Prevalence and Associated Metabolic Factors of Gallstone Disease in the Elderly Agricultural and Fishing Population of Taiwan

Purpose. To evaluate sex-related differences in the prevalence of and cardiovascular risk factors related to gallstone disease (GSD) in an elderly agricultural and fishing population of Taipei, Taiwan. Methods. The study sample consisted of 6511 healthy elderly participants (3971 men and 2540 women) who were voluntarily admitted to a teaching hospital for a physical checkup in 2010. The participants’ blood samples and real-time ultrasound fatty liver results were collected. Results. The prevalence of GSD in the study population was 13.2%, which increased significantly with population age (P<.0001). Women were associated with significantly higher GSD prevalence than men (14.8% versus 12.2%; for the chi-square test, P=.003). In a multiple logistic regression analysis, female sex, older age, and metabolic syndrome (MetS) were significantly associated with GSD. Multiple logistic regression analysis also revealed that obesity (odds ratio OR=1.26, 95% confidence interval (CI): 1.09–1.44) and metabolic factors (one or 2 versus none, OR=1.48, 95% CI: 1.08–1.76) were significantly associated with GSD in women but not in men. Conclusion. In the study population, female sex, older age, and MetS were associated with higher GSD prevalence. The population exhibited other sex-related differences

Clinical characteristics and risk behavior as a function of HIV status among heroin users enrolled in methadone treatment in northern Taiwan

<p>Abstract</p> <p>Background</p> <p>Methadone treatment was introduced in Taiwan in 2006 as a harm-reduction program in response to the human immunodeficiency virus (HIV), which is endemic among Taiwanese heroin users. The present study was aimed at examining the clinical and behavioral characteristics of methadone patients in northern Taiwan according to their HIV status.</p> <p>Methods</p> <p>The study was conducted at four methadone clinics. Participants were patients who had undergone methadone treatment at the clinics and who voluntarily signed a consent form. Between August and November 2008, each participant completed a face-to-face interview that included questions on demographics, risk behavior, quality of life, and psychiatric symptoms. Data on HIV and hepatitis C virus (HCV) infections, methadone dosage, and morphine in the urine were retrieved from patient files on the clinical premises, with permission of the participants.</p> <p>Results</p> <p>Of 576 participants, 71 were HIV positive, and 514 had hepatitis C. There were significant differences between the HIV-positive and HIV-negative groups on source of treatment payment, HCV infection, urine test results, methadone dosage, and treatment duration. The results indicate that HIV-negative heroin users were more likely to have sexual intercourse and not use condoms during the 6 months prior to the study. A substantial percent of the sample reported anxiety (21.0%), depression (27.2%), memory loss (32.7%), attempted suicide (32.7%), and administration of psychiatric medications (16.1%). There were no significant differences between the HIV-positive and HIV-negative patients on psychiatric symptoms or quality of life.</p> <p>Conclusions</p> <p>HIV-positive IDUs were comorbid with HCV, indicating the need to refer both HIV- and HCV-infected individuals for treatment in methadone clinics. Currently, there is a gap between psychiatric/psychosocial services and patient symptoms, and more integrated medical services should be provided to heroin-using populations.</p

Evaluation of a Fall Prevention Education Intervention for Elderly Inpatients in Taipei County Hospital

[[abstract]]The purpose of this study is to explore the effect of “health education of falling prevention for aged hospitalized patients”. In this study, we adopted “quasi-experiment design”--- the experimental group is the 50 patients of internal medicine who are over 65 in Sanchung Branch of Taipei County, while the control group is the 50 patients of internal medicine who are over 65 in Banqiao Branch of Taipei County. The involving teaching materials for the experimental group include health education of falling prevention DVD and manual based theoretically on the model of health belief with the contents of 3 parts such as1.attentions for living（attention for footwear, attention before sleeping, attention for getting on and off bed）2.arrangement for hospitalizing environment（settings of daily utensils, ground, lights）3. attentions for actions（attentions for walking and using assistives like wheelchairs, canes and walking-assisting device）, and the health educational personnel are the trained researchers and nurses in hospital; as for the control group, it adopted the previous health education. Both experimental group and control group accepted pre-test and post-test of the survey of “questionnaires for the involving effect of health education of falling prevention for aged hospitalized patients”. The important results of this study are as follows: I. After the involvement of health education of falling prevention for aged hospitalized patients, through the analysis of covariance, we find experimental group’ scores in “knowledge of falling prevention”, “health belief of falling prevention”, “action clue of falling prevention”, “self-efficacy of falling prevention” and “behavior of falling prevention” are all better than those of control group showing that the involvement of health education of falling prevention for aged hospitalized patients created effects the validity variables of “knowledge of falling prevention”, “health belief of falling prevention”, “action clue of falling prevention”, “self-efficacy of falling prevention” and “behavior of falling prevention”. II. After the involvement of health education of falling prevention for aged hospitalized patients, through the analysis of covariance, we find there is no salient deviation in “frequency of falling” between experimental group and control group. In this study, though “frequency of falling” doesn’t have effect, but according to the average after frequency adjustment, we find the post-test frequency of falling is fewer than that of control group; this is possibly because the short time of observation didn’t create effect, so its effect needs longer time of observation. We suggest, in the future researches, they can prolong time of observation and increase such health education content as muscle force training to enhance its effect.

