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Patients receiving hemodialysis (HD) are at risk of TB development. IGRA-positive patients showed significant decrease in quantitative IGRA result with alterations in CD3+CD4+CD45RO+, NK cell, and monocyte subsets immediately upon HD procedure. Our result suggested that the timing of IGRA testing is crucial in end-stage renal disease population.
Denise Utami Putri; Chia-Ling Chen; Cheng-Hui Wang; Yuh-Mou Sue; Po-Chun Tseng; Chiou-Feng Lin; Ching-Wen Tsai; Yi-Jun Liu; Chih-Hsin Lee. Hemodialysis Acutely Altered Interferon-Gamma Release Assay Test Result and Immune Cell Profile. Journal of Microbiology, Immunology and Infection 2021, 1 .
AMA StyleDenise Utami Putri, Chia-Ling Chen, Cheng-Hui Wang, Yuh-Mou Sue, Po-Chun Tseng, Chiou-Feng Lin, Ching-Wen Tsai, Yi-Jun Liu, Chih-Hsin Lee. Hemodialysis Acutely Altered Interferon-Gamma Release Assay Test Result and Immune Cell Profile. Journal of Microbiology, Immunology and Infection. 2021; ():1.
Chicago/Turabian StyleDenise Utami Putri; Chia-Ling Chen; Cheng-Hui Wang; Yuh-Mou Sue; Po-Chun Tseng; Chiou-Feng Lin; Ching-Wen Tsai; Yi-Jun Liu; Chih-Hsin Lee. 2021. "Hemodialysis Acutely Altered Interferon-Gamma Release Assay Test Result and Immune Cell Profile." Journal of Microbiology, Immunology and Infection , no. : 1.
The heterogeneity of immune response to COVID-19 has been reported to correlate with disease severity and prognosis. While so, how the immune response progress along the period of viral RNA-shedding (VRS), which determines the infectiousness of disease, is yet to be elucidated. We aim to exhaustively evaluate the peripheral immune cells to expose the interplay of the immune system in uncomplicated COVID-19 cases with different VRS periods and dynamic changes of the immune cell profile in the prolonged cases. We prospectively recruited four uncomplicated COVID-19 patients and four healthy controls (HCs) and evaluated the immune cell profile throughout the disease course. Peripheral blood mononuclear cells (PBMCs) were collected and submitted to a multi-panel flowcytometric assay. CD19+-B cells were upregulated, while CD4, CD8, and NK cells were downregulated in prolonged VRS patients. Additionally, the pro-inflammatory-Th1 population showed downregulation, followed by improvement along the disease course, while the immunoregulatory cells showed upregulation with subsequent decline. COVID-19 patients with longer VRS expressed an immune profile comparable to those with severe disease, although they remained clinically stable. Further studies of immune signature in a larger cohort are warranted.
Denise Putri; Cheng-Hui Wang; Po-Chun Tseng; Wen-Sen Lee; Fu-Lun Chen; Han-Pin Kuo; Chih-Hsin Lee; Chiou-Feng Lin. Profiles of Peripheral Immune Cells of Uncomplicated COVID-19 Cases with Distinct Viral RNA Shedding Periods. Viruses 2021, 13, 514 .
AMA StyleDenise Putri, Cheng-Hui Wang, Po-Chun Tseng, Wen-Sen Lee, Fu-Lun Chen, Han-Pin Kuo, Chih-Hsin Lee, Chiou-Feng Lin. Profiles of Peripheral Immune Cells of Uncomplicated COVID-19 Cases with Distinct Viral RNA Shedding Periods. Viruses. 2021; 13 (3):514.
Chicago/Turabian StyleDenise Putri; Cheng-Hui Wang; Po-Chun Tseng; Wen-Sen Lee; Fu-Lun Chen; Han-Pin Kuo; Chih-Hsin Lee; Chiou-Feng Lin. 2021. "Profiles of Peripheral Immune Cells of Uncomplicated COVID-19 Cases with Distinct Viral RNA Shedding Periods." Viruses 13, no. 3: 514.
Global pandemic resulted from the coronavirus disease-19 (COVID-19) demands mental health concerns on the affected population. We examine the time-course shift of psychological burden among suspected and confirmed COVID-19 patients. Participants with suspected or confirmed COVID-19 were included in the cohort. Consecutive surveys were conducted upon hospital admission, discharge, and during outpatient follow-up by adapting the 5-item brief symptom rating scale (BSRS-5) assessing psychological symptoms including anxiety, depression, hostility, interpersonal sensitivity, and insomnia. The sixth measure to observe suicidal ideation was also included. A total of 109 eligible patients participated in the study, in which 83.49% reported no distress upon hospital admission, while 2.75%, 3.66%, and 10.1% patients were assessed as being with severe, moderate and mild psychological distress, respectively. Overall, age, sex, and history of contact did not significantly differ between patients with and without psychological distress. Multivariate logistic regression revealed that patients admitted during April–May (OR: 7.66, 95% CI: 1.46–40.28) and presented with symptoms including sore throat (OR: 4.24, 95% CI: 1.17–15.29) and malaise (OR: 5.24, 95% CI: 1.21–22.77) showed significantly higher risk of psychological distress. Cough symptom interestingly showed lower risk of emotional distress (OR: 0.25, 95% CI: 0.08–0.81). Subsequent surveys upon hospital discharge and during outpatient follow-up revealed steadily declining distress among all cohort. At least 16.5% of our cohort reported psychological distress upon hospital admission, with distinct time-dependent decline. Access to mental health support, alongside with promoting positive activities for good mental health are pivotal for those directly affected.
Denise Utami Putri; Yi-San Tsai; Jin-Hua Chen; Ching-Wen Tsai; Chung-Yi Ou; Chiao-Ru Chang; Hui-Chun Chen; Mong-Liang Lu; Ming-Chih Yu; Chih-Hsin Lee. Psychological distress assessment among patients with suspected and confirmed COVID-19: A cohort study. Journal of the Formosan Medical Association 2021, 1 .
