Women with endometriosis have higher comorbidities: Analysis of domestic data in Taiwan

AbstractEndometriosis, defined by the presence of viable extrauterine endometrial glands and stroma, can grow or bleed cyclically, and possesses characteristics including a destructive, invasive, and metastatic nature. Since endometriosis may result in pelvic inflammation, adhesion, chronic pain, and infertility, and can progress to biologically malignant tumors, it is a long-term major health issue in women of reproductive age. In this review, we analyze the Taiwan domestic research addressing associations between endometriosis and other diseases. Concerning malignant tumors, we identified four studies on the links between endometriosis and ovarian cancer, one on breast cancer, two on endometrial cancer, one on colorectal cancer, and one on other malignancies, as well as one on associations between endometriosis and irritable bowel syndrome, one on links with migraine headache, three on links with pelvic inflammatory diseases, four on links with infertility, four on links with obesity, four on links with chronic liver disease, four on links with rheumatoid arthritis, four on links with chronic renal disease, five on links with diabetes mellitus, and five on links with cardiovascular diseases (hypertension, hyperlipidemia, etc.). The data available to date support that women with endometriosis might be at risk of some chronic illnesses and certain malignancies, although we consider the evidence for some comorbidities to be of low quality, for example, the association between colon cancer and adenomyosis/endometriosis. We still believe that the risk of comorbidity might be higher in women with endometriosis than that we supposed before. More research is needed to determine whether women with endometriosis are really at risk of these comorbidities

Design and Fabrication of Smart Diapers with Antibacterial Yarn

In this study, intelligent eco-diapers are made by combining antibacterial yarns coated with quaternary ammonium salts with conductive yarns to improve caretaking for urinary incontinence. The combination of conductive yarns and sensors can detect the moisture content in eco-diapers, and an alarm is sent when moisture is significant. A wireless module is used to send detected signals to a smartphone or tablet PC via the Internet. This concept is used for a scenario in which nurses do not randomly check on patients in a long-term care institution. When used offline, eco-diapers can send caregivers an alarm for the need to change diapers via cell phones. The diameters of the copper and silver-plated copper fibers are 0.08 and 0.10 mm, respectively. Cotton yarns are twisted with copper and silver-plated copper fibers to form the conductive yarns, which are 0.12 mm in diameter. Moreover, 30-count cotton and 150 D nylon yarns are coated with quaternary ammonium salt via dyeing and finishing processes to form antibacterial yarns. In the current study, intelligent eco-diapers are tested for their electrical and antibacterial properties as specified by AATC and JISL test standards

Preparation and Characterization of PEDOT:PSS/TiO₂ Micro/Nanofiber-Based Gas Sensors

In this study, we employed electrospinning technology and in situ polymerization to prepare wearable and highly sensitive PVP/PEDOT:PSS/TiO2 micro/nanofiber gas sensors. PEDOT, PEDOT:PSS, and TiO2 were prepared via in situ polymerization and tested for characteristic peaks using energy-dispersive X-ray spectroscopy (EDS) and Fourier transform infrared spectroscopy (FT-IR), then characterized using a scanning electron microscope (SEM), a four-point probe resistance measurement, and a gas sensor test system. The gas sensitivity was 3.46–12.06% when ethanol with a concentration between 12.5 ppm and 6250 ppm was measured; 625 ppm of ethanol was used in the gas sensitivity measurements for the PEDOT/composite conductive woven fabrics, PVP/PEDOT:PSS nanofiber membranes, and PVP/PEDOT:PSS/TiO2 micro/nanofiber gas sensors. The latter exhibited the highest gas sensitivity, which was 5.52% and 2.35% greater than that of the PEDOT/composite conductive woven fabrics and PVP/PEDOT:PSS nanofiber membranes, respectively. In addition, the influence of relative humidity on the performance of the PVP/PEDOT:PSS/TiO2 micro/nanofiber gas sensors was examined. The electrical sensitivity decreased with a decrease in ethanol concentration. The gas sensitivity exhibited a linear relationship with relative humidity lower than 75%; however, when the relative humidity was higher than 75%, the gas sensitivity showed a highly non-linear correlation. The test results indicated that the PVP/PEDOT:PSS/TiO2 micro/nanofiber gas sensors were flexible and highly sensitive to gas, qualifying them for use as a wearable gas sensor platform at room temperature. The proposed gas sensors demonstrated vital functions and an innovative design for the development of a smart wearable device

Metachronous Esophageal Cancer and Colon Cancer Treated by Endoscopic Mucosal Resection

Most cases of esophageal cancer and colorectal cancer in Taiwan are diagnosed in the advanced stage and treated by surgery or concurrent chemoirradiation. The detection rates of early esophageal cancer and early colorectal cancer are still low in Taiwan. Metachronous early esophageal cancer and early colorectal cancer have rarely been reported. Endoscopic mucosal resection (EMR) is a well-established method for treatment of early gastrointestinal cancer in Japan. We report a 77-year-old man with metachronous early esophageal cancer and early colorectal cancer detected by chromoendoscopy with 3% Lugol's iodine and 0.2% indigo carmine, respectively. These two lesions were successfully treated by EMR. Endoscopic mucosal resection of early cancer in the gastrointestinal tract may be considered in patients who are not suitable for open surgery. [J Formos Med Assoc 2007;106(3 Suppl):S5-S9

