OBJECTIVE Post-renal transplantation diarrhea is a common complication; however, it is easily ign... more OBJECTIVE Post-renal transplantation diarrhea is a common complication; however, it is easily ignored. This study aimed to determine the factors influencing graft function for renal transplant recipients with diarrhea. METHODS A single-center retrospective study with the use of the Hyperion data warehouse was conducted to search and evaluate for renal transplant recipients who came for medical care for diarrhea at our transplant center from January 2009 to August 2015. The clinical features of patients with diarrhea were compared with the features of recipients without diarrhea. The causes and risk factors of post-transplantation diarrhea were also evaluated. RESULTS For the 67 patients collected for the study, infectious diarrhea (ID) was confirmed in 27 patients (40.3%), and the most common causes were cytomegalovirus and Clostridium difficile infection. A significant difference was found between ID and noninfectious (NID) groups for serum creatinine change (0.31 ± 0.51 vs 0.1 ± 0.27 mg/dL; P = .0319), revealing that the impact of diarrhea on renal function was greater for ID patients. When diarrhea of ≥10 days was used as a cutoff for serum creatinine change, the change of serum creatinine became greater when the diarrhea period was longer (<7 d vs >14 d: 0.07 ± 0.22 vs 0.55 ± 0.6 mg/mL; P = .0001). CONCLUSIONS Infectious diarrhea does more damage to the kidney graft than NID in transplant recipients. If the period of diarrhea is lengthened to >10 days, the renal function of the graft would be impaired and irreversible graft loss would be expected.
A high-performance liquid chromatographic (HPLC) method for determining ketoprofen in dosage form... more A high-performance liquid chromatographic (HPLC) method for determining ketoprofen in dosage forms and plasma is developed. The drug was chromatographed in a C18 column, using a mobile phase consisting of acetonitrile and 1 % acetic acid aqueous solution with ratio 40 : 60, and detected at 254 nm. The linear detector response to the concentration was confirmed. Recoveries from standard addition to tablets and nonaqueous solution were 100.43 and 100.15, for humans and for rabbit plasmas 82.4 and 82.7, respectively. The procedure showed excellent reproduction inside of two days.It is suggested that this HPLC method could be used for routine assay of ketoprofen in pharmaceutic dosage forms and plasma.
The core abilities in correct medication usage was developed in Taiwan through the following stag... more The core abilities in correct medication usage was developed in Taiwan through the following stages: literature research and information collection, focus groups and experts meetings to discuss and develop core abilities, disseminate the education activities of these core abilities in 51 schools, and evaluative survey. Forty-four articles were abstracted for reference of voting in the focus groups. The most popular issues related medication usage and safety were ”medications provided by medical or pharmacy experts” and ”how to take medications correctly”. The experts meetings generated five core abilities of correct medication usages: ability to clearly express personal conditions to your physicians, ability to check information on the medication packages, ability to correctly take medications as prescribed, ability to be the master of yourself in taking medications, and ability to be friends with pharmacists and physicians. 444 teachers and 4035 students participated in the evaluative survey on the core ability of correct medication usage. The education activities implemented enhances the core ability of correct medication usage in the knowledge, attitude, and behaviors of the students and teachers. Each question in the survey was developed with a single correct response and addressed five aspects: knowledge, attitude, practice, actual use of medications, and partnership. The scale has good reliability and validity, with content validity index of 0.91 and the internal consistency reliability above 0.69, the split-half re1iability above 0.77, and the test-retest reliability above 0.83. The study concluded that the five core abilities of correct medications usage in Taiwan can enhance the health literacy. Further studies are needed to evaluate the utilization in subjects with different backgrounds or health conditions.
Aims A high rate of suicide has been reported in patients who sustain fractures, but the associat... more Aims A high rate of suicide has been reported in patients who sustain fractures, but the association remains uncertain in the context of other factors. The aim of this study was to examine the association between fractures and the risk of suicide in this contextual setting. Patients and Methods We performed a case-control study of patients aged 40 years or older who died by suicide between 2000 and 2011. We included patients’ demographics, physical and mental health problems, and socioeconomic factors. We performed conditional logistic regression to evaluate the associations between fractures and the risk of suicide. Results We included a total of 34 794 patients who died by suicide and 139 176 control patients. We found that fractures as a homogenous group (adjusted odds ratios (aOR), 1.48; 95% confidence interval (CI) 1.43 to 1.53), and specifically pelvic (aOR 2.04; 95% CI 1.68 to 2.47) and spinal fractures (aOR 1.53; 95% CI 1.43 to 1.64), were associated with a higher risk of su...