AMA StyleDenise Utami Putri, Yi-San Tsai, Jin-Hua Chen, Ching-Wen Tsai, Chung-Yi Ou, Chiao-Ru Chang, Hui-Chun Chen, Mong-Liang Lu, Ming-Chih Yu, Chih-Hsin Lee. Psychological distress assessment among patients with suspected and confirmed COVID-19: A cohort study. Journal of the Formosan Medical Association. 2021; ():1.
Chicago/Turabian StyleDenise Utami Putri; Yi-San Tsai; Jin-Hua Chen; Ching-Wen Tsai; Chung-Yi Ou; Chiao-Ru Chang; Hui-Chun Chen; Mong-Liang Lu; Ming-Chih Yu; Chih-Hsin Lee. 2021. "Psychological distress assessment among patients with suspected and confirmed COVID-19: A cohort study." Journal of the Formosan Medical Association , no. : 1.
Therapeutic drug monitoring is important for achieving desirable outcomes in tuberculosis treatment. In this study, microwave-assisted extraction was used to extract levofloxacin, ciprofloxacin, and moxifloxacin from dried plasma spots for subsequent detection and quantification with ultra-high performance liquid chromatography-tandem mass spectrometry. Dried plasma spotting was performed by dropping 15 µL of plasma on a protein saver card. Analyte extraction was performed with microwave-assisted extraction at 400 W for 40 seconds in 90% methanol. Samples were analyzed with a core-shell C18 column (100 mm × 2.1 mm, 2.6 μm, 100 Å). Multiple reaction monitoring was used and the ion source was operated in positive electrospray ionization mode. The correlation coefficients of the calibration curves were > 0.999 for all three drugs over a range of 0.2-20 µg/mL. The intraday precision (n = 5) of the peak area ratios of the analyte to the internal standard was between 1.3 and 4.0% relative standard deviation (RSD). The intraday accuracy ranged from 93.6 to 106.9%. The interday (n = 3) precision of the peak area ratios ranged from 1.9 to 8.8% RSD, and the accuracy ranged from 94.9 to 107.1%. Regarding clinical application, the quantification results for moxifloxacin from dried plasma spots (DPSs) were strongly similar to the results from the plasma samples, which showed that Pearson’s rho > 0.949. The validation and application results showed that the developed method can be used as an efficient analytical technique for therapeutic drug monitoring of fluoroquinolones for patients with tuberculosis.
Ageng Brahmadhi; Michael X. Chen; San-Yuan Wang; Yun-Yu Cho; Ming-Chih Yu; Chih-Hsin Lee; I-Lin Tsai. Determination of fluoroquinolones in dried plasma spots by using microwave-assisted extraction coupled to ultra-high performance liquid chromatography-tandem mass spectrometry for therapeutic drug monitoring. Journal of Pharmaceutical and Biomedical Analysis 2020, 195, 113821 .
AMA StyleAgeng Brahmadhi, Michael X. Chen, San-Yuan Wang, Yun-Yu Cho, Ming-Chih Yu, Chih-Hsin Lee, I-Lin Tsai. Determination of fluoroquinolones in dried plasma spots by using microwave-assisted extraction coupled to ultra-high performance liquid chromatography-tandem mass spectrometry for therapeutic drug monitoring. Journal of Pharmaceutical and Biomedical Analysis. 2020; 195 ():113821.
Chicago/Turabian StyleAgeng Brahmadhi; Michael X. Chen; San-Yuan Wang; Yun-Yu Cho; Ming-Chih Yu; Chih-Hsin Lee; I-Lin Tsai. 2020. "Determination of fluoroquinolones in dried plasma spots by using microwave-assisted extraction coupled to ultra-high performance liquid chromatography-tandem mass spectrometry for therapeutic drug monitoring." Journal of Pharmaceutical and Biomedical Analysis 195, no. : 113821.
Treatment of latent tuberculosis infection (LTBI) is an important strategy for active disease prevention. Conventional in-person DOT (CDOT) programs are challenged by patient dissatisfaction over problems of convenience and privacy. The present study assessed satisfaction to DOT program and treatment adherence of synchronous video observed treatment (SVOT) programs from patients’ perspectives. A two-part questionnaire was presented to 240 subjects with LTBI who received a 9-month isoniazid treatment regimen along with mandatory DOT monitoring during January 2014 to December 2017. Satisfactions with location arrangement (p < 0.001), ensuring treatment adherence (p = 0.027), and privacy issues (p = 0.005) were superior in the SVOT group. The overall rate of LTBI treatment completion was 91.25%. One (1.25%) and 20 (12.50%) of the participants in the SVOT and CDOT groups, respectively, quit LTBI treatment (p = 0.008). Development of adverse events [adjusted hazard ratio, aHR 8.01 (3.42–18.79)], and the concern of privacy infringement [aHR 5.86 (2.69–12.76)] by the DOT program independently increase the risk of withdrawal. SVOT program [aHR 0.21 (0.06–0.68)] and a belief in the importance of adherence on treatment efficacy [aHR 0.29 (0.08–0.98)] were independent predictors preventing patients from withdrawing from treatment. A comprehensive patient-centered DOT program enables high treatment adherence for the 9-month isoniazid LTBI treatment. Furthermore, SVOT was associated with superior patients’ satisfactions which translate into higher treatment completion rates. As treatment adherence is the key to the efficacy of LTBI treatment, SVOT should be a reasonable supplement for LTBI treatment.
Szu-Hsuan Chen; Irene Wang; Han-Lin Hsu; Chi-Ching Huang; Yi-Jun Liu; Denise Utami Putri; Chih-Hsin Lee. Advantage in privacy protection by using synchronous video observed treatment enhances treatment adherence among patients with latent tuberculosis infection. Journal of Infection and Public Health 2020, 13, 1354 -1359.
AMA StyleSzu-Hsuan Chen, Irene Wang, Han-Lin Hsu, Chi-Ching Huang, Yi-Jun Liu, Denise Utami Putri, Chih-Hsin Lee. Advantage in privacy protection by using synchronous video observed treatment enhances treatment adherence among patients with latent tuberculosis infection. Journal of Infection and Public Health. 2020; 13 (9):1354-1359.
