Elderly People\u27s Social Support and Walking Space by Space-time Path：A Case Study of Taipei Xinyi District

Due to the trend of global aging, issues of the elderly should be paid attention to. In January 2014, the elderly accounted for 11.57% of the population in Taiwan. By around 2017 Taiwan will become an Aged society. In order to provide seniors with a healthy and better life, the living environment and space arrangements will be important factors in the urban city. This study statistically assesses the walking space and the living path of elders by out-door activity type, walking range time and walking environment to understand the activity conditions and types of elders in Xin-Yu district, referencing the World Health Organisation’s recommendations on “Global Age-friendly Cities: Outdoor Spaces and Buildings”. This study investigates 22 seniors in the Xin-Yi district using the Global Positioning System, observations and deep interviews to explore the influencing factors, such as activity type, activity item, space equipment and walking environment of elders, to propose the requirements of walking spaces and suggestions for improvement in Xin-Yi district. The result found that the condition of elders’ activity and societal support demanded the utilisation of activity environments and walking spaces for social-type elders, including public social spaces, safe road crossings, bus stops and bus information support; for selection-type elders, demand was identified for communication chairs at shopping arcades and diverse sports facilities; and for essential-type elders, demands were on participatory open space and cooperative group facilities. Through the setting and improving of the urban resources above, social support for elders can be improved through the provision of friendly and healthy urban city activity spaces

Association of Chinese Herbal Medicines Use with Development of Chronic Obstructive Pulmonary Disease Among Patients with Rheumatoid Arthritis: A Population-Based Cohort Study

Purpose: Rheumatoid arthritis (RA) patients appear to report a higher risk of chronic obstructive pulmonary disease (COPD). While Chinese herbal medicine (CHMs) is proven to lower COPD risk, the scientific evidence regarding its effect in relation to COPD onset among them is limited. This longitudinal cohort study aimed to determine the relationship between CHMs use and the COPD risk in RA patients. Methods: Using the nationwide claim data, 8349 patients newly diagnosed with RA and simultaneously free of COPD between 1998 and 2010 were eligible for enrollment. From this sample, we enrolled 3360 CHMs users and 3360 non-CHMs users, randomly selected using propensity scores matching from the remaining cases. They were followed until the end of 2012 to record COPD incidence. The hazard ratio (HR) of COPD with regard to CHMs use was estimated by the Cox proportional hazards regression model. Results: In the follow-up period, 136 CHMs users and 202 non-CHMs users developed COPD, representing incidence rates of 5.16 and 7.66, respectively, per 1000 person-years. CHMs use was associated with a 32% lower subsequent risk of COPD (adjusted HR: 0.68, 95% Confidence Interval: 0.54–0.84). Eight commonly prescribed CHMs were discovered to be associated with lower COPD risk: Yan Hu Suo, Sānɡ Zhī, Dang Shen, Huang Qin, Jia-Wei-Xiao-Yao-San, Shu-Jing-Huo-Xue-Tang, Du-Huo-Ji-Sheng-Tang and Ge-Gen-Tang. Conclusion: A significant association of CHMs use with a lower risk of COPD onset in RA patients was found, suggesting that CHMs could be integrated into conventional therapy to reduce COPD risk

De novo duplication of Xq22.1→q24 with a disruption of the NXF gene cluster in a mentally retarded woman with short stature and premature ovarian failure

AbstractObjectiveTo present molecular cytogenetic characterization of a de novo duplication of Xq22.1→q24 in a mentally retarded woman with short stature and premature ovarian failure.Materials and MethodsA 19-year-old woman presented with psychomotor retardation, developmental delay, mental retardation, short stature, low body weight, general muscle hypotonia, distal muscle hypotrophy of the lower extremities, elongated digits, scanty pubic and axillary hair, hypoplastic external female genitalia, and secondary amenorrhea but no clinical features of Pelizaeus-Merzbacher disease. Conventional cytogenetic analysis revealed a karyotype of 46,X,dup(X)(q22.1q24). Fluorescence in situ hybridization determined a direct duplication with a linear tandem orientation. Array comparative genomic hybridization demonstrated partial trisomy Xq [arr cgh Xq22.1q24 (101,490,234–119,070,188 bp)×3] with a 17.6-Mb duplication.ResultsThe duplicated region contained NXF2B, NXF4, NXF3, PLP1, and PGRMC1 genes. There was a disruption of the NXF gene cluster of Xcen-NXF5-NXF2-NXF2B-NXF4-NXF3-Xqter.ConclusionA duplication of Xq22.1→q24 with a disruption of the NXF gene cluster in female patients can be associated with clinical manifestations of mental retardation in addition to short stature and premature ovarian failure

Prenatal Diagnosis and Molecular Cytogenetic Characterization of a Small Supernumerary Marker Chromosome Derived from Chromosome 18 and Associated With a Reciprocal Translocation Involving Chromosomes 17 And 18