The Cardiovascular Factors and Metabolic Syndrome in an Elderly Male Chinese Occupational Population

Purpose This study was conducted to explore the prevalence of metabolic syndrome and identify associated risk factors in an elderly male occupational population in Taipei, Taiwan.   Methods A total of 2734 healthy subjects over age 65 voluntarily presented to a teaching hospital for a physical check-up in 2010. Demographic data and blood test results were collected. Metabolic syndrome was diagnosed according to NCEP ATP III criteria.   Results The mean age of study participants was 74.4±6.6 years. The prevalence of metabolic syndrome was estimated at 29.9% (95%CI: 28.2%-31.6%). After adjustment for confounding factors, higher body-mass index (OR=1.50, 95%CI 1.41–1.62), higher mean body fat (% of total mass, OR=1.11, 95%CI: 1.04–1.20), elevated serum uric acid (OR=1.13, 95%CI: 1.02–1.26), and elevated alanine aminotransferase (OR=1.01, 95%CI: 1.00–1.02), and sedentary lifestyle  (yes vs. no, OR=1.22, 95%CI: 1.09–1.37) were identified as the most significant risk factors associated with metabolic syndrome.   Conclusion The prevalence of metabolic syndrome is related to several cardiovascular risk factors. Health initiatives directed towards preventing and treating metabolic syndrome could significantly reduce the prevalence of diabetes and cardiovascular disease in this older population

Clinical Epidemiology of Reduced Kidney Function among Elderly Male Fishing and Agricultural Population in Taipei, Taiwan

Purpose. To quantify the prevalence of and associated factors for chronic kidney disease (CKD) among male elderly fishing and agricultural population in Taipei, Taiwan. Methods. Subjects (n=2,766) aged 65 years and over voluntarily admitted to a teaching hospital for a physical checkup were collected in 2010. CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2. Results. Among these subjects, the over prevalence of chronic kidney disease was 13.6% (95% CI: 12.3–14.9%). The age-specific prevalence of CKD in 65–74 years, 75–84 years, and ≥85 years was 8.2%, 19.1%, and 27.0%, respectively. From the multiple logistic regression, age (OR = 1.05, 95% CI: 1.02–1.09), hyperuricemia (OR = 2.94, 95% CI: 1.90–3.78), central obesity (OR = 1.17, 95% CI: 1.02–1.56), hyperglycemia (OR = 1.23, 95% CI: 1.11–1.67), hypertriglyceridemia (OR = 1.25, 95% CI: 1.08–1.66), and lower HDL-C (OR = 1.61, 95% CI: 1.23–1.92) were statistically significantly related to CKD. The presence of metabolic components (one or two versus none, OR = 1.10, 95% CI: 1.04–1.25; three or more versus none, OR = 2.12, 95% CI: 1.86–2.78) also appeared to be statistically significantly related to CKD after adjustment for other independent factors. Conclusion. Several clinical factors independently affect the development of CKD in the elderly male fishing and agricultural population

Tomotherapy as an Alternative Irradiative Treatment for Complicated Keloids

The aim of this study was to investigate the treatment of complicated keloids with helical tomotherapy (HT) and electron beam radiotherapy. From July 2018 to September 2018, 11 patients with 23 keloid lesions treated with HT were enrolled. Additionally, 11 patients with 20 lesions treated with electron beam radiotherapy in the same period were enrolled. Patients in both groups were treated within 24 h after surgical excision of the keloid lesion with 13.5 Gy in three consecutive daily fractions. The median follow-up period was 15 months. The local control rate was 91.3% and 80% in the HT group and the electron beam group, respectively. No acute adverse effects were observed in either group, but most patients exhibited pigmentation. No radiation-induced cancer occurred in these patients up to the time of this report. Pain and pruritus improved for all patients and more obviously for three patients with complicated keloids treated with HT. The measured surface dose was 103.7–112.5% and 92.8–97.6% of the prescribed dose in the HT group and the electron beam group, respectively. HT can be considered an alternative in cases where it is not feasible to use multiple electron fields, due to encouraging clinical outcomes