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Lee YM, Liu YM, Chen TC. Disseminated Cryptococcus neoformans infection involving multiple bones and lung in an immunocompetent patient: a case report. BMC Infect Dis 2024; 24:397. [PMID: 38609851 PMCID: PMC11015676 DOI: 10.1186/s12879-024-09264-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/26/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Cryptococcal osteomyelitis is a rare and potentially serious condition, typically encountered in individuals with compromised immune systems. This case underscores the unusual occurrence of disseminated Cryptococcosis in an immunocompetent person, involving multiple bones and lungs, with Cryptococcus neoformans identified as the causative agent. CASE PRESENTATION An Indonesian man, previously in good health, presented with a chief complaint of successive multiple bone pain lasting for more one month, without any prior history of trauma. Additionally, he reported a recent onset of fever. On physical examination, tenderness was observed in the left lateral chest wall and right iliac crest. Laboratory findings indicated mildly elevated inflammatory markers. A computed tomography (CT) scan of the chest revealed an ovoid solid nodule in the right lower lung and multifocal osteolytic lesions in the sternum, ribs, and humeral head. A magnetic resonance imaging (MRI) study of the sacrum showed multiple lesions in the bilateral iliac bone and the lower L4 vertebral body. Confirmation of Cryptococcal osteomyelitis involved a fine-needle biopsy and culture, identifying Cryptococcus neoformans in the aspirate. The patient responded positively to targeted antifungal treatments, leading to a gradual improvement in his condition. CONCLUSIONS This case emphasizes the need to consider Cryptococcus neoformans osteomyelitis in immunocompetent patients with bone pain. A definitive diagnosis involves a fine-needle biopsy for pathology and culture, and prompt initiation of appropriate antifungal treatment has proven effective in preventing mortality.
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Affiliation(s)
- Yang-Ming Lee
- Department of Internal Medicine, Changhua Christian Hospital, 135 Nanhsiao Street, 500, Changhua, Taiwan.
| | - Yuag-Meng Liu
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Tsung-Chia Chen
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung City, Taiwan
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Axfors C, Schmitt AM, Janiaud P, Van't Hooft J, Abd-Elsalam S, Abdo EF, Abella BS, Akram J, Amaravadi RK, Angus DC, Arabi YM, Azhar S, Baden LR, Baker AW, Belkhir L, Benfield T, Berrevoets MAH, Chen CP, Chen TC, Cheng SH, Cheng CY, Chung WS, Cohen YZ, Cowan LN, Dalgard O, de Almeida E Val FF, de Lacerda MVG, de Melo GC, Derde L, Dubee V, Elfakir A, Gordon AC, Hernandez-Cardenas CM, Hills T, Hoepelman AIM, Huang YW, Igau B, Jin R, Jurado-Camacho F, Khan KS, Kremsner PG, Kreuels B, Kuo CY, Le T, Lin YC, Lin WP, Lin TH, Lyngbakken MN, McArthur C, McVerry BJ, Meza-Meneses P, Monteiro WM, Morpeth SC, Mourad A, Mulligan MJ, Murthy S, Naggie S, Narayanasamy S, Nichol A, Novack LA, O'Brien SM, Okeke NL, Perez L, Perez-Padilla R, Perrin L, Remigio-Luna A, Rivera-Martinez NE, Rockhold FW, Rodriguez-Llamazares S, Rolfe R, Rosa R, Røsjø H, Sampaio VS, Seto TB, Shahzad M, Soliman S, Stout JE, Thirion-Romero I, Troxel AB, Tseng TY, Turner NA, Ulrich RJ, Walsh SR, Webb SA, Weehuizen JM, Velinova M, Wong HL, Wrenn R, Zampieri FG, Zhong W, Moher D, Goodman SN, Ioannidis JPA, Hemkens LG. Author Correction: Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials. Nat Commun 2024; 15:1075. [PMID: 38316844 PMCID: PMC10844287 DOI: 10.1038/s41467-024-45360-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024] Open
Affiliation(s)
- Cathrine Axfors
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Andreas M Schmitt
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Medical Oncology, University of Basel, Basel, Switzerland
| | - Perrine Janiaud
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Janneke Van't Hooft
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
- Amsterdam University Medical Center, Amsterdam University, Amsterdam, the Netherlands
| | - Sherief Abd-Elsalam
- Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ehab F Abdo
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Benjamin S Abella
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Javed Akram
- Department of Internal Medicine, Vice Chancellor, University of Health Sciences, Lahore, Punjab, Pakistan
| | - Ravi K Amaravadi
- Abramson Cancer Center and Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Derek C Angus
- Department of Critical Care Medicine, The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, University of Pittsburgh, Pittsburgh, PA, USA
- the UPMC Health System Office of Healthcare Innovation, University of Pittsburgh Medical Centre, Pittsburgh, PA, USA
| | - Yaseen M Arabi
- Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Shehnoor Azhar
- Department of Public Health, University of Health Sciences, Lahore, Punjab, Pakistan
| | - Lindsey R Baden
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Arthur W Baker
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Leila Belkhir
- Infectious Diseases Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Thomas Benfield
- Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital, Amager and Hvidovre, Hvidovre, Denmark
| | - Marvin A H Berrevoets
- Department of Internal Medicine, Elisabeth-Tweesteden hospital, Tilburg, Netherlands
| | - Cheng-Pin Chen
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Tsung-Chia Chen
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Shu-Hsing Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Chien-Yu Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Wei-Sheng Chung
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | | | | | - Olav Dalgard
- Department of Infectious Diseases, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Marcus V G de Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil
- Instituto Leonidas e Maria Deane - ILMD, FIOCRUZ-AM, Manaus, AM, Brazil
| | - Gisely C de Melo
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil
- Universidade do Estado do Amazonas, Manaus, AM, Brazil
| | - Lennie Derde
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Intensive Care Centre, University Medical Center Utrecht, Utrecht, Netherlands
| | - Vincent Dubee
- Infectious and Tropical Diseases Department, Angers University Hospital, Angers, France
| | | | - Anthony C Gordon
- Department of Surgery and Cancer, Anaesthetics, Pain Medicine, and Intensive Care Medicine, Imperial College London and Imperial College Healthcare NHS Trust, London, UK
| | - Carmen M Hernandez-Cardenas
- Critical Care Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Thomas Hills
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Auckland City Hospital, Auckland, New Zealand
| | - Andy I M Hoepelman
- Department of Infectious Diseases, University Medical Center Utrecht, Utrecht, Netherlands
| | - Yi-Wen Huang
- Department of Internal Medicine, Chang Hua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
| | | | - Ronghua Jin
- Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Felipe Jurado-Camacho
- Critical Care Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Khalid S Khan
- Department of Preventive Medicine & Public Health, University of Granada, Hospital Real, Avenida del Hospicio, Granada, Granada, Spain