The use of pre-medication to improve visibility in gastrointestinal endoscopy has not been well a... more The use of pre-medication to improve visibility in gastrointestinal endoscopy has not been well addressed and remains controversial. The aim is to evaluate the effects of current pre-medication on endoscopic visualization. We made the overall strategies to search the different databases and assessed the quality of included studies according to the included and excluded standard. 1541 patients were treated with pre-medication. Ten prospective studies involving 1541 patients were included. There was improved visibility in patients treated with Simethicone (weighted mean difference -4.3; 95% confidence interval (CI), -4.94 to -3.67), compared to those who did not use Simethicone. In the Simethicone based regiment, administration of Pronase was noted with significantly improved visibility in the location of antrum and fundus, compared to those who did not use; however, administration of N-acetyl-L-cysteine could not lead to significantly improved visibility. Simethicone offered better v...
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi, 2001
Effective empiric treatment of pneumonia requires antibiotic coverage against gram-negative and g... more Effective empiric treatment of pneumonia requires antibiotic coverage against gram-negative and gram-positive pathogens, including drug-resistant isolates. This study evaluated the efficacy of cefepime treatment in 20 patients with community-acquired pneumonia (CAP) and 21 patients with hospital-acquired pneumonia (HAP), and ceftazidime treatment in 20 patients with HAP. The mean age of patients was over 70 years. More than half of the patients had multiple lobe involvement. There was no significant difference in the severity of illness according to the acute physiology, age, chronic health evaluation (APACHE) III score between the HAP-cefepime and HAP-ceftazidime group. The most common bacteria isolated from sputum of patients with CAP were Streptococcus pneumoniae (n = 7), Klebsiella pneumoniae (n = 4), and Pseudomonas aeruginosa (n = 2). In patients with HAP, P. aeruginosa (n = 13), Acinetobacter baumannii (n = 11), Serratia marcescens (n = 6), K. pneumoniae (n = 5), Stenotrophom...
Microparticles containing 5-fluorouracil (5-FU) were prepared using poly(DL-lactide-co-glycolide)... more Microparticles containing 5-fluorouracil (5-FU) were prepared using poly(DL-lactide-co-glycolide) with an oil-in-oil emulsion/solvent extraction technique. Particle characteristics including size distribution, 5-FU loading efficiencies, in vitro release and degradation were investigated. The dispersed phase was composed of PLG dissolved in dichloromethane, and the continuous phase was paraffin oil containing lecithin. 5-FU was successfully entrapped in the microparticles with trapping efficiencies up to 76%, loading level 10% w/v, and particle size 3 microm. Release profiles of 5-FU loaded microparticles were determined to follow a first-order-time relationship. An optimized preparation of 5-FU microparticles was achieved and was capable of controlling the release of 5-FU over 21 days with an in vitro delivery rate of 0.4 microg 5-FU/mg particles/day in the study. Preliminary animal studies indicated that the 5-FU loaded microparticles as an ocular delivery system showed no ocular toxicity and no significant inflammatory response in rabbits for 2 months. The 5-FU loaded microparticles approach, with PLG, might be a potential for the application of long-term delivery of hydrophilic drugs in the eye.
Vibrio cholerae (VC)-loaded microparticles were prepared using poly(DL lactide-co-glycolide) with... more Vibrio cholerae (VC)-loaded microparticles were prepared using poly(DL lactide-co-glycolide) with a water-in-oil-in-water emulsion/solvent extraction technique. Particle characteristics including size distribution, VC-loading efficiencies, and in-vitro release pattern were investigated. The dispersed phase was PLG dissolved in dichloromethane, and the continuous phase was water containing PVP as a stabilizer with varied sodium chloride concentrations. VC was successfully entrapped in the microparticles with trapping efficiencies up to 97.8%, a loading level of 55.4 g/mg, and particle size of 3.8 microm. Using 10% w/v PVP with 5% w/v NaCl in the continuous phase resulted in a higher loading level (55.4 +/- 6.9 g/mg), loading efficiency (97.8%), core region content (25.7 +/- 1.9 g/mg) and lower surface content (6.2 +/- 0.9 g/mg) than without NaCl (loading content: 40.7 +/- 5.1 g/mg; loading efficiency 52.1%; core region content: 8.3 +/- 0.5 g/mg; surface content: 19.5 +/- 1.1 g/mg). A linear release profile from VC-loaded microparticles was found. A preliminary animal oral administration study indicated that the VC-loaded microparticles, as an oral delivery system, have shown effective immunogencity in rats for 2 months. The VC incorporation and physicochemical characterization data obtained in this study may be relevant in optimising the vaccine incorporation and delivery properties of these potential vaccine targeting carriers.