Chicago/Turabian StyleSzu-Hsuan Chen; Irene Wang; Han-Lin Hsu; Chi-Ching Huang; Yi-Jun Liu; Denise Utami Putri; Chih-Hsin Lee. 2020. "Advantage in privacy protection by using synchronous video observed treatment enhances treatment adherence among patients with latent tuberculosis infection." Journal of Infection and Public Health 13, no. 9: 1354-1359.
Little remains known regarding whether newer FQ with less anti-mycobacterial activity (gemifloxacin) would reduce treatment delay. We identified one hospital-based cohort (HBC) and one population-based cohort (PBC) including patients receiving amoxicillin/clavulanate acid (Beta-lactam), gemifloxacin (Gemi), and fluoroquinolones other than gemifloxacin (Non-Gemi FQ) prior to TB treatment. A total of 201 patients in the HBC and 3544 patients in the PBC were recruited. After 1:1 propensity score matching, TB treatment delay was statistically insignificant between Beta-lactam, Gemi group, and Non-Gemi FQ group in HBC (Beta-lactam vs Gemi: 22.3 ± 21.4 d vs 28.6 ± 27.9 d, p = 0.292; Beta-lactam vs Non-Gemi FQ: 33.3 ± 26.5 d vs 50.3 ± 47.3 d, p = 0.135) and PBC (Beta-lactam vs Gemi: 26.4 ± 29.1 vs 25.0 ± 28.1, p = 0.638; Beta-lactam vs Non-Gemi FQ: 29.4 ± 36.0 d vs 32.7 ± 35.0 d, p = 0.124, Non-Gemi FQ vs Gemi: 28.4 ± 33.0 d vs 25.0 ± 28.1 d, p = 0.29). While limited by relatively low case number, our study showed that use of gemifloxacin neither results in nor reduces delay in TB treatment. The issue of FQ use on TB treatment delay was also not observed in our study. Early survey and maintaining high clinical alertness remains the key to reducing TB treatment delay.
Meng-Rui Lee; Chih-Hsin Lee; Jann-Yuan Wang; Shih-Wei Lee; Jen-Chung Ko; Li-Na Lee. Clinical impact of using fluoroquinolone with low antimycobacterial activity on treatment delay in tuberculosis: Hospital-based and population-based cohort study. Journal of the Formosan Medical Association 2019, 119, 367 -376.
AMA StyleMeng-Rui Lee, Chih-Hsin Lee, Jann-Yuan Wang, Shih-Wei Lee, Jen-Chung Ko, Li-Na Lee. Clinical impact of using fluoroquinolone with low antimycobacterial activity on treatment delay in tuberculosis: Hospital-based and population-based cohort study. Journal of the Formosan Medical Association. 2019; 119 (1):367-376.
Chicago/Turabian StyleMeng-Rui Lee; Chih-Hsin Lee; Jann-Yuan Wang; Shih-Wei Lee; Jen-Chung Ko; Li-Na Lee. 2019. "Clinical impact of using fluoroquinolone with low antimycobacterial activity on treatment delay in tuberculosis: Hospital-based and population-based cohort study." Journal of the Formosan Medical Association 119, no. 1: 367-376.
While evidence is accumulating that platelets contribute to tissue destruction in tuberculosis (TB) disease, it is still not known whether antiplatelet agents are beneficial to TB patients. We performed this retrospective cohort study and identified incident TB cases in the Taiwan National Tuberculosis Registry from 2008 to 2014. These cases were further classified into antiplatelet users and non-users according to the use of antiplatelet agents prior to the TB diagnosis, and the cohorts were matched using propensity scores (PSs). The primary outcome was survival after a TB diagnosis. In total, 74,753 incident TB cases were recruited; 9497 (12.7%) were antiplatelet users, and 7764 (10.4%) were aspirin (ASA) users. A 1:1 PS-matched cohort with 8864 antiplatelet agent users and 8864 non-users was created. After PS matching, antiplatelet use remained associated with a longer survival (adjusted hazard ratio (HR): 0.91, 95% confidence interval (CI): 0.88-0.95, p < 0.0001). The risk of major bleeding was not elevated in antiplatelet users compared to non-users (p = 0.604). This study shows that use of antiplatelet agents has been associated with improved survival in TB patients. The immunomodulatory and anti-inflammatory effects of antiplatelet agents in TB disease warrant further investigation. Antiplatelets are promising as an adjunct anti-TB therapy.
Meng-Rui Lee; Ming-Chia Lee; Chia-Hao Chang; Chia-Jung Liu; Lih-Yu Chang; Jun-Fu Zhang; Jann-Yuan Wang; Chih-Hsin Lee. Use of Antiplatelet Agents and Survival of Tuberculosis Patients: A Population-Based Cohort Study. Journal of Clinical Medicine 2019, 8, 923 .
AMA StyleMeng-Rui Lee, Ming-Chia Lee, Chia-Hao Chang, Chia-Jung Liu, Lih-Yu Chang, Jun-Fu Zhang, Jann-Yuan Wang, Chih-Hsin Lee. Use of Antiplatelet Agents and Survival of Tuberculosis Patients: A Population-Based Cohort Study. Journal of Clinical Medicine. 2019; 8 (7):923.
Chicago/Turabian StyleMeng-Rui Lee; Ming-Chia Lee; Chia-Hao Chang; Chia-Jung Liu; Lih-Yu Chang; Jun-Fu Zhang; Jann-Yuan Wang; Chih-Hsin Lee. 2019. "Use of Antiplatelet Agents and Survival of Tuberculosis Patients: A Population-Based Cohort Study." Journal of Clinical Medicine 8, no. 7: 923.