| | - Peter G Kremsner
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research, Partner Site Tübingen, Tübingen, Germany
| | - Benno Kreuels
- Department of Medicine, Division of Tropical Medicine and Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Cheng-Yu Kuo
- Department of Internal Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
| | - Thuy Le
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Yi-Chun Lin
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Wu-Pu Lin
- Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Tse-Hung Lin
- Department of Internal Medicine, Chang Hua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
| | - Magnus Nakrem Lyngbakken
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Colin McArthur
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Auckland City Hospital, Auckland, New Zealand
- School of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Bryan J McVerry
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Wuelton M Monteiro
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil
- Universidade do Estado do Amazonas, Manaus, AM, Brazil
| | | | - Ahmad Mourad
- Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA
| | - Mark J Mulligan
- Department of Microbiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Internal Medicine, Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, NY, USA
| | - Srinivas Murthy
- University of British Columbia School of Medicine, Vancouver, BC, Canada
| | - Susanna Naggie
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Shanti Narayanasamy
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Alistair Nichol
- School of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
- Department of Intensive Care, Alfred Health, Melbourne, VIC, Australia
- Department of Anesthesia and Intensive Care, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Lewis A Novack
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sean M O'Brien
- Department of Biostatistics and Bioinformatics, Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA
| | - Nwora Lance Okeke
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | | | - Rogelio Perez-Padilla
- Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | | | - Arantxa Remigio-Luna
- Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | | | - Frank W Rockhold
- Department of Biostatistics and Bioinformatics, Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA
| | - Sebastian Rodriguez-Llamazares
- Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Robert Rolfe
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | | | - Helge Røsjø
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Research and Innovation, Akershus University Hospital, Lørenskog, Norway
| | - Vanderson S Sampaio
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil
- Fundação de Vigilância em Saúde do Amazonas, Manaus, AM, Brazil
| | - Todd B Seto
- University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
- The Queen's Medical Center, Honolulu, HI, USA
| | - Muhammad Shahzad
- Department of Pharmacology, University of Health Sciences, Lahore, Punjab, Pakistan
| | - Shaimaa Soliman
- Public Health and Community Medicine, Menoufia University, Menoufia, Egypt
| | - Jason E Stout
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Ireri Thirion-Romero
- Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Andrea B Troxel
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Ting-Yu Tseng
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Nicholas A Turner
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Robert J Ulrich
- Department of Medicine, Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, NY, USA
| | - Stephen R Walsh
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Steve A Webb
- School of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
- St. John of God Hospital, Subiaco, WA, Australia
| | - Jesper M Weehuizen
- Department of Infectious Diseases, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Hon-Lai Wong
- Department of Internal Medicine, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Rebekah Wrenn
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Fernando G Zampieri
- Research Institute, HCor-Hospital do Coração, São Paulo, Brazil
- Research Institute, BRICNet-Brazilian Research in Intensive Care Network, São Paulo, Brazil
- IDor Research Institute, São Paulo, Brazil
| | - Wu Zhong
- National Engineering Research Center for the Emergency Drug, Beijing Institute of Pharmacology and Toxicology, Beijing, People's Republic of China
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Steven N Goodman
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - John P A Ioannidis
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
- Meta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany
| | - Lars G Hemkens
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
- Meta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany.
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Chen TC. Monkeypox presenting with unusual sign of penis ulcer in a newly diagnosed human immunodeficiency virus infected patient. J Formos Med Assoc 2024; 123:293-294. [PMID: 37758542 DOI: 10.1016/j.jfma.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 09/12/2023] [Indexed: 09/29/2023] Open
Affiliation(s)
- Tsung-Chia Chen
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, No.199, Sec 1, San-Min Road, Taichung City, Taiwan.
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Chen TC, Wu CH. Non-Tuberculous Mycobacterium facial cellulitis in an immunocompromised rheumatoid arthritis patient - Skin biopsy can help. IDCases 2023; 33:e01869. [PMID: 37583785 PMCID: PMC10424121 DOI: 10.1016/j.idcr.2023.e01869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/17/2023] Open
Affiliation(s)
- Tsung-Chia Chen
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Chia-Hua Wu
- Department of Dermatology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
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Tsai YH, Yan YJ, Li YS, Chang CH, Haung CC, Chen TC, Lin SG, Ou-Yang M. Development and verification of the coaxial heterogeneous hyperspectral imaging system. Rev Sci Instrum 2022; 93:063105. [PMID: 35778029 DOI: 10.1063/5.0088474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
A hyperspectral imaging system (HIS) is a helpful tool that acquires spatial and spectral information from a target. This study developed a coaxial heterogeneous HIS (CHHIS) to collect spectral images with wavelengths ranging from 400 to 1700 nm. In this system, a visible (VIS) spectrometer and a short-wave infrared (SWIR) spectrometer are combined with a coaxial optical path to share the same field of view. This structure reduces the complexity of spatial registration and maintains the scanning duration of two spectrometers as that of a single spectrometer. The spectrometers are also replaceable for extending the detecting spectral range of the system. The calibration methodologies, including spatial correction, spectral calibration, and reflectance calibration, were developed for this system. The signal-to-noise ratio of VIS and SWIR spectrometers in the CHHIS was up to 40 and 60 dB when the exposure time of the VIS and SWIR imaging sensors was 1000 and 10 ms, respectively. When the target distance was at 600 mm, the spatial error of VIS and SWIR images in the scanning direction was less than 1 pixel; these results proved that the system was stable.
