Taipei Veterans General Hospital

About: Taipei Veterans General Hospital is a healthcare organization based out in Taipei, Taiwan. It is known for research contribution in the topics: Population & Cancer. The organization has 11878 authors who have published 16478 publications receiving 363424 citations. The organization is also known as: Táiběi Róngmín Zǒngyī Yuàn.

Postextubation laryngeal edema in adults. Risk factor evaluation and prevention by hydrocortisone.

Abstract: To evaluate the risk factors for postextubation laryngeal stridor and its prevention by hydrocortisone in adult patients.Design: Prospective, randomized, double-blind, placebo controlled study. Medical and surgical ICU of a tertiary teaching hospital. 77 consecutive patients of both sexes, who had undergone tracheal intubation for more than 24 h and fulfilled the weaning criteria, were eligible for the study. Patients were excluded if they were less than 15 years of age, had a disease or the surgery of the throat, or had been extubated during the current hospitalization. The control group received placebo (normal saline 3 cc) and the experimental group received hydrocortisone 100 mg by intravenous infusion 60 min before extubation. Patients were observed 24 h after extubation for symptoms or signs of laryngeal edema or stridor: prolonged inspiration with accessory usage of respiratory muscles or crowing sound with inspiration or reintubation. The overall incidence of postextubation stridor was 22% (17/77). Only one patient (1%), who belonged to the control group, needed reintubation. 39% of female patients and 17% of male patients developed stridor. The relative risk of females developing this complication was 2.29. 7/39 of the hydrocortisone group and 10/38 of patients in the control group developed postextubation stridor.Conclusions: Hydrocortisone did not significantly reduce the incidence of postextubation laryngeal edema or stridor. From the risk factors evaluated, we were unable to demonstrate a statistical correlation between postextubation stidor and the duration of the intubation, the patient's age, the internal diameter of the endotracheal tube, or the route of intubation. However, female patients were more likely to develop this complication.

Association of ocular dominance and anisometropic myopia.

Abstract: PURPOSE. To determine the association between ocular dominance and degree of myopia in patients with anisometropia. METHODS. Fifty-five subjects with anisometropic myopia were recruited. None of them had amblyopia. Refractive error and axial length were measured in each subject. Ocular dominance was determined using the hole-in-the-card test and convergence near-point test. RESULTS. There was a threshold level of anisometropia (1.75 D) beyond which the dominant eye was always more myopic than the nondominant eye. Of the 33 subjects with anisometropia of ≤1.75 D, the dominant eye was more myopic in 17 (51.5%) subjects. Dominant eyes, determined by the hole-in-the-card test, had a significantly greater myopic spherical equivalent (-5.27 ± 2.45 D) than nondominant eyes (-3.94 ± 3.10 D; P 1.75 D), but was not significant in those with lower anisometropia (≤1.75 D). Similar results were obtained using the convergence near-point test. CONCLUSIONS. The present study shows that the dominant eye has a greater degree of myopia than the nondominant eye in subjects with anisometropic myopia. Taking ocular dominance into account in the design of randomized clinical trails to assess the efficacy of myopia interventions may provide useful information.

Seroepidemiology of Klebsiella pneumoniae colonizing the intestinal tract of healthy Chinese and overseas Chinese adults in Asian countries.

Abstract: Capsular serotypes K1 and K2 of Klebsiella pneumoniae are thought to the major virulence determinants responsible for liver abscess. The intestine is one of the major reservoirs of K. pneumoniae, and epidemiological studies have suggested that the majority of K. pneumoniae infections are preceded by colonization of the gastrointestinal tract. The possibility of fecal-oral transmission in liver abscess has been raised on the basis of molecular typing of isolates. Data on the serotype distribution of K. pneumoniae in stool samples from healthy individuals has not been previously reported. This study investigated the seroepidemiology of K. pneumoniae isolates from the intestinal tract of healthy Chinese in Asian countries. Stool specimens from healthy adult Chinese residents of Taiwan, Japan, Hong Kong, China, Thailand, Malaysia, Singapore, and Vietnam were collected from August 2004 to August 2010 for analysis. Serotypes K1/K2 accounted for 9.8% of all K. pneumoniae isolates from stools in all countries. There was no significant difference in the prevalence of K1/K2 isolates among the countries excluding Thailand and Vietnam. The antimicrobial susceptibility pattern was nearly the same in K. pneumoniae isolates. The result of pulsed-field gel electrophoresis revealed no major clonal cluster of serotype K1 isolates. The result showed that Chinese ethnicity itself might be a major factor predisposing to intestinal colonization by serotype K1/K2 K. pneumoniae isolates. The prevalent serotype K1/K2 isolates may partially correspond to the prevalence of K. pneumoniae liver abscess in Asian countries.