We previously synthesized new tubulin inhibitors, MPT0B169 and MPT0B002, which induced growth inhibition and apoptosis in leukemia cells. However, their effects on solid tumor cells have not been determined. In this study, we investigated the effects of MPT0B169 and MPT0B002 on glioblastoma, breast, lung, and colorectal cancer (CRC) cell lines. A cell viability analysis showed that MPT0B169 and MPT0B002 were more effective in inhibiting the proliferation of COLO205 and HT29 CRC cells than U87MG and GBM8401 glioblastoma, MCF-7 and MDA-MB-231 breast cancer, and A549 lung cancer cells. MPT0B169 and MPT0B002 inhibited growth of COLO205 and HT29 cells in dose- and time-dependent manners. A colony-formation assay confirmed the growth inhibitory effects of MPT0B169 and MPT0B002 on COLO205 and HT29 cells. MPT0B169 and MPT0B002 disrupted tubulin polymerization and arrested the cell cycle at the G2/M phase, with a concomitant increase of the cyclin B1 level. MPT0B169 and MPT0B002 induced apoptosis, accompanied by induction of the intrinsic apoptotic pathway, as shown by a reduction in the caspase-9 level and increases in cleaved caspase-3 and cleaved PARP. These results suggest that MPT0B169 and MPT0B002, new tubulin inhibitors, induced growth inhibition, G2/M arrest, and apoptosis in COLO205 and HT29 cells, and they could potentially be anticancer agents for CRC cells.
Chih-Hsin Lee; Yuan-Feng Lin; Yen-Chou Chen; Shuit-Mun Wong; Shu-Hui Juan; Huei-Mei Huang. MPT0B169 and MPT0B002, New Tubulin Inhibitors, Induce Growth Inhibition, G2/M Cell Cycle Arrest, and Apoptosis in Human Colorectal Cancer Cells. Pharmacology 2018, 102, 262 -271.
AMA StyleChih-Hsin Lee, Yuan-Feng Lin, Yen-Chou Chen, Shuit-Mun Wong, Shu-Hui Juan, Huei-Mei Huang. MPT0B169 and MPT0B002, New Tubulin Inhibitors, Induce Growth Inhibition, G2/M Cell Cycle Arrest, and Apoptosis in Human Colorectal Cancer Cells. Pharmacology. 2018; 102 (5-6):262-271.
Chicago/Turabian StyleChih-Hsin Lee; Yuan-Feng Lin; Yen-Chou Chen; Shuit-Mun Wong; Shu-Hui Juan; Huei-Mei Huang. 2018. "MPT0B169 and MPT0B002, New Tubulin Inhibitors, Induce Growth Inhibition, G2/M Cell Cycle Arrest, and Apoptosis in Human Colorectal Cancer Cells." Pharmacology 102, no. 5-6: 262-271.
Research has revealed that angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) may prevent cancers such as hepatocellular carcinoma (HCC). The comparative chemopreventive effects of ACEIs and ARBs in high-risk populations with hepatitis B virus (HBV) or hepatitis C virus (HCV) infection have yet to be investigated. From 2005 to 2014, high-risk HBV and HCV cohorts of hypertensive patients without HCC history were recruited from three linked national databases of Taiwan, and were classified into two groups based on the ACEI or ARB exposure within the initial six months after initiating antiviral agent. Intergroup differences in clinical characteristics and duration of drug exposure within study period were evaluated. HCC-free survival was compared using the log-rank test. Multivariate Cox regression including time-dependent variables for the use of ACEIs or ARBs and other medications was applied to adjust for confounders. Among the 7724 patients with HBV and 7873 with HCV, 46.3% and 42.5%, respectively, had an initial exposure to ACEIs or ARBs. The median durations of exposure were 36.4 and 38.9 months for the HBV and HCV cohorts, respectively. The median durations of ACEI or ARB use during study period between initial exposure and nonexposure groups were 41.8 vs. 18.3 months and 46.4 vs. 22.7 months for the HBV and HCV cohorts, respectively. No significant difference was observed in HCC risk within 7 years between the initial exposure and non-exposure groups. After adjustment for comorbidities, namely liver cirrhosis, diabetes mellitus (DM), and hyperlipidemia, and medications, namely aspirin, metformin, and statins, the hazard ratios (HRs) for ACEI or ARB exposure for HCC risk were 0.97 (95% confidence interval [CI]: 0.81–1.16) and 0.96 (0.80–1.16) in the HBV and HCV cohorts, respectively. In the HCV cohort, the increased HCC risk was associated with ACEI or ARB use in patients without cirrhosis, DM, and hyperlipidemia (HR: 4.53, 95% CI: 1.46–14.1). Compared with other significant risk and protective factors for HCC, ACEI or ARB use in the HBV and HCV cohorts was not associated with adequate protective effectiveness under standard dosages and may not be completely safe.
Cheng-Maw Ho; Chih-Hsin Lee; Ming-Chia Lee; Jun-Fu Zhang; Jann-Yuan Wang; Rey-Heng Hu; Po-Huang Lee. Comparative effectiveness of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in chemoprevention of hepatocellular carcinoma: a nationwide high-risk cohort study. BMC Cancer 2018, 18, 401 .
AMA StyleCheng-Maw Ho, Chih-Hsin Lee, Ming-Chia Lee, Jun-Fu Zhang, Jann-Yuan Wang, Rey-Heng Hu, Po-Huang Lee. Comparative effectiveness of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in chemoprevention of hepatocellular carcinoma: a nationwide high-risk cohort study. BMC Cancer. 2018; 18 (1):401.
Chicago/Turabian StyleCheng-Maw Ho; Chih-Hsin Lee; Ming-Chia Lee; Jun-Fu Zhang; Jann-Yuan Wang; Rey-Heng Hu; Po-Huang Lee. 2018. "Comparative effectiveness of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in chemoprevention of hepatocellular carcinoma: a nationwide high-risk cohort study." BMC Cancer 18, no. 1: 401.