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Affiliation(s)
- Y H Tsai
- Institute of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Y J Yan
- Institute of Electrical and Control Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Y S Li
- Institute of Electrical and Control Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - C H Chang
- Institute of Biomedical Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - C C Haung
- Department of Tropical Fruit Trees (Fengshan Tropical Horticultural Experiment Branch), Taiwan Agricultural Research Institute, Kaohsiung 30010, Taiwan
| | - T C Chen
- Department of Aerospace and Systems Engineering, Feng Chia University, Taichung 30010, Taiwan
| | - S G Lin
- Department of Communication, Navigation and Control Engineering, National Taiwan Ocean University, Keelung, Taiwan
| | - M Ou-Yang
- Institute of Electrical and Computer Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
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Chiang HY, Chen TC, Lin CC, Ho LC, Kuo CC, Chi CY. Trend and Predictors of Short-term Mortality of Adult Bacteremia at Emergency Departments: A 14-Year Cohort Study of 14 625 Patients. Open Forum Infect Dis 2021; 8:ofab485. [PMID: 34805430 PMCID: PMC8598924 DOI: 10.1093/ofid/ofab485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/22/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Bacteremia is a life-threatening condition with a high mortality rate in critical care and emergency settings. The current study investigated the trend of mortality and developed predictive models of mortality for adults with bacteremia at emergency departments (EDs). METHODS We conducted a retrospective cohort study of adults with bacteremia at the ED of China Medical University Hospital. Patient data were obtained from the Clinical Research Data Repository, and mortality information was obtained from the National Death Registry. We developed a new model to predict 7-day mortality in the derivation population and compared the model performance of the new model with Pitt Bacteremia Score (PBS) and Bloodstream Infection Mortality Risk Score (BSIMRS) in the validation population. RESULTS We identified 14625 adult patients with first-time bacteremia at the ED, of whom 8.4% died within 7 days. From 2003 to 2016, both the cumulative incidence and 7-day mortality rate of bacteremia decreased significantly. The ED bacteremia mortality (ED-BM) model included PBS parameters, age, infection source, baseline steroid use, and biochemical profiles (estimated glomerular filtration rate, platelet, blood urea nitrogen, potassium, and hemoglobin) for predicting 7-day mortality. The discrimination performance of the ED-BM model (area under curve [AUC], 0.903) was significantly better than that of PBS (AUC, 0.848) or BSIMRS (AUC, 0.885). CONCLUSIONS Although the cumulative incidence and mortality of ED bacteremia decreased, its mortality burden remains critical. The proposed ED-BM model had significantly better model performance than other scoring systems in predicting short-term mortality for adult patients with bacteremia at EDs.
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Affiliation(s)
- Hsiu-Yin Chiang
- Big Data Center, China Medical University Hospital, Taichung, Taiwan
| | - Tsung-Chia Chen
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Che-Chen Lin
- Big Data Center, China Medical University Hospital, Taichung, Taiwan
| | - Lu-Ching Ho
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan
| | - Chin-Chi Kuo
- Big Data Center, China Medical University Hospital, Taichung, Taiwan
- Division of Nephrology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yu Chi
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
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Axfors C, Schmitt AM, Janiaud P, van’t Hooft J, Abd-Elsalam S, Abdo EF, Abella BS, Akram J, Amaravadi RK, Angus DC, Arabi YM, Azhar S, Baden LR, Baker AW, Belkhir L, Benfield T, Berrevoets MAH, Chen CP, Chen TC, Cheng SH, Cheng CY, Chung WS, Cohen YZ, Cowan LN, Dalgard O, de Almeida e Val FF, de Lacerda MVG, de Melo GC, Derde L, Dubee V, Elfakir A, Gordon AC, Hernandez-Cardenas CM, Hills T, Hoepelman AIM, Huang YW, Igau B, Jin R, Jurado-Camacho F, Khan KS, Kremsner PG, Kreuels B, Kuo CY, Le T, Lin YC, Lin WP, Lin TH, Lyngbakken MN, McArthur C, McVerry BJ, Meza-Meneses P, Monteiro WM, Morpeth SC, Mourad A, Mulligan MJ, Murthy S, Naggie S, Narayanasamy S, Nichol A, Novack LA, O’Brien SM, Okeke NL, Perez L, Perez-Padilla R, Perrin L, Remigio-Luna A, Rivera-Martinez NE, Rockhold FW, Rodriguez-Llamazares S, Rolfe R, Rosa R, Røsjø H, Sampaio VS, Seto TB, Shahzad M, Soliman S, Stout JE, Thirion-Romero I, Troxel AB, Tseng TY, Turner NA, Ulrich RJ, Walsh SR, Webb SA, Weehuizen JM, Velinova M, Wong HL, Wrenn R, Zampieri FG, Zhong W, Moher D, Goodman SN, Ioannidis JPA, Hemkens LG. Author Correction: Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials. Nat Commun 2021; 12:3001. [PMID: 33990619 PMCID: PMC8121133 DOI: 10.1038/s41467-021-23559-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Affiliation(s)
- Cathrine Axfors
- grid.168010.e0000000419368956Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA USA ,grid.8993.b0000 0004 1936 9457Department for Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Andreas M. Schmitt
- grid.6612.30000 0004 1937 0642Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland ,grid.6612.30000 0004 1937 0642Department of Medical Oncology, University of Basel, Basel, Switzerland
| | - Perrine Janiaud
- grid.6612.30000 0004 1937 0642Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Janneke van’t Hooft
- grid.168010.e0000000419368956Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA USA ,grid.7177.60000000084992262Amsterdam University Medical Center, Amsterdam University, Amsterdam, the Netherlands
| | - Sherief Abd-Elsalam
- grid.412258.80000 0000 9477 7793Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ehab F. Abdo
- grid.252487.e0000 0000 8632 679XTropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Benjamin S. Abella
- grid.25879.310000 0004 1936 8972Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Javed Akram
- grid.412956.dDepartment of Internal Medicine, Vice Chancellor, University of Health Sciences, Lahore, Punjab Pakistan
| | - Ravi K. Amaravadi
