi nedovoljno teških porastao većom brzinom nego u grupama normalnih i prekomjerno teških učenika. Nije utvrđena značajna razlika u rezultatima skoka u dalj s mjesta između grupa nedovoljno teških i normalnih ispitanika. Nedovoljno teški ispitanici imali su najbolje rezultate u aerobnoj izdržljivosti u odnosu na ostale grupe, dok su u fleksibilnosti i mišićnoj izdržljivosti bili nešto slabiji nego ispitanici u normalnoj grupi. ITM je u tajvanske djece značajno porastao u razdoblju od 1993. do 2006. godine, ali je i stagnirao u razdoblju od 2006. do 2008. godine. Nedovoljno teška djeca ne bi se smjela a priori smatrati fizički slabijom ili nespremnom tijekom perioda odrastanja

Synthesis and Optical Characteristics of Trialkoxycapped Poly(methyl methacrylate)-Silica Hybrid Films

Abstract In this study, trialkoxycapped poly(methyl methacrylate) (PMMA)-silica hybrid films were successfully prepared for optical applications. The acrylic copolymer precursor with alkoxy side group was prepared using 2,2'-azobisisobutyronitrile (AIBN) as the initiator first. Then, it was reacted with partially hydrolyzed tetraethoxysilane solution, followed by spin coating and curing to obtain the thin films. The prepared hybrid films had high surface planarity and homogeneity. The optical properties of the prepared hybrid films could be tuned by the silica moiety. The refractive indices of the prepared films reduced from 1.495 to 1.460 by increasing the silica content. The near infrared optical spectra of the prepared films were shifted by the silica moiety. It was probably due to increase the anharmonicity of C-H bond by the silica moiety. The optical loss of the prepared optical waveguides was reduced from 0.243 to 0.198 dB/cm by increasing the silica content, which was less than that of the PMMA based waveguide. The trend on the optical loss was probably due to the reduction of the C-H number density and enhancing the anharmoncity of the C-H bond. The hybrid films prepared from the initiator of AIBN had a higher surface planarity than that from BPO and resulted in a lower optical loss of the prepared waveguides

Use of Fomepizole in Pediatric Methanol Exposure: The First Case Report in Taiwan and a Literature Review

Methanol poisoning is rare in the pediatric population, but a delay in diagnosis and intervention may cause severe morbidity and mortality. The current therapy for methanol poisoning is ethanol or fomepizole, which acts as a competitive inhibitor of hepatic alcohol dehydrogenase to inhibit the production of toxic metabolites derived from the oxidation of methanol. However, clinical experience in pediatric methanol poisoning is limited, and the safety profiles of the antidotes have not been established in children, especially in Asian populations. This is the first case to describe the use of fomepizole in a child with methanol exposure in Taiwan

A close association of body cell mass loss with disease activity and disability in Chinese patients with rheumatoid arthritis

OBJECTIVES: To investigate the association of body cell mass loss with disease activity and disability in rheumatoid arthritis patients. INTRODUCTION: Rheumatoid cachexia, defined as the loss of body cell mass, is important but under-recognized and contributes to morbidity and mortality in patients with rheumatoid arthritis. METHODS: One hundred forty-nine rheumatoid arthritis patients and 53 healthy, non-rheumatoid arthritis control subjects underwent anthropometric measurements of body mass index and waist and hip circumferences. Bioelectrical impedance analysis was used to determine the subjects' body compositions, including fat mass, skeletal lean mass, and body cell mass. The disease activity of rheumatoid arthritis was assessed using C-reactive protein serum, the erythrocyte sedimentation rate and the 28-joint disease activity score, while disability was evaluated using a health assessment questionnaire. RESULTS: Rheumatoid arthritis patients had lower waist-to-hip ratio (0.86 ± 0.07 vs. 0.95 ± 0.06; p<0.001) and lower skeletal lean mass indexes (14.44 ±1.52 vs. 15.18 ± 1.35; p = 0.002) than those in the healthy control group. Compared with rheumatoid arthritis patients with higher body cell masses, those with body cell masses lower than median had higher erythrocyte sedimentation rates (40.10 ± 27.33 vs. 25.09 ± 14.85; p<0.001), higher disease activity scores (5.36 ± 3.79 vs. 4.23 ± 1.21; p = 0.022) and greater disability as measured by health assessment questionnaire scores (1.26 ± 0.79 vs. 0.87 ± 0.79; p = 0.004). CONCLUSIONS: The loss of body cell mass is associated with higher disease activity and greater disability in rheumatoid arthritis patients. Body composition determined by bioelectrical impedance analysis can provide valuable information for a rheumatologist to more rapidly recognize rheumatoid cachexia in rheumatoid arthritis patients