Health-related quality of life as a predictor of mortality among community-dwelling older persons.

Abstract: Health-related quality of life (HRQOL) measures predict cause-specific mortality, but few studies have explored whether generic self-reported HRQOL measures are independently associated with mortality in community-dwelling older persons. We postulated that a general measure of HRQOL, the short form 36-item questionnaire (SF-36), would be independently predictive of mortality among community-dwelling older persons. To evaluate this hypothesis, we followed a fixed cohort of 4,424 community-dwelling older persons recruited from a 2000 population-based survey in Taiwan until 2003 and investigated whether HRQOL was predictive of 3-year mortality, even after adjusting for traditional clinical risk variables. The data were collected via a door-to-door survey, and interviewers collected information on the subjects' demographics, medical history, utilization of health services, functional ability, falls, and self-reported physical and mental symptoms. Of the 6053 eligible subjects, 4,424 residents agreed to participate in the baseline survey and were contacted in 2003. During the 3-year period, the 3-year cumulative mortality rate for the study population was 5%. Mortality was significantly higher among males (5.57% vs. 4.27%, p = 0.049), and cumulative mortality increased with age (chi (2)-test for trend; chi (2) = 7.734, p = 0.001). For all scales except bodily pain, there was a significant relationship between a 10-point lower baseline score and mortality. Our primary multivariate risk model, which included two summary measures of HRQOL and significant clinical variables, demonstrated that a 10-point decrease in either the baseline Physical Component Summary (PCS) score or the baseline Mental Component Summary (MCS) score was associated with higher mortality (PCS: RR: 1.60, 95% CI: 1.39-1.83; p < 0.001; MCS: RR: 1.16, 95% CI: 1.01-1.34; p = 0.036). The findings suggested that low baseline PCS and MCS scores were important independent risk factors for 3-year mortality among community-dwelling older persons, even after adjusting for other risk factors.

An SSVEP-Actuated Brain Computer Interface Using Phase-Tagged Flickering Sequences: A Cursor System

Abstract: This study presents a new steady-state visual evoked potential (SSVEP)-based brain computer interface (BCI). SSVEPs, induced by phase-tagged flashes in eight light emitting diodes (LEDs), were used to control four cursor movements (up, right, down, and left) and four button functions (on, off, right-, and left-clicks) on a screen menu. EEG signals were measured by one EEG electrode placed at Oz position, referring to the international EEG 10-20 system. Since SSVEPs are time-locked and phase-locked to the onsets of SSVEP flashes, EEG signals were bandpass-filtered and segmented into epochs, and then averaged across a number of epochs to sharpen the recorded SSVEPs. Phase lags between the measured SSVEPs and a reference SSVEP were measured, and targets were recognized based on these phase lags. The current design used eight LEDs to flicker at 31.25 Hz with 45° phase margin between any two adjacent SSVEP flickers. The SSVEP responses were filtered within 29.25-33.25 Hz and then averaged over 60 epochs. Owing to the utilization of high-frequency flickers, the induced SSVEPs were away from low-frequency noises, 60 Hz electricity noise, and eye movement artifacts. As a conse- quence, we achieved a simple architecture that did not require eye movement monitoring or other artifact detection and removal. The high-frequency design also achieved a flicker fusion effect for better visualization. Seven subjects were recruited in this study to sequentially input a command sequence, consisting of a sequence of eight cursor functions, repeated three times. The accuracy and information transfer rate (mean ± SD) over the seven subjects were 93.14 ± 5.73% and 28.29 ± 12.19 bits/min, respectively. The proposed system can provide a reliable channel for severely disabled patients to communicate with external environments. Keywords—Brain-computer interface (BCI), Steady-state visual evoked potential (SSVEP), Electroencephalography (EEG), Phase-tagged flickering sequence.