- grid.25879.310000 0004 1936 8972Abramson Cancer Center and Department of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Derek C. Angus
- grid.21925.3d0000 0004 1936 9000Department of Critical Care Medicine, The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, University of Pittsburgh, Pittsburgh, PA USA ,grid.21925.3d0000 0004 1936 9000the UPMC Health System Office of Healthcare Innovation, University of Pittsburgh Medical Centre, Pittsburgh, PA USA
| | - Yaseen M. Arabi
- grid.412149.b0000 0004 0608 0662Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Shehnoor Azhar
- grid.412956.dDepartment of Public Health, University of Health Sciences, Lahore, Punjab Pakistan
| | - Lindsey R. Baden
- grid.62560.370000 0004 0378 8294Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, MA USA
| | - Arthur W. Baker
- grid.189509.c0000000100241216Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC USA
| | - Leila Belkhir
- grid.7942.80000 0001 2294 713XInfectious Diseases Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Thomas Benfield
- grid.4973.90000 0004 0646 7373Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital, Amager and Hvidovre, Hvidovre, Denmark
| | - Marvin A. H. Berrevoets
- grid.416373.4Department of Internal Medicine, Elisabeth-Tweesteden hospital, Tilburg, Netherlands
| | - Cheng-Pin Chen
- grid.454740.6Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Tsung-Chia Chen
- grid.454740.6Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Shu-Hsing Cheng
- grid.454740.6Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Chien-Yu Cheng
- grid.454740.6Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Wei-Sheng Chung
- grid.454740.6Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | | | - Lisa N. Cowan
- grid.417555.70000 0000 8814 392XSanofi, Bridgewater, NJ USA
| | - Olav Dalgard
- grid.411279.80000 0000 9637 455XDepartment of Infectious Diseases, Division of Medicine, Akershus University Hospital, Lørenskog, Norway ,grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Marcus V. G. de Lacerda
- grid.418153.a0000 0004 0486 0972Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM Brazil ,Instituto Leonidas e Maria Deane – ILMD, FIOCRUZ-AM, Manaus, AM Brazil
| | - Gisely C. de Melo
- grid.418153.a0000 0004 0486 0972Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM Brazil ,grid.412290.c0000 0000 8024 0602Universidade do Estado do Amazonas, Manaus, AM Brazil
| | - Lennie Derde
- grid.7692.a0000000090126352Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands ,grid.7692.a0000000090126352Intensive Care Centre, University Medical Center Utrecht, Utrecht, Netherlands
| | - Vincent Dubee
- grid.411147.60000 0004 0472 0283Infectious and Tropical Diseases Department, Angers University Hospital, Angers, France
| | | | - Anthony C. Gordon
- grid.417895.60000 0001 0693 2181Department of Surgery and Cancer, Anaesthetics, Pain Medicine, and Intensive Care Medicine, Imperial College London and Imperial College Healthcare NHS Trust, London, UK
| | - Carmen M. Hernandez-Cardenas
- grid.419179.30000 0000 8515 3604Critical Care Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Thomas Hills
- grid.415117.70000 0004 0445 6830Medical Research Institute of New Zealand, Wellington, New Zealand ,grid.414055.10000 0000 9027 2851Auckland City Hospital, Auckland, New Zealand
| | - Andy I. M. Hoepelman
- grid.7692.a0000000090126352Department of Infectious Diseases, University Medical Center Utrecht, Utrecht, Netherlands
| | - Yi-Wen Huang
- grid.454740.6Department of Internal Medicine, Chang Hua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
| | - Bruno Igau
- grid.417555.70000 0000 8814 392XSanofi, Bridgewater, NJ USA
| | - Ronghua Jin
- grid.24696.3f0000 0004 0369 153XBeijing Youan Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Felipe Jurado-Camacho
- grid.419179.30000 0000 8515 3604Critical Care Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Khalid S. Khan
- grid.4489.10000000121678994Department of Preventive Medicine & Public Health, University of Granada, Hospital Real, Avenida del Hospicio, Granada, Granada, Spain
| | - Peter G. Kremsner
- grid.10392.390000 0001 2190 1447Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany ,grid.452268.fCentre de Recherches Médicales de Lambaréné, Lambaréné, Gabon ,grid.452463.2German Center for Infection Research, Partner Site Tübingen, Tübingen, Germany
| | - Benno Kreuels
- grid.13648.380000 0001 2180 3484Department of Medicine, Division of Tropical Medicine and Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ,grid.424065.10000 0001 0701 3136Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Cheng-Yu Kuo
- grid.454740.6Department of Internal Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
| | - Thuy Le
- grid.189509.c0000000100241216Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC USA
| | - Yi-Chun Lin
- grid.454740.6Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Wu-Pu Lin
- grid.454740.6Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Tse-Hung Lin
- grid.454740.6Department of Internal Medicine, Chang Hua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
| | - Magnus Nakrem Lyngbakken
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway ,grid.411279.80000 0000 9637 455XDivision of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Colin McArthur
- grid.415117.70000 0004 0445 6830Medical Research Institute of New Zealand, Wellington, New Zealand ,grid.414055.10000 0000 9027 2851Auckland City Hospital, Auckland, New Zealand ,grid.1002.30000 0004 1936 7857School of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC Australia
| | - Bryan J. McVerry
- grid.21925.3d0000 0004 1936 9000Department of Medicine, University of Pittsburgh, Pittsburgh, PA USA
| | | | - Wuelton M. Monteiro
- grid.418153.a0000 0004 0486 0972Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM Brazil ,grid.412290.c0000 0000 8024 0602Universidade do Estado do Amazonas, Manaus, AM Brazil
| | - Susan C. Morpeth
- grid.415534.20000 0004 0372 0644Middlemore Hospital, Auckland, New Zealand
| | - Ahmad Mourad
- grid.189509.c0000000100241216Department of Medicine, Duke University Medical Center, Durham, NC 27710 USA
| | - Mark J. Mulligan
- grid.137628.90000 0004 1936 8753Department of Microbiology, NYU Grossman School of Medicine, New York, NY USA ,grid.137628.90000 0004 1936 8753Department of Internal Medicine, Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, NY USA