Simethicone and N-acetylcysteine have been widely used in improving endoscopic visibility. Howeve... more Simethicone and N-acetylcysteine have been widely used in improving endoscopic visibility. However, the optimal dose, volume, and dosing time for the premedication regimen are still unclear. Our aim was to assess the efficacy of premedication in improving endoscopic visibility and determine the contributions of dose, volume, and premedication time. A total of 1849 patients were prospectively treated in three groups: group A: 100-mg simethicone suspension in 5 mL water; group B: 100-mg simethicone suspension in 100 mL water; and group C: 100-mg simethicone suspension in 100 mL water containing 200 mg N-acetylcysteine. Mucosa visibility was assessed at seven sites of upper gastrointestinal tract. The sum of scores was considered as total mucosal visibility score (TMVS). The upper body of stomach had the worst visibility score for all groups. TMVS of groups B and C were significantly lower than those of group A. Group C had a significantly fewer patients requiring endoscopic flushing than groups A and B. The TMVS for groups B and C were significantly lower than for group A within 30 min of beginning premedication. Beyond 30 min of premedication, there was no significant difference in the TMVS among groups. Premedication using 100 mg simethicone in 100 mL of water improves endoscopic visibility. Addition of N-acetylcysteine to simethicone in 100 mL of water reduces the need for endoscopic flushing. For patients unable to tolerate a large fluid volume, a 5-mL simethicone suspension administered more than 30 min prior to upper endoscopy is suggested.
OBJECTIVE Post-renal transplantation diarrhea is a common complication; however, it is easily ign... more OBJECTIVE Post-renal transplantation diarrhea is a common complication; however, it is easily ignored. This study aimed to determine the factors influencing graft function for renal transplant recipients with diarrhea. METHODS A single-center retrospective study with the use of the Hyperion data warehouse was conducted to search and evaluate for renal transplant recipients who came for medical care for diarrhea at our transplant center from January 2009 to August 2015. The clinical features of patients with diarrhea were compared with the features of recipients without diarrhea. The causes and risk factors of post-transplantation diarrhea were also evaluated. RESULTS For the 67 patients collected for the study, infectious diarrhea (ID) was confirmed in 27 patients (40.3%), and the most common causes were cytomegalovirus and Clostridium difficile infection. A significant difference was found between ID and noninfectious (NID) groups for serum creatinine change (0.31 ± 0.51 vs 0.1 ± 0.27 mg/dL; P = .0319), revealing that the impact of diarrhea on renal function was greater for ID patients. When diarrhea of ≥10 days was used as a cutoff for serum creatinine change, the change of serum creatinine became greater when the diarrhea period was longer (<7 d vs >14 d: 0.07 ± 0.22 vs 0.55 ± 0.6 mg/mL; P = .0001). CONCLUSIONS Infectious diarrhea does more damage to the kidney graft than NID in transplant recipients. If the period of diarrhea is lengthened to >10 days, the renal function of the graft would be impaired and irreversible graft loss would be expected.
A high-performance liquid chromatographic (HPLC) method for determining ketoprofen in dosage form... more A high-performance liquid chromatographic (HPLC) method for determining ketoprofen in dosage forms and plasma is developed. The drug was chromatographed in a C18 column, using a mobile phase consisting of acetonitrile and 1 % acetic acid aqueous solution with ratio 40 : 60, and detected at 254 nm. The linear detector response to the concentration was confirmed. Recoveries from standard addition to tablets and nonaqueous solution were 100.43 and 100.15, for humans and for rabbit plasmas 82.4 and 82.7, respectively. The procedure showed excellent reproduction inside of two days.It is suggested that this HPLC method could be used for routine assay of ketoprofen in pharmaceutic dosage forms and plasma.