SummaryObjectivePrenatal diagnosis of small supernumerary marker chromosomes (sSMC) gives rise to difficulties in genetic counseling, and requires molecular cytogenetic technologies such as spectral karyotyping, fluorescence in situ hybridization, multicolor-fluorescence in situ hybridization, or array-comparative genomic hybridization to identify the nature of the aberrant chromosome. We report such a case associated with a reciprocal translocation.Materials, Methods and ResultsA 36-year-old woman, gravida 7, para 1, abortus 5, was referred for amniocentesis at 18 weeks of gestation because of advanced maternal age. Amniocentesis revealed a reciprocal translocation between chromosomes 17q and 18q and an sSMC. The karyotype was 47,XY,t(17;18)(q11.1;q11.2), +mar. Chromosome preparations from blood lymphocytes revealed that she had the same reciprocal translocation and sSMC. Spectral karyotyping showed that the sSMC was derived from the centromeric region of chromosome 18, and there was a reciprocal translocation between chromosomes 17 and 18. The derivative chromosome 17 had positive 17p terminal (17pTEL) and chromosome 17 centromeric (cep17) signals but did not have a positive chromosome 18 centromeric signal (cep18). The derivative chromosome 18 had positive 18p terminal (18pTEL), chromosome 18 centromeric (cep18) and cep17 signals. The sSMC had only a positive cep18 signal. These findings suggested that a breakpoint occurred at 17q11.1 and another at 18q11.2 during translocation, and the sSMC originated from chromosome 18. The karyotype of the fetus was thus 47,XY,t(17;18)(q11.1;q11.2), +mar.ish der(17)t(17;18)(q11.1;q11.2)(17pTEL+,D17Z1+),der(18)t(17;18)(q11.1;q11.2)(18pTEL+,D18Z1+,D17Z1+), + der(18)(D18Z1+). Oligonucleotide-based array comparative genomic hybridization demonstrated no gain or loss of the gene dosage on chromosomes 17 and 18.ConclusionOur case adds to the reported cases of sSMCs derived from the centromeric region of chromosome 18 without phenotypic consequences

Open lung biopsy in early-stage acute respiratory distress syndrome

INTRODUCTION: Acute respiratory distress syndrome (ARDS) has heterogeneous etiologies, rapid progressive change and a high mortality rate. To improve the outcome of ARDS, accurate diagnosis is essential to the application of effective early treatment. The present study investigated the clinical effects and safety of open lung biopsy (OLB) in patients with early-stage ARDS of suspected non-infectious origin. METHODS: We undertook a retrospective study of 41 patients with early-stage ARDS (defined as one week or less after intubation) who underwent OLB in two medical intensive care units of a tertiary care hospital from 1999 to 2005. Data analyzed included baseline characteristics, complication rate, pathological diagnoses, treatment alterations, and hospital survival. RESULTS: The age of patients was 55 ± 17 years (mean ± SD). The average ratio of arterial partial pressure of oxygen (PaO(2)) to fraction of inspired oxygen (FiO(2)) was 116 ± 43 mmHg (mean ± SD) at biopsy. Seventeen patients (41%) were immunocompromised. Postoperative complications occurred in 20% of patients (8/41). All biopsies provided a pathological diagnosis with a diagnostic yield of 100%. Specific pathological diagnoses were made for 44% of patients (18/41). Biopsy findings led to an alteration of treatment modality in 73% of patients (30/41). The treatment alteration rate was higher in patients with nonspecific diagnoses than in patients with specific diagnoses (p = 0.0024). Overall mortality was 50% (21/41) and was not influenced by age, gender, pre-OLB oxygenation, complication rate, pathological results, and alteration of treatment. There was no surgery-related mortality. The survival rate for immunocompromised patients was better than that for immunocompetent patients (71% versus 33%; p = 0.0187) in this study. CONCLUSION: Our retrospective study suggests that OLB was a useful and acceptably safe diagnostic procedure in some selected patients with early-stage ARDS

Delayed Suspicion, Treatment and Isolation of Tuberculosis Patients in Pulmonology/Infectious Diseases and Non-Pulmonology/Infectious Diseases Wards

Background/PurposeDelayed diagnosis and isolation increases the risk of nosocomial transmission of tuberculosis (TB). To assess the risk of delayed management of TB, we analyzed the risk factors of prolonged delay in isolation of smear-positive TB patients in pulmonology/infectious diseases and other wards in a tertiary teaching hospital.MethodsWe enrolled smear-positive TB patients aged > 16 years with delayed respiratory isolation following hospitalization. Medical records were reviewed retrospectively. Time intervals between admission, order of sputum acid-fast staining, initiation of anti-tuberculous treatment and isolation were compared between pulmonology/infectious diseases wards (PIWs) and other wards. Risk factors were analyzed in patients with prolonged isolation delay of > 7 days in individual groups.ResultsIsolation was delayed in 191 (73.7%) of 259 hospitalized smear-positive TB patients. Median suspicion, treatment and isolation delays were 0, 3 and 4 days in PIWs and 1, 5 and 7 days in other wards. For patients admitted to non-PIWs, atypical chest radiographs, symptoms without dyspnea or not being admitted from the emergency department (ED) were risk factors for prolonged isolation delay exceeding 7 days. The only risk factor for delayed isolation in patients admitted to PIWs was age ≥ 70 years.ConclusionDelays in suspicion, treatment and isolation of TB patients were longer in non-PIWs. Clinicians should be alert to those admitted to non-PIWs with atypical chest radiographs, atypical symptoms, or not admitted from the ED