| | - Srinivas Murthy
- grid.17091.3e0000 0001 2288 9830University of British Columbia School of Medicine, Vancouver, BC Canada
| | - Susanna Naggie
- grid.189509.c0000000100241216Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC USA
| | - Shanti Narayanasamy
- grid.189509.c0000000100241216Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC USA
| | - Alistair Nichol
- grid.1002.30000 0004 1936 7857School of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC Australia ,grid.267362.40000 0004 0432 5259Department of Intensive Care, Alfred Health, Melbourne, VIC Australia ,grid.412751.40000 0001 0315 8143Department of Anesthesia and Intensive Care, St Vincent’s University Hospital, Dublin, Ireland ,grid.7886.10000 0001 0768 2743School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Lewis A. Novack
- grid.38142.3c000000041936754XDivision of Infectious Diseases, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
| | - Sean M. O’Brien
- grid.189509.c0000000100241216Department of Biostatistics and Bioinformatics, Duke University Medical Center and Duke Clinical Research Institute, Durham, NC USA
| | - Nwora Lance Okeke
- grid.189509.c0000000100241216Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC USA
| | | | - Rogelio Perez-Padilla
- grid.419179.30000 0000 8515 3604Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | | | - Arantxa Remigio-Luna
- grid.419179.30000 0000 8515 3604Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | | | - Frank W. Rockhold
- grid.189509.c0000000100241216Department of Biostatistics and Bioinformatics, Duke University Medical Center and Duke Clinical Research Institute, Durham, NC USA
| | - Sebastian Rodriguez-Llamazares
- grid.419179.30000 0000 8515 3604Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Robert Rolfe
- grid.189509.c0000000100241216Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC USA
| | - Rossana Rosa
- grid.430652.60000 0004 0396 2096UnityPoint Health, Des Moines, IA USA
| | - Helge Røsjø
- grid.5510.10000 0004 1936 8921Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway ,grid.411279.80000 0000 9637 455XDivision of Research and Innovation, Akershus University Hospital, Lørenskog, Norway
| | - Vanderson S. Sampaio
- grid.418153.a0000 0004 0486 0972Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM Brazil ,Fundação de Vigilância em Saúde do Amazonas, Manaus, AM Brazil
| | - Todd B. Seto
- grid.410445.00000 0001 2188 0957University of Hawaii John A. Burns School of Medicine, Honolulu, HI USA ,grid.415594.8The Queen’s Medical Center, Honolulu, HI USA
| | - Muhammad Shahzad
- grid.412956.dDepartment of Pharmacology, University of Health Sciences, Lahore, Punjab Pakistan
| | - Shaimaa Soliman
- grid.411775.10000 0004 0621 4712Public Health and Community Medicine, Menoufia University, Menoufia, Egypt
| | - Jason E. Stout
- grid.189509.c0000000100241216Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC USA
| | - Ireri Thirion-Romero
- grid.419179.30000 0000 8515 3604Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Andrea B. Troxel
- grid.137628.90000 0004 1936 8753Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, NY USA
| | - Ting-Yu Tseng
- grid.454740.6Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Nicholas A. Turner
- grid.189509.c0000000100241216Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC USA
| | - Robert J. Ulrich
- grid.137628.90000 0004 1936 8753Department of Medicine, Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, NY USA
| | - Stephen R. Walsh
- grid.62560.370000 0004 0378 8294Division of Infectious Diseases, Brigham and Women’s Hospital, Boston, MA USA
| | - Steve A. Webb
- grid.1002.30000 0004 1936 7857School of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC Australia ,grid.460013.0St. John of God Hospital, Subiaco, WA Australia
| | - Jesper M. Weehuizen
- grid.7692.a0000000090126352Department of Infectious Diseases, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Hon-Lai Wong
- grid.454740.6Department of Internal Medicine, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Rebekah Wrenn
- grid.189509.c0000000100241216Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC USA
| | - Fernando G. Zampieri
- grid.477370.00000 0004 0454 243XResearch Institute, HCor-Hospital do Coração, São Paulo, Brazil ,Research Institute, BRICNet - Brazilian Research in Intensive Care Network, São Paulo, Brazil ,IDor Research Institute, São Paulo, Brazil
| | - Wu Zhong
- grid.410740.60000 0004 1803 4911National Engineering Research Center for the Emergency Drug, Beijing Institute of Pharmacology and Toxicology, Beijing, People’s Republic of China
| | - David Moher
- grid.412687.e0000 0000 9606 5108Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Steven N. Goodman
- grid.168010.e0000000419368956Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA USA ,grid.168010.e0000000419368956Stanford University School of Medicine, Stanford, CA USA ,grid.168010.e0000000419368956Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA USA
| | - John P. A. Ioannidis
- grid.168010.e0000000419368956Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA USA ,grid.168010.e0000000419368956Stanford University School of Medicine, Stanford, CA USA ,grid.168010.e0000000419368956Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA USA ,grid.168010.e0000000419368956Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA USA ,grid.484013.aMeta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany
| | - Lars G. Hemkens
- grid.168010.e0000000419368956Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA USA ,grid.6612.30000 0004 1937 0642Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland ,grid.484013.aMeta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany
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8