Evaluation of Mechanical Properties of Porous Chitosan/Gelatin/Polycaprolactone Bone Scaffold Prepared by Microwave Foaming Method

Bone tissue may suffer from bone injury and bone defects due to accidents or diseases. Since the demand for autologous bone and allograft tissue far exceeds the supply, bone scaffolds have taken the lead. The use of bone scaffolds is one of the measures to help heal or regenerate bone tissue. Therefore, a new bone scaffold was proposed in this study, which has a simpler preparation process and stronger performance. This study proposes bone scaffolds with an attempt to use polymers that are synthesized separately with three types of minerals as the filler using the microwave foaming method as follows. A 0.1 wt% of montmorillonite (MMT), zinc oxide (ZnO), or titanium dioxide (TiO2) is added to chitosan (CS)/gelatin mixtures, respectively, after which sodium bicarbonate is added as a foaming agent, thereby forming porous gels. The polymer synthesized from three minerals was used as filler. The following microwave foaming method was adopted: 0.1 wt% MMT, ZnO, or TiO2 was added to the CS/gelatin mixture, and then sodium bicarbonate was added as a foaming agent to form a porous gel. Next, porous gels and polycaprolactone were combined in a self-made mold in order to form bone scaffolds. A stereo microscope is used to observe the morphology of bone scaffolds, after which the pore size analysis, pore connectivity, swell property, porosity, and compressive strength are tested, examining the effects of the mineral type on bone scaffolds. The test results indicate that with MMT being the filler and sodium bicarbonate being the foaming agent, the resulting bone scaffolds yield a porous structure with a pore size between 120 μm and 370 μm. Besides, the incorporation of polycaprolactone also provides samples of 1MCG-P, 2MCG-P, and 5MCG-P with a certain compressive strength of 150–170 MPa. To sum up, the test results substantiate that a combination of the microwave foaming method and MMT generates a porous structure for bone scaffolds (1MCG-P, 2MCG-P, and 5MCG-P), involving a porosity of 38%, an inter-connected porous structure, and the compressive strength that exceeds 150 MPa

Large Early Gastric Cancers Treated by Endoscopic Submucosal Dissection with an Insulation-tipped Diathermic Knife

It is difficult to remove a large early gastric cancer (≥ 3 cm) in one-piece resection using conventional endoscopic mucosal resection. We tried to use an insulation-tipped (IT) diathermic knife to dissect these lesions. IT-endoscopic submucosal dissection (ESD) was performed in four aging patients with gastric malignancy. All lesions could be removed in one-piece resection by IT-ESD, although three of them exhibited remarkable fibrosis and ulceration. Three cases experienced curative treatment with IT-ESD after the pathologic evaluation, but it was not curative in one case because the pathology showed angiolymphatic invasion. This patient refused additional surgery in consideration of existing major systemic diseases. At 3 months to 1 year of follow-up, endoscopy showed no evidence of residual cancer. IT-ESD is effective in the treatment of large early gastric cancer and is an alternative treatment for early gastric cancer patients who are at risk for major operation. [J Formos Med Assoc 2007;106(3):260-264

Propofol versus Midazolam for Upper Gastrointestinal Endoscopy in Cirrhotic Patients: A Meta-Analysis of Randomized Controlled Trials

<div><p>Background</p><p>Sedation during gastrointestinal endoscopy is often achieved using propofol or midazolam in general population. However, impaired protein synthesis, altered drug metabolism, and compromised hepatic blood flow in patients with liver cirrhosis might affect the pharmacokinetics of sedatives, placing cirrhotic patients undergoing endoscopy at a greater risk of adverse events. The objective of this study was to assess comparative efficacies and safety of propofol and midazolam in cirrhotic patients undergoing endoscopy.</p><p>Methods</p><p>Randomized, controlled trials comparing propofol with midazolam in cirrhotic patients undergoing gastrointestinal endoscopy were selected. We performed the meta-analysis, using a random-effect model, the Review Manager, Version 5.2, statistical software package (Cochrane Collaboration, Oxford, UK) according to the PRISMA guidelines.</p><p>Results</p><p>Five studies between 2003 and 2012, including 433 patients, were included. Propofol provided a shorter time to sedation (weight mean difference: -2.76 min, 95% confidence interval: -3.00 to -2.51) and a shorter recovery time (weight mean difference -6.17 min, 95% confidence interval: -6.81 to -5.54) than midazolam did. No intergroup difference in the incidence of hypotension, bradycardia, or hypoxemia was observed. Midazolam was associated with the deterioration of psychometric scores for a longer period than propofol.</p><p>Conclusion</p><p>This meta-analysis suggests that Propofol sedation for endoscopy provides more rapid sedation and recovery than midazolam does. The risk of sedation-related side effects for propofol does not differ significantly from that of midazolam. The efficacy of propofol in cirrhotic patients undergoing endoscopy is superior to those of midazolam.</p></div

The Methodological Quality Assessment of Selected Trials.

<p>ETT = endotracheal tube; ITT = intention-to-treat; PP = per-protocol.</p><p>The Methodological Quality Assessment of Selected Trials.</p