Tuberculosis (TB) remains one of the major infectious diseases worldwide. Adverse reactions are common during TB treatment. Few reports, however, are available on treatment-related acute biliary events (ABEs), such as cholelithiasis, biliary obstruction, acute cholecystitis, and cholangitis. We first report four pulmonary TB patients who developed ABEs during anti-TB treatment. Abdominal sonography revealed multiple gall stones with dilated intrahepatic ducts in three patients and cholecystitis in one patient. To investigate the incidence of and risk factors for ABEs during anti-TB treatment, we subsequently conducted a nationwide cohort study using the National Health Insurance Research Database of Taiwan. A total of 159,566 pulmonary TB patients were identified from the database between 1996 and 2010, and among them, 195 (0.12%) developed ABEs within 180 days after beginning anti-TB treatment. Logistic regression analysis revealed that the risk factors associated with ABEs are older age (relative risk [RR]: 1.32 [1.21-1.44] per 10-year increment) and diabetes mellitus (RR: 1.59 [1.19-2.13]). Although infrequently encountered, ABEs should be considered among patients with TB who experience abdominal discomfort with hyperbilirubinemia, especially patients who have older age or diabetes.
Lih-Yu Chang; Chih-Hsin Lee; Chia-Hao Chang; Ming-Chia Lee; Meng-Rui Lee; Jann-Yuan Wang; Li-Na Lee. Acute biliary events during anti-tuberculosis treatment: hospital case series and a nationwide cohort study. BMC Infectious Diseases 2018, 18, 64 .
AMA StyleLih-Yu Chang, Chih-Hsin Lee, Chia-Hao Chang, Ming-Chia Lee, Meng-Rui Lee, Jann-Yuan Wang, Li-Na Lee. Acute biliary events during anti-tuberculosis treatment: hospital case series and a nationwide cohort study. BMC Infectious Diseases. 2018; 18 (1):64.
Chicago/Turabian StyleLih-Yu Chang; Chih-Hsin Lee; Chia-Hao Chang; Ming-Chia Lee; Meng-Rui Lee; Jann-Yuan Wang; Li-Na Lee. 2018. "Acute biliary events during anti-tuberculosis treatment: hospital case series and a nationwide cohort study." BMC Infectious Diseases 18, no. 1: 64.
Studies focusing on pulmonary tuberculosis in advanced age (≥80 years) are lacking. This study aimed to explore treatment delay, outcomes and their predictors in this group. Adult (≥20 years) patients with pulmonary tuberculosis were identified from the National Health Insurance Research Database of Taiwan from 2004 to 2009. Treatment completion and mortality rates were noted at one year after treatment. Among the 81,081 patients with pulmonary tuberculosis identified, 13,923 (17.2%) were aged ≥80 years, and 26,897 (33.2%) were aged 65–79 years. The treatment completion, mortality rates and treatment delay were 54.8%, 34.7% and 61 (12–128) [median, (1st-3rd quartiles)] days in patients aged ≥80 years, 68.3%, 18.5% and 53 (8–122) days in patients aged 65–79 years, and 78.9%, 6.5% and 21 (1–84) days in patients aged <65 years, respectively. The elder patients were more likely to receive second-line anti-tuberculosis agents. The treatment completion rate decreased with older age, female sex, comorbidities, low income, requiring second-line anti-tuberculosis agents, severity of pulmonary tuberculosis and longer treatment delay. Older age, female sex, comorbidities, low income, and not undergoing rapid molecular diagnostic tests were independently associated with longer treatment delays. Pulmonary tuberculosis in advanced age has a longer treatment delay and a higher mortality rate. Applying rapid molecular diagnostic tools may reduce treatment delay and should be integrated into the diagnostic algorithm for pulmonary tuberculosis, particularly in elderly patients.
Chih-Hsin Lee; Jann-Yuan Wang; Hsien-Chun Lin; Pai-Yang Lin; Jer-Hwa Chang; Chi-Won Suk; Li-Na Lee; Chou-Chin Lan; Kuan-Jen Bai. Treatment delay and fatal outcomes of pulmonary tuberculosis in advanced age: a retrospective nationwide cohort study. BMC Infectious Diseases 2017, 17, 1 -11.
AMA StyleChih-Hsin Lee, Jann-Yuan Wang, Hsien-Chun Lin, Pai-Yang Lin, Jer-Hwa Chang, Chi-Won Suk, Li-Na Lee, Chou-Chin Lan, Kuan-Jen Bai. Treatment delay and fatal outcomes of pulmonary tuberculosis in advanced age: a retrospective nationwide cohort study. BMC Infectious Diseases. 2017; 17 (1):1-11.
Chicago/Turabian StyleChih-Hsin Lee; Jann-Yuan Wang; Hsien-Chun Lin; Pai-Yang Lin; Jer-Hwa Chang; Chi-Won Suk; Li-Na Lee; Chou-Chin Lan; Kuan-Jen Bai. 2017. "Treatment delay and fatal outcomes of pulmonary tuberculosis in advanced age: a retrospective nationwide cohort study." BMC Infectious Diseases 17, no. 1: 1-11.
Among treatment modalities for lung cancer, the most promising therapy is the use of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). Both erlotinib and gefitinib, the two first-generation EGFR-TKIs, exhibit significant clinical responses for patients with lung adenocarcinoma. However, few studies have compared the effects of these two drugs, and results have been inconclusive because of the small sample sizes in these studies. Therefore, this study was conducted to investigate this issue. This retrospective nationwide cohort study enrolled NSCLC patients who received EGFR-TKIs after previous chemotherapy in Taiwan between 1996 and 2010 from the National Health Insurance Research Database. Clinical response and survival after receiving erlotinib and gefitinib were compared using logistic and Cox regression analyses, respectively. Inverse propensity score weighting and a sensitivity analysis in the EGFR-TKI responder (clinical improvement by taking EGFR-TKIs for 90 days), adherent patients (receiving EGFR-TKI on a daily basis), adenocarcinoma, and adenocarcinoma with second-line TKIs subgroup were performed for bias adjustment. A total of 7222 patients, including 4592 (63.6%) who received gefitinib, were identified. In the survival analysis, erlotinib was associated with a decline in 1-year progression-free survival (PFS) (hazard ratio, HR: 1.15 [1.09–1.21]) and overall survival (OS) (HR: 1.10 [1.03–1.18]). The effects of various TKIs were consistent in the 4939 EGFR-TKI responders, adherent subgroup, adenocarcinoma subgroup, and adenocarcinoma with second-line TKIs subgroup. In previously treated EGFT-TKI-naive NSCLC patients, those receiving gefitinib exhibited a longer PFS and OS than those receiving erlotinib. Additional large-scale randomized controlled trials are warranted to confirm this finding.