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Axfors C, Schmitt AM, Janiaud P, Van't Hooft J, Abd-Elsalam S, Abdo EF, Abella BS, Akram J, Amaravadi RK, Angus DC, Arabi YM, Azhar S, Baden LR, Baker AW, Belkhir L, Benfield T, Berrevoets MAH, Chen CP, Chen TC, Cheng SH, Cheng CY, Chung WS, Cohen YZ, Cowan LN, Dalgard O, de Almeida E Val FF, de Lacerda MVG, de Melo GC, Derde L, Dubee V, Elfakir A, Gordon AC, Hernandez-Cardenas CM, Hills T, Hoepelman AIM, Huang YW, Igau B, Jin R, Jurado-Camacho F, Khan KS, Kremsner PG, Kreuels B, Kuo CY, Le T, Lin YC, Lin WP, Lin TH, Lyngbakken MN, McArthur C, McVerry BJ, Meza-Meneses P, Monteiro WM, Morpeth SC, Mourad A, Mulligan MJ, Murthy S, Naggie S, Narayanasamy S, Nichol A, Novack LA, O'Brien SM, Okeke NL, Perez L, Perez-Padilla R, Perrin L, Remigio-Luna A, Rivera-Martinez NE, Rockhold FW, Rodriguez-Llamazares S, Rolfe R, Rosa R, Røsjø H, Sampaio VS, Seto TB, Shahzad M, Soliman S, Stout JE, Thirion-Romero I, Troxel AB, Tseng TY, Turner NA, Ulrich RJ, Walsh SR, Webb SA, Weehuizen JM, Velinova M, Wong HL, Wrenn R, Zampieri FG, Zhong W, Moher D, Goodman SN, Ioannidis JPA, Hemkens LG. Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19 from an international collaborative meta-analysis of randomized trials. Nat Commun 2021; 12:2349. [PMID: 33859192 PMCID: PMC8050319 DOI: 10.1038/s41467-021-22446-z] [Citation(s) in RCA: 149] [Impact Index Per Article: 49.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 03/15/2021] [Indexed: 02/06/2023] Open
Abstract
Substantial COVID-19 research investment has been allocated to randomized clinical trials (RCTs) on hydroxychloroquine/chloroquine, which currently face recruitment challenges or early discontinuation. We aim to estimate the effects of hydroxychloroquine and chloroquine on survival in COVID-19 from all currently available RCT evidence, published and unpublished. We present a rapid meta-analysis of ongoing, completed, or discontinued RCTs on hydroxychloroquine or chloroquine treatment for any COVID-19 patients (protocol: https://osf.io/QESV4/ ). We systematically identified unpublished RCTs (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, Cochrane COVID-registry up to June 11, 2020), and published RCTs (PubMed, medRxiv and bioRxiv up to October 16, 2020). All-cause mortality has been extracted (publications/preprints) or requested from investigators and combined in random-effects meta-analyses, calculating odds ratios (ORs) with 95% confidence intervals (CIs), separately for hydroxychloroquine and chloroquine. Prespecified subgroup analyses include patient setting, diagnostic confirmation, control type, and publication status. Sixty-three trials were potentially eligible. We included 14 unpublished trials (1308 patients) and 14 publications/preprints (9011 patients). Results for hydroxychloroquine are dominated by RECOVERY and WHO SOLIDARITY, two highly pragmatic trials, which employed relatively high doses and included 4716 and 1853 patients, respectively (67% of the total sample size). The combined OR on all-cause mortality for hydroxychloroquine is 1.11 (95% CI: 1.02, 1.20; I² = 0%; 26 trials; 10,012 patients) and for chloroquine 1.77 (95%CI: 0.15, 21.13, I² = 0%; 4 trials; 307 patients). We identified no subgroup effects. We found that treatment with hydroxychloroquine is associated with increased mortality in COVID-19 patients, and there is no benefit of chloroquine. Findings have unclear generalizability to outpatients, children, pregnant women, and people with comorbidities.
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Affiliation(s)
- Cathrine Axfors
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Andreas M Schmitt
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
- Department of Medical Oncology, University of Basel, Basel, Switzerland
| | - Perrine Janiaud
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Janneke Van't Hooft
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
- Amsterdam University Medical Center, Amsterdam University, Amsterdam, the Netherlands
| | - Sherief Abd-Elsalam
- Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Ehab F Abdo
- Tropical Medicine and Gastroenterology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Benjamin S Abella
- Department of Emergency Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Javed Akram
- Department of Internal Medicine, Vice Chancellor, University of Health Sciences, Lahore, Punjab, Pakistan
| | - Ravi K Amaravadi
- Abramson Cancer Center and Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Derek C Angus
- Department of Critical Care Medicine, The Clinical Research Investigation and Systems Modeling of Acute Illness (CRISMA) Center, University of Pittsburgh, Pittsburgh, PA, USA
- the UPMC Health System Office of Healthcare Innovation, University of Pittsburgh Medical Centre, Pittsburgh, PA, USA
| | - Yaseen M Arabi
- Intensive Care Department, King Saud Bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Shehnoor Azhar
- Department of Public Health, University of Health Sciences, Lahore, Punjab, Pakistan
| | - Lindsey R Baden
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Arthur W Baker
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Leila Belkhir
- Infectious Diseases Department, Cliniques universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Thomas Benfield
- Center of Research & Disruption of Infectious Diseases, Department of Infectious Diseases, Copenhagen University Hospital, Amager and Hvidovre, Hvidovre, Denmark
| | - Marvin A H Berrevoets
- Department of Internal Medicine, Elisabeth-Tweesteden hospital, Tilburg, Netherlands
| | - Cheng-Pin Chen
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Tsung-Chia Chen
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Shu-Hsing Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Chien-Yu Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Wei-Sheng Chung
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | | | | | - Olav Dalgard
- Department of Infectious Diseases, Division of Medicine, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Marcus V G de Lacerda
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil
- Instituto Leonidas e Maria Deane - ILMD, FIOCRUZ-AM, Manaus, AM, Brazil
| | - Gisely C de Melo
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil
- Universidade do Estado do Amazonas, Manaus, AM, Brazil
| | - Lennie Derde
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
- Intensive Care Centre, University Medical Center Utrecht, Utrecht, Netherlands
| | - Vincent Dubee
- Infectious and Tropical Diseases Department, Angers University Hospital, Angers, France
| | | | - Anthony C Gordon
- Department of Surgery and Cancer, Anaesthetics, Pain Medicine, and Intensive Care Medicine, Imperial College London and Imperial College Healthcare NHS Trust, London, UK
| | - Carmen M Hernandez-Cardenas