Konsep Demokrasi Politik Dalam Islam

Coexistence of chronic rhinosinusitis (CRS) with asthma appears to impair asthma control. Type-2 innate lymphoid cells (ILC2s) respond to the cytokines of thymic stromal lymphopoietin (TSLP), interleukin (IL)-25 and IL-33, thus contributing to airway diseases such as CRS and asthma. We investigate whether the augmented Th2-cytokines in CRS might be related to sinonasal tract ILC2s corresponding to enhanced IL-25, IL-33 and TSLP release in severe asthmatics, and be involved in asthma control. Twenty-eight asthmatics (12 non-severe and 16 severe) with CRS receiving nasal surgery were enrolled. The predicted FEV1 inversely associated with CRS severity of CT or endoscopy scores. Higher expression of Th2-driven cytokines (IL-4, IL-5, IL-9, and IL-13), TSLP, IL-25 and IL-33 in nasal tissues was observed in severe asthma. Severe asthmatics had higher ILC2 cell counts in their nasal tissues. ILC2 counts were positively correlated with Th2-cytokines. Nasal surgery significantly improved asthma control and lung function decline in severe asthma and CRS. The higher expression of IL-33/ILC2 axis-directed type 2 immune responses in nasal tissue of CRS brought the greater decline of lung function in severe asthma. ILC2-induced the upregulated activity of Th2-related cytokines in asthmatics with CRS may contribute to a recalcitrant status of asthma control

Predictors of intra-abdominal coagulopathic hemorrhage after living donor liver transplantation

AbstractBackgroundResults of preoperative conventional coagulation assays are a poor predictor of hemorrhage after liver transplantation. In this study, we evaluated the factors that are predictive of intra-abdominal coagulopathic hemorrhage after living donor liver transplantation surgery.MethodsDuring the period from January 2009 to December 2012, 118 adults underwent living donor liver transplantation (LDLT) in our institution. Of those patients, 18 (15.3%) developed intra-abdominal coagulopathic hemorrhage (n = 7) or hemorrhage due to non-coagulopathic causes (n = 11) that required emergency medical, radiological, or surgical intervention within the first month after LDLT. Possible predictors of postoperative coagulopathic hemorrhage included donor-related factors, age, body mass index, MELD score, INR value, intra-operative blood transfusion, graft/recipient weight ratio, anhepatic phase, cold ischemia time, operative time, APACHE II score, onset of re-bleeding, and hemoglobin levels during rebleeding episodes.ResultsThere were no differences in any of the variables between the two groups (coagulopathic and noncoagulopathic hemorrhage) except for cold ischemia time. We found that cold ischemia time was significantly longer in patients with postoperative coagulopathic hemorrhage (160.50 ± 45.02 min) than in patients with hemorrhage due to non-coagulopathic causes (113.55 ± 29.31 min; P = 0.027).ConclusionProlonged cold ischemia time is associated with postoperative intra-abdominal coagulopathic hemorrhage in patients after LDLT. It is, therefore, necessary to shorten the cold ischemia time in order to reduce the risk of postoperative intra-abdominal hemorrhage due to coagulopathic causes