Chia-Hao Chang; Chih-Hsin Lee; Jen-Chung Ko; Lih-Yu Chang; Ming-Chia Lee; Jann-Yuan Wang; Wang Jann-Yuan. Gefitinib or erlotinib in previously treated non-small-cell lung cancer patients: a cohort study in Taiwan. Cancer Medicine 2017, 6, 1563 -1572.
AMA StyleChia-Hao Chang, Chih-Hsin Lee, Jen-Chung Ko, Lih-Yu Chang, Ming-Chia Lee, Jann-Yuan Wang, Wang Jann-Yuan. Gefitinib or erlotinib in previously treated non-small-cell lung cancer patients: a cohort study in Taiwan. Cancer Medicine. 2017; 6 (7):1563-1572.
Chicago/Turabian StyleChia-Hao Chang; Chih-Hsin Lee; Jen-Chung Ko; Lih-Yu Chang; Ming-Chia Lee; Jann-Yuan Wang; Wang Jann-Yuan. 2017. "Gefitinib or erlotinib in previously treated non-small-cell lung cancer patients: a cohort study in Taiwan." Cancer Medicine 6, no. 7: 1563-1572.
Chia-Hao Chang; Chih-Hsin Lee; Jann-Yuan Wang. Gefitinib or Erlotinib for Previously Treated Lung Adenocarcinoma: Which Is Superior? Journal of Clinical Oncology 2017, 35, 1374 -1375.
AMA StyleChia-Hao Chang, Chih-Hsin Lee, Jann-Yuan Wang. Gefitinib or Erlotinib for Previously Treated Lung Adenocarcinoma: Which Is Superior? Journal of Clinical Oncology. 2017; 35 (12):1374-1375.
Chicago/Turabian StyleChia-Hao Chang; Chih-Hsin Lee; Jann-Yuan Wang. 2017. "Gefitinib or Erlotinib for Previously Treated Lung Adenocarcinoma: Which Is Superior?" Journal of Clinical Oncology 35, no. 12: 1374-1375.
Esophagogastroduodenal pneumatosis is the presence of air in esophagus, stomach, and duodenum simultaneously, which have never been described in the literature. Intramural duodenal hematoma (IDH) rarely occurs after endoscopic intervention. The diagnosis and treatment in both conditions are great challenge in daily practice. A 70-year-old male patient, who had been taking warfarin for artificial valve replacement, developed IDH and esophagogastroduodenal pneumatosis after endoscopic hemostasis for duodenal ulcer bleeding. Initially, he had abdominal pain, gastrointestinal bleeding and hypotension. Later, he was found to have acute pancreatitis, biliary obstruction, gastric outlet obstruction and rapid decline of hemoglobin also ensued. The intramural duodenal hematoma and critical condition resolved spontaneously after conservative medical treatment. Based on this case report, we suggest that intramural duodenal hematoma should be considered if a patient has the tetrad of pancreatitis, biliary obstruction, gastric outlet obstruction and rapid decline of hemoglobin after an endoscopic intervention. Those patients could be treated conservatively. But, surgery should be considered if the diseases progress or complications persist.
Wei-Cheng Huang; Chih-Hsin Lee; Fat-Moon Suk. Esophagogastroduodenal pneumatosis with subsequent pneumoporta and intramural duodenal hematoma after endoscopic hemostasis: a case report. BMC Gastroenterology 2015, 15, 1 -4.
AMA StyleWei-Cheng Huang, Chih-Hsin Lee, Fat-Moon Suk. Esophagogastroduodenal pneumatosis with subsequent pneumoporta and intramural duodenal hematoma after endoscopic hemostasis: a case report. BMC Gastroenterology. 2015; 15 (1):1-4.
Chicago/Turabian StyleWei-Cheng Huang; Chih-Hsin Lee; Fat-Moon Suk. 2015. "Esophagogastroduodenal pneumatosis with subsequent pneumoporta and intramural duodenal hematoma after endoscopic hemostasis: a case report." BMC Gastroenterology 15, no. 1: 1-4.
This retrospective national surveillance study investigated the burden of and risk factors for nosocomial exposure of pulmonary tuberculosis (TB) in intensive care units. Patients admitted to intensive care units were identified from the National Health Insurance Research Database. During 2004–2009, there were 1 387 707 intensive care unit admissions of 900 562 adult patients. Pulmonary tuberculosis association was considered if the patient was diagnosed with pulmonary tuberculosis during admission or within 3 months after discharge. Nosocomial transmissible period was calculated based on the length of anti‐tuberculosis treatment and negative‐pressure isolation during admission. Pulmonary tuberculosis was associated with 1.20% of all intensive care unit admissions and 6731 (38.9%) started anti‐TB treatment during admission. For the other 10 583 admissions, the diagnosis was made after discharge and anti‐TB treatment was not prescribed during admission. The probability paralleled the regional tuberculosis incidence. On average, 2794 pulmonary tuberculosis associated intensive care unit admissions contributed to 42 999–44 062 days of nosocomial exposure per year. The length of nosocomial transmissible period decreased with the gradual implementation of Mycobacterium tuberculosis nucleic acid amplification tests in intensive care practice. Multivariate linear regression analysis revealed that the length of nosocomial transmissible period was inversely associated with male gender, airway symptoms prior to admission and performing M. tuberculosis nucleic acid amplification tests and mycobacterial culture. Nosocomial tuberculosis exposure is not uncommon in intensive care units. Performing rapid molecular diagnostic tests in those suspected of tuberculosis is recommended to reduce the risk of nosocomial exposure.
Jann-Yuan Wang; Ming‐Chia Lee; Jer‐Hwa Chang; Ming‐Chih Yu; Vin-Cent Wu; Kuo‐Liang Huang; Chiu‐Ping Su; Kun-Ma0 Chao; Chih‐Hsin Lee. M ycobacterium tuberculosis nucleic acid amplification tests reduce nosocomial tuberculosis exposure in intensive care units: A nationwide cohort study. Respirology 2015, 20, 1233 -1240.