- Critical Care Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Thomas Hills
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Auckland City Hospital, Auckland, New Zealand
| | - Andy I M Hoepelman
- Department of Infectious Diseases, University Medical Center Utrecht, Utrecht, Netherlands
| | - Yi-Wen Huang
- Department of Internal Medicine, Chang Hua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
| | | | - Ronghua Jin
- Beijing Youan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Felipe Jurado-Camacho
- Critical Care Department, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Khalid S Khan
- Department of Preventive Medicine & Public Health, University of Granada, Hospital Real, Avenida del Hospicio, Granada, Granada, Spain
| | - Peter G Kremsner
- Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- German Center for Infection Research, Partner Site Tübingen, Tübingen, Germany
| | - Benno Kreuels
- Department of Medicine, Division of Tropical Medicine and Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Cheng-Yu Kuo
- Department of Internal Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
| | - Thuy Le
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Yi-Chun Lin
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Wu-Pu Lin
- Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Tse-Hung Lin
- Department of Internal Medicine, Chang Hua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
| | - Magnus Nakrem Lyngbakken
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Colin McArthur
- Medical Research Institute of New Zealand, Wellington, New Zealand
- Auckland City Hospital, Auckland, New Zealand
- School of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Bryan J McVerry
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Wuelton M Monteiro
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil
- Universidade do Estado do Amazonas, Manaus, AM, Brazil
| | | | - Ahmad Mourad
- Department of Medicine, Duke University Medical Center, Durham, NC, 27710, USA
| | - Mark J Mulligan
- Department of Microbiology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Internal Medicine, Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, NY, USA
| | - Srinivas Murthy
- University of British Columbia School of Medicine, Vancouver, BC, Canada
| | - Susanna Naggie
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Shanti Narayanasamy
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Alistair Nichol
- School of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
- Department of Intensive Care, Alfred Health, Melbourne, VIC, Australia
- Department of Anesthesia and Intensive Care, St Vincent's University Hospital, Dublin, Ireland
- School of Medicine and Medical Sciences, University College Dublin, Dublin, Ireland
| | - Lewis A Novack
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sean M O'Brien
- Department of Biostatistics and Bioinformatics, Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA
| | - Nwora Lance Okeke
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | | | - Rogelio Perez-Padilla
- Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | | | - Arantxa Remigio-Luna
- Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | | | - Frank W Rockhold
- Department of Biostatistics and Bioinformatics, Duke University Medical Center and Duke Clinical Research Institute, Durham, NC, USA
| | - Sebastian Rodriguez-Llamazares
- Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Robert Rolfe
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | | | - Helge Røsjø
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Division of Research and Innovation, Akershus University Hospital, Lørenskog, Norway
| | - Vanderson S Sampaio
- Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, AM, Brazil
- Fundação de Vigilância em Saúde do Amazonas, Manaus, AM, Brazil
| | - Todd B Seto
- University of Hawaii John A. Burns School of Medicine, Honolulu, HI, USA
- The Queen's Medical Center, Honolulu, HI, USA
| | - Muhammad Shahzad
- Department of Pharmacology, University of Health Sciences, Lahore, Punjab, Pakistan
| | - Shaimaa Soliman
- Public Health and Community Medicine, Menoufia University, Menoufia, Egypt
| | - Jason E Stout
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Ireri Thirion-Romero
- Department of Smoking and COPD, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Ciudad de México, Mexico
| | - Andrea B Troxel
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Ting-Yu Tseng
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Nicholas A Turner
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Robert J Ulrich
- Department of Medicine, Division of Infectious Diseases and Immunology, NYU Grossman School of Medicine, New York, NY, USA
| | - Stephen R Walsh
- Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA
| | - Steve A Webb
- School of Epidemiology and Preventive Medicine, Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
- St. John of God Hospital, Subiaco, WA, Australia
| | - Jesper M Weehuizen
- Department of Infectious Diseases, University Medical Center Utrecht, Utrecht, Netherlands
| | | | - Hon-Lai Wong
- Department of Internal Medicine, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan
| | - Rebekah Wrenn
- Department of Medicine, Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, NC, USA
| | - Fernando G Zampieri
- Research Institute, HCor-Hospital do Coração, São Paulo, Brazil
- Research Institute, BRICNet - Brazilian Research in Intensive Care Network, São Paulo, Brazil
- IDor Research Institute, São Paulo, Brazil
| | - Wu Zhong
- National Engineering Research Center for the Emergency Drug, Beijing Institute of Pharmacology and Toxicology, Beijing, People's Republic of China
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Steven N Goodman
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
| | - John P A Ioannidis
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
- Stanford University School of Medicine, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, CA, USA
- Meta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany
| | - Lars G Hemkens
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.
- Department of Clinical Research, University Hospital Basel, University of Basel, Basel, Switzerland.
- Meta-Research Innovation Center Berlin (METRIC-B), Berlin Institute of Health, Berlin, Germany.