The core abilities in correct medication usage was developed in Taiwan through the following stag... more The core abilities in correct medication usage was developed in Taiwan through the following stages: literature research and information collection, focus groups and experts meetings to discuss and develop core abilities, disseminate the education activities of these core abilities in 51 schools, and evaluative survey. Forty-four articles were abstracted for reference of voting in the focus groups. The most popular issues related medication usage and safety were ”medications provided by medical or pharmacy experts” and ”how to take medications correctly”. The experts meetings generated five core abilities of correct medication usages: ability to clearly express personal conditions to your physicians, ability to check information on the medication packages, ability to correctly take medications as prescribed, ability to be the master of yourself in taking medications, and ability to be friends with pharmacists and physicians. 444 teachers and 4035 students participated in the evaluative survey on the core ability of correct medication usage. The education activities implemented enhances the core ability of correct medication usage in the knowledge, attitude, and behaviors of the students and teachers. Each question in the survey was developed with a single correct response and addressed five aspects: knowledge, attitude, practice, actual use of medications, and partnership. The scale has good reliability and validity, with content validity index of 0.91 and the internal consistency reliability above 0.69, the split-half re1iability above 0.77, and the test-retest reliability above 0.83. The study concluded that the five core abilities of correct medications usage in Taiwan can enhance the health literacy. Further studies are needed to evaluate the utilization in subjects with different backgrounds or health conditions.
Aims A high rate of suicide has been reported in patients who sustain fractures, but the associat... more Aims A high rate of suicide has been reported in patients who sustain fractures, but the association remains uncertain in the context of other factors. The aim of this study was to examine the association between fractures and the risk of suicide in this contextual setting. Patients and Methods We performed a case-control study of patients aged 40 years or older who died by suicide between 2000 and 2011. We included patients’ demographics, physical and mental health problems, and socioeconomic factors. We performed conditional logistic regression to evaluate the associations between fractures and the risk of suicide. Results We included a total of 34 794 patients who died by suicide and 139 176 control patients. We found that fractures as a homogenous group (adjusted odds ratios (aOR), 1.48; 95% confidence interval (CI) 1.43 to 1.53), and specifically pelvic (aOR 2.04; 95% CI 1.68 to 2.47) and spinal fractures (aOR 1.53; 95% CI 1.43 to 1.64), were associated with a higher risk of su...
The use of pre-medication to improve visibility in gastrointestinal endoscopy has not been well a... more The use of pre-medication to improve visibility in gastrointestinal endoscopy has not been well addressed and remains controversial. The aim is to evaluate the effects of current pre-medication on endoscopic visualization. We made the overall strategies to search the different databases and assessed the quality of included studies according to the included and excluded standard. 1541 patients were treated with pre-medication. Ten prospective studies involving 1541 patients were included. There was improved visibility in patients treated with Simethicone (weighted mean difference -4.3; 95% confidence interval (CI), -4.94 to -3.67), compared to those who did not use Simethicone. In the Simethicone based regiment, administration of Pronase was noted with significantly improved visibility in the location of antrum and fundus, compared to those who did not use; however, administration of N-acetyl-L-cysteine could not lead to significantly improved visibility. Simethicone offered better v...
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi, 2001
Effective empiric treatment of pneumonia requires antibiotic coverage against gram-negative and g... more Effective empiric treatment of pneumonia requires antibiotic coverage against gram-negative and gram-positive pathogens, including drug-resistant isolates. This study evaluated the efficacy of cefepime treatment in 20 patients with community-acquired pneumonia (CAP) and 21 patients with hospital-acquired pneumonia (HAP), and ceftazidime treatment in 20 patients with HAP. The mean age of patients was over 70 years. More than half of the patients had multiple lobe involvement. There was no significant difference in the severity of illness according to the acute physiology, age, chronic health evaluation (APACHE) III score between the HAP-cefepime and HAP-ceftazidime group. The most common bacteria isolated from sputum of patients with CAP were Streptococcus pneumoniae (n = 7), Klebsiella pneumoniae (n = 4), and Pseudomonas aeruginosa (n = 2). In patients with HAP, P. aeruginosa (n = 13), Acinetobacter baumannii (n = 11), Serratia marcescens (n = 6), K. pneumoniae (n = 5), Stenotrophom...