AMA StyleJann-Yuan Wang, Ming‐Chia Lee, Jer‐Hwa Chang, Ming‐Chih Yu, Vin-Cent Wu, Kuo‐Liang Huang, Chiu‐Ping Su, Kun-Ma0 Chao, Chih‐Hsin Lee. M ycobacterium tuberculosis nucleic acid amplification tests reduce nosocomial tuberculosis exposure in intensive care units: A nationwide cohort study. Respirology. 2015; 20 (8):1233-1240.
Chicago/Turabian StyleJann-Yuan Wang; Ming‐Chia Lee; Jer‐Hwa Chang; Ming‐Chih Yu; Vin-Cent Wu; Kuo‐Liang Huang; Chiu‐Ping Su; Kun-Ma0 Chao; Chih‐Hsin Lee. 2015. "M ycobacterium tuberculosis nucleic acid amplification tests reduce nosocomial tuberculosis exposure in intensive care units: A nationwide cohort study." Respirology 20, no. 8: 1233-1240.
Jann-Yuan Wang; Chih-Hsin Lee; Ming-Chi Yu; Ming-Chia Lee; L.-N. Lee; Jann-Tay Wang. Fluoroquinolone use delays tuberculosis treatment despite immediate mycobacteriology study. European Respiratory Journal 2015, 46, 567 -570.
AMA StyleJann-Yuan Wang, Chih-Hsin Lee, Ming-Chi Yu, Ming-Chia Lee, L.-N. Lee, Jann-Tay Wang. Fluoroquinolone use delays tuberculosis treatment despite immediate mycobacteriology study. European Respiratory Journal. 2015; 46 (2):567-570.
Chicago/Turabian StyleJann-Yuan Wang; Chih-Hsin Lee; Ming-Chi Yu; Ming-Chia Lee; L.-N. Lee; Jann-Tay Wang. 2015. "Fluoroquinolone use delays tuberculosis treatment despite immediate mycobacteriology study." European Respiratory Journal 46, no. 2: 567-570.
BACKGROUNDDiabetes mellitus (DM) increases the risk of TB recurrence. This study investigated whether 9-month anti-TB treatment is associated with a lower risk of TB recurrence within 2 years after complete treatment than 6-month treatment in patients with DM with an emphasis on the impact of directly observed therapy, short course (DOTs).METHODSPatients with pulmonary but not extrapulmonary TB receiving treatment of 173 to 277 days between 2002 and 2010 were identified from the National Health Insurance Research Database of Taiwan. Patients with DM were then selected and classified into two groups based on anti-TB treatment duration (9 months vs 6 months). Factors predicting 2-year TB recurrence were explored using Cox regression analysis.RESULTSAmong 12, 688 patients with DM and 43, 195 patients without DM, the 2-year TB recurrence rate was 2.20% and 1.38%, respectively (P < .001). Of the patients with DM, recurrence rate decreased from 3.54% to 1.19% after implementation of DOTs (P < .001). A total of 4, 506 (35.5%) were classified into 9-month anti-TB treatment group. Although a 9-month anti-TB treatment was associated with a lower recurrence rate (hazard ratio, 0.76 [95% CI, 0.59-0.97]), the benefit disappeared (hazard ratio, 0.69 [95% CI, 0.43-1.11]) under DOTs. Other predictors of recurrence included older age, male sex, malignancy, earlier TB diagnosis year, culture positivity after 2 months of anti-TB treatment, and anti-TB treatment being ≤ 80% consistent with standard regimen.CONCLUSIONSThe 2-year TB recurrence rate is higher in a diabetic population in Taiwan and can be reduced by treatment supervision. Extending the anti-TB treatment by 3 months may also decrease the recurrence rate when treatment is not supervised
Jann-Yuan Wang; Ming-Chia Lee; Chin-Chung Shu; Chih-Hsin Lee; Li-Na Lee; Kun-Mao Chao; Feng-Yee Chang. Optimal Duration of Anti-TB Treatment in Patients With Diabetes. Chest 2015, 147, 520 -528.
AMA StyleJann-Yuan Wang, Ming-Chia Lee, Chin-Chung Shu, Chih-Hsin Lee, Li-Na Lee, Kun-Mao Chao, Feng-Yee Chang. Optimal Duration of Anti-TB Treatment in Patients With Diabetes. Chest. 2015; 147 (2):520-528.
Chicago/Turabian StyleJann-Yuan Wang; Ming-Chia Lee; Chin-Chung Shu; Chih-Hsin Lee; Li-Na Lee; Kun-Mao Chao; Feng-Yee Chang. 2015. "Optimal Duration of Anti-TB Treatment in Patients With Diabetes." Chest 147, no. 2: 520-528.
To compare the risk factors of developing a pneumothorax after computed tomography-guided lung biopsy in cases in which aerated lung is traversed and in cases in which aerated lung is not traversed. The records of 381 patients from July 2005-December 2009 were retrospectively reviewed. Multivariable analysis of patient demographic characteristics, lung lesion characteristics, and biopsy procedure details was performed with respect to the development of pneumothorax. Among 381 patients, 249 biopsies traversed aerated lung tissue, and 132 biopsies did not traverse aerated lung tissue. Patients in whom aerated lung tissue was traversed had a significantly higher rate of pneumothorax. When aerated lung was not traversed, lesion size (≤ 2 cm vs > 2 cm; P = .025) and pleural-lesion angle (odds ratio = 1.033/degree; P = .004) were associated with pneumothorax. When aerated lung was traversed, location (middle vs upper; P = .009) and a transfissure approach (yes vs no; P = .001) were associated with pneumothorax. When aerated lung was not traversed, lesion size and pleural-lesion angle were associated with pneumothorax, and when aerated lung was traversed, location and a transfissure approach were associated with pneumothorax.