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9
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Cheng MY, Hsih WH, Ho MW, Lai YC, Liao WC, Chen CY, Chen TC, Lee YL, Liu PY, Kao CC, Chou CH, Lin PC, Chi CY, Leong LY, Tai CJ, Lu MC. Younger adults with mild-to-moderate COVID-19 exhibited more prevalent olfactory dysfunction in Taiwan. J Microbiol Immunol Infect 2021; 54:794-800. [PMID: 33610511 PMCID: PMC7869675 DOI: 10.1016/j.jmii.2021.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 12/23/2022]
Abstract
Background Coronavirus Disease 2019 (COVID-19) is rapidly transmitted from person to person, causing global pandemic since December 2019. Instantly detecting COVID-19 is crucial for epidemic prevention. In this study, olfactory dysfunction is a significant symptom in mild to moderate COVID-19 patients but relatively rare in other respiratory viral infections. The Taiwan smell identification test (TWSIT) is a speedy and inexpensive option for accurately distinguishing anosmia that also quantifies the degree of anosmia. Using TWSIT in the outpatient clinic for early identifying the patients with mild to moderate COVID-19 can be promising. Methods Nineteen patients confirmed COVID-19 in central Taiwan were collected and divided into two groups: olfactory dysfunction and non-olfactory dysfunction. Demographic characteristics, laboratory findings, and the results of the olfactory test were compared between these two groups. Findings Thirteen (68.4%) of the 19 patients had olfactory dysfunction. The patients with olfactory dysfunction were younger than those without this symptom. The statistical difference in age distribution was significant between these two groups (IQR: 25.5–35.5 vs. IQR: 32.5–60.3; p-value: 0.012). There was no significant difference in gender, smoking history, comorbidities, travel history, respiratory tract infection symptoms, and laboratory findings between these two groups. Conclusion This study demonstrated that young adults were prone to develop olfactory dysfunctions. In the flu season, olfactory dysfunction is considered a specific screening criterion for early detecting COVID-19 in the community. TWSIT can serve as a decent test for quantifying and qualifying olfactory dysfunction.
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Affiliation(s)
- Meng-Yu Cheng
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
| | - Wen-Hsin Hsih
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
| | - Mao-Wang Ho
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yi-Chyi Lai
- Department of Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan; Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Wei-Chih Liao
- Division of Pulmonary and Critical Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yu Chen
- Division of Pulmonary and Critical Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Tsung-Chia Chen
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Yu-Lin Lee
- Division of Infectious Diseases, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Po-Yu Liu
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chih-Chuan Kao
- Division of Infectious Diseases, Department of Internal Medicine, Tungs' Taichung Metroharbor Hospital, Taichung, Taiwan
| | - Chia-Huei Chou
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Po-Chang Lin
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Yu Chi
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Lih-Ying Leong
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Jaan Tai
- Department of Otorhinolaryngology, China Medical University Hospital, Taichung, Taiwan; Department of Health Services Administration, China Medical University, Taichung, Taiwan.
| | - Min-Chi Lu
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Department of Microbiology and Immunology, School of Medicine, China Medical University, Taichung, Taiwan.
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10
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Chen CP, Lin YC, Chen TC, Tseng TY, Wong HL, Kuo CY, Lin WP, Huang SR, Wang WY, Liao JH, Liao CS, Hung YP, Lin TH, Chang TY, Hsiao CF, Huang YW, Chung WS, Cheng CY, Cheng SH. A multicenter, randomized, open-label, controlled trial to evaluate the efficacy and tolerability of hydroxychloroquine and a retrospective study in adult patients with mild to moderate coronavirus disease 2019 (COVID-19). PLoS One 2020; 15:e0242763. [PMID: 33264337 PMCID: PMC7710068 DOI: 10.1371/journal.pone.0242763] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 11/09/2020] [Indexed: 12/23/2022] Open
Abstract
Objective In this study, we evaluated the efficacy of hydroxychloroquine (HCQ) against coronavirus disease 2019 (COVID-19) via a randomized controlled trial (RCT) and a retrospective study. Methods Subjects admitted to 11 designated public hospitals in Taiwan between April 1 and May 31, 2020, with COVID-19 diagnosis confirmed by pharyngeal real-time RT-PCR for SARS-CoV-2, were randomized at a 2:1 ratio and stratified by mild or moderate illness. HCQ (400 mg twice for 1 d or HCQ 200 mg twice daily for 6 days) was administered. Both the study and control group received standard of care (SOC). Pharyngeal swabs and sputum were collected every other day. The proportion and time to negative viral PCR were assessed on day 14. In the retrospective study, medical records were reviewed for patients admitted before March 31, 2020. Results There were 33 and 37 cases in the RCT and retrospective study, respectively. In the RCT, the median times to negative rRT-PCR from randomization to hospital day 14 were 5 days (95% CI; 1, 9 days) and 10 days (95% CI; 2, 12 days) for the HCQ and SOC groups, respectively (p = 0.40). On day 14, 81.0% (17/21) and 75.0% (9/12) of the subjects in the HCQ and SOC groups, respectively, had undetected virus (p = 0.36). In the retrospective study, 12 (42.9%) in the HCQ group and 5 (55.6%) in the control group had negative rRT-PCR results on hospital day 14 (p = 0.70). Conclusions Neither study demonstrated that HCQ shortened viral shedding in mild to moderate COVID-19 subjects.
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Affiliation(s)
- Cheng-Pin Chen
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yi-Chun Lin
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- Graduate Institute of Clinical Medicine, Taipei Medical University, Taipei, Taiwan
| | - Tsung-Chia Chen
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Ting-Yu Tseng
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Hon-Lai Wong
- Department of Internal Medicine, Keelung Hospital, Ministry of Health and Welfare, Keelung City, Taiwan
| | - Cheng-Yu Kuo
- Department of Internal Medicine, Pingtung Hospital, Ministry of Health and Welfare, Pingtung, Taiwan
| | - Wu-Pu Lin
- Department of Internal Medicine, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan
| | - Sz-Rung Huang
- Department of Internal Medicine, Miaoli General Hospital, Ministry of Health and Welfare, Miaoli, Taiwan
| | - Wei-Yao Wang
- Department of Internal Medicine, Feng Yuan Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Jia-Hung Liao
- Department of Internal Medicine, Nantou Hospital, Ministry of Health and Welfare, Nantou, Taiwan
| | - Chung-Shin Liao
- Department