Microparticles containing 5-fluorouracil (5-FU) were prepared using poly(DL-lactide-co-glycolide)... more Microparticles containing 5-fluorouracil (5-FU) were prepared using poly(DL-lactide-co-glycolide) with an oil-in-oil emulsion/solvent extraction technique. Particle characteristics including size distribution, 5-FU loading efficiencies, in vitro release and degradation were investigated. The dispersed phase was composed of PLG dissolved in dichloromethane, and the continuous phase was paraffin oil containing lecithin. 5-FU was successfully entrapped in the microparticles with trapping efficiencies up to 76%, loading level 10% w/v, and particle size 3 microm. Release profiles of 5-FU loaded microparticles were determined to follow a first-order-time relationship. An optimized preparation of 5-FU microparticles was achieved and was capable of controlling the release of 5-FU over 21 days with an in vitro delivery rate of 0.4 microg 5-FU/mg particles/day in the study. Preliminary animal studies indicated that the 5-FU loaded microparticles as an ocular delivery system showed no ocular toxicity and no significant inflammatory response in rabbits for 2 months. The 5-FU loaded microparticles approach, with PLG, might be a potential for the application of long-term delivery of hydrophilic drugs in the eye.
Vibrio cholerae (VC)-loaded microparticles were prepared using poly(DL lactide-co-glycolide) with... more Vibrio cholerae (VC)-loaded microparticles were prepared using poly(DL lactide-co-glycolide) with a water-in-oil-in-water emulsion/solvent extraction technique. Particle characteristics including size distribution, VC-loading efficiencies, and in-vitro release pattern were investigated. The dispersed phase was PLG dissolved in dichloromethane, and the continuous phase was water containing PVP as a stabilizer with varied sodium chloride concentrations. VC was successfully entrapped in the microparticles with trapping efficiencies up to 97.8%, a loading level of 55.4 g/mg, and particle size of 3.8 microm. Using 10% w/v PVP with 5% w/v NaCl in the continuous phase resulted in a higher loading level (55.4 +/- 6.9 g/mg), loading efficiency (97.8%), core region content (25.7 +/- 1.9 g/mg) and lower surface content (6.2 +/- 0.9 g/mg) than without NaCl (loading content: 40.7 +/- 5.1 g/mg; loading efficiency 52.1%; core region content: 8.3 +/- 0.5 g/mg; surface content: 19.5 +/- 1.1 g/mg). A linear release profile from VC-loaded microparticles was found. A preliminary animal oral administration study indicated that the VC-loaded microparticles, as an oral delivery system, have shown effective immunogencity in rats for 2 months. The VC incorporation and physicochemical characterization data obtained in this study may be relevant in optimising the vaccine incorporation and delivery properties of these potential vaccine targeting carriers.
Simethicone and N-acetylcysteine have been widely used in improving endoscopic visibility. Howeve... more Simethicone and N-acetylcysteine have been widely used in improving endoscopic visibility. However, the optimal dose, volume, and dosing time for the premedication regimen are still unclear. Our aim was to assess the efficacy of premedication in improving endoscopic visibility and determine the contributions of dose, volume, and premedication time. A total of 1849 patients were prospectively treated in three groups: group A: 100-mg simethicone suspension in 5 mL water; group B: 100-mg simethicone suspension in 100 mL water; and group C: 100-mg simethicone suspension in 100 mL water containing 200 mg N-acetylcysteine. Mucosa visibility was assessed at seven sites of upper gastrointestinal tract. The sum of scores was considered as total mucosal visibility score (TMVS). The upper body of stomach had the worst visibility score for all groups. TMVS of groups B and C were significantly lower than those of group A. Group C had a significantly fewer patients requiring endoscopic flushing than groups A and B. The TMVS for groups B and C were significantly lower than for group A within 30 min of beginning premedication. Beyond 30 min of premedication, there was no significant difference in the TMVS among groups. Premedication using 100 mg simethicone in 100 mL of water improves endoscopic visibility. Addition of N-acetylcysteine to simethicone in 100 mL of water reduces the need for endoscopic flushing. For patients unable to tolerate a large fluid volume, a 5-mL simethicone suspension administered more than 30 min prior to upper endoscopy is suggested.
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