Chor-Shen Lim; Lan-Eng Tan; Jann-Yuan Wang; Chih-Hsin Lee; Hsu-Chao Chang; Chou-Chin Lan; Mei-Chen Yang; Thomas Chang-Yao Tsao; Yao-Kuang Wu. Risk Factors of Pneumothorax after CT-Guided Coaxial Cutting Needle Lung Biopsy through Aerated versus Nonaerated Lung. Journal of Vascular and Interventional Radiology 2014, 25, 1209 -1217.
AMA StyleChor-Shen Lim, Lan-Eng Tan, Jann-Yuan Wang, Chih-Hsin Lee, Hsu-Chao Chang, Chou-Chin Lan, Mei-Chen Yang, Thomas Chang-Yao Tsao, Yao-Kuang Wu. Risk Factors of Pneumothorax after CT-Guided Coaxial Cutting Needle Lung Biopsy through Aerated versus Nonaerated Lung. Journal of Vascular and Interventional Radiology. 2014; 25 (8):1209-1217.
Chicago/Turabian StyleChor-Shen Lim; Lan-Eng Tan; Jann-Yuan Wang; Chih-Hsin Lee; Hsu-Chao Chang; Chou-Chin Lan; Mei-Chen Yang; Thomas Chang-Yao Tsao; Yao-Kuang Wu. 2014. "Risk Factors of Pneumothorax after CT-Guided Coaxial Cutting Needle Lung Biopsy through Aerated versus Nonaerated Lung." Journal of Vascular and Interventional Radiology 25, no. 8: 1209-1217.
Survivin, a structurally unique protein expressed in most common human neoplasms, is thought to support cell cycle progression and suppress apoptosis. Survivin expression is highly correlated with advanced non-small cell lung cancer (NSCLC) and poor prognosis. In this retrospective study of banked pathology tissue of patients with advanced NSCLC, we tested for correlations of N-survivin expression in tumor tissues and responsiveness to treatment with platinum-based regimens containing paclitaxel or docetaxel. The 48 patients with NSCLC included 32 (66.7 %) males and 16 (33.3 %) females. Mean age at diagnosis was 59.4 years (range 36–83 years), and median follow-up time was 20.4 months (range 3.4–59.0 months). Patients with high tumor N-survivin expression had significantly better responses to taxane–platinum chemotherapy than those with low tumor N-survivin expression (P P = 0.008). Median overall survival differed significantly between those with high tumor N-survivin expression who did/did not respond to chemotherapy and between those with low tumor N-survivin expression who did/did not respond to chemotherapy (P
Yao-Kuang Wu; Chun-Yao Huang; Mei-Chen Yang; Chou-Chin Lan; Chih-Hsin Lee; Err-Cheng Chan; Kuei-Tien Chen. Nuclear survivin expression: a prognostic factor for the response to taxane–platinum chemotherapy in patients with advanced non-small cell lung cancer. Medical Oncology 2014, 31, 1 .
AMA StyleYao-Kuang Wu, Chun-Yao Huang, Mei-Chen Yang, Chou-Chin Lan, Chih-Hsin Lee, Err-Cheng Chan, Kuei-Tien Chen. Nuclear survivin expression: a prognostic factor for the response to taxane–platinum chemotherapy in patients with advanced non-small cell lung cancer. Medical Oncology. 2014; 31 (8):1.
Chicago/Turabian StyleYao-Kuang Wu; Chun-Yao Huang; Mei-Chen Yang; Chou-Chin Lan; Chih-Hsin Lee; Err-Cheng Chan; Kuei-Tien Chen. 2014. "Nuclear survivin expression: a prognostic factor for the response to taxane–platinum chemotherapy in patients with advanced non-small cell lung cancer." Medical Oncology 31, no. 8: 1.
Patients on anti-tuberculosis treatment may develop acute kidney injury (AKI), but little is known about the renal outcome and prognostic factors, especially in an aging population. This study aimed to calculate the incidence of AKI due to anti-TB drugs and analyze the outcomes and predictors of renal recovery. From 2006 to 2010, patients on anti-TB treatment were identified and their medical records reviewed. Acute kidney injury was defined according to the criteria established by the AKI Network, while renal recovery was defined as a return of serum creatinine to baseline. Predictors of renal recovery were identified by Cox regression analysis. Ninety-nine out of 1394 (7.1%) patients on anti-TB treatment had AKI. Their median age was 68 years and there was male predominance. Sixty (61%) developed AKI within two months of anti-TB treatment, including 11 (11%) with a prior history of rifampin exposure. Thirty (30%) had co-morbid chronic kidney disease or end-stage renal disease. The median time of renal recovery was 39.6 days (range, 1–180 days). Factors predicting renal recovery were the presence of fever, rash, and gastro-intestinal disturbance at the onset of AKI. Sixty-two of the 71 (87%) patients who recovered from AKI had successful re-introduction or continuation of rifampin. Renal function impairment is not a rare complication during anti-TB treatment in an elderly population. The presence of fever and rash may be associated with renal recovery. Rifampin can still be used in most patients who recover from AKI.
Chia-Hao Chang; Yen-Fu Chen; Vin-Cent Wu; Chin-Chung Shu; Chih-Hsin Lee; Jann-Yuan Wang; Li-Na Lee; Chong-Jen Yu. Acute kidney injury due to anti-tuberculosis drugs: a five-year experience in an aging population. BMC Infectious Diseases 2014, 14, 23 -23.
AMA StyleChia-Hao Chang, Yen-Fu Chen, Vin-Cent Wu, Chin-Chung Shu, Chih-Hsin Lee, Jann-Yuan Wang, Li-Na Lee, Chong-Jen Yu. Acute kidney injury due to anti-tuberculosis drugs: a five-year experience in an aging population. BMC Infectious Diseases. 2014; 14 (1):23-23.
Chicago/Turabian StyleChia-Hao Chang; Yen-Fu Chen; Vin-Cent Wu; Chin-Chung Shu; Chih-Hsin Lee; Jann-Yuan Wang; Li-Na Lee; Chong-Jen Yu. 2014. "Acute kidney injury due to anti-tuberculosis drugs: a five-year experience in an aging population." BMC Infectious Diseases 14, no. 1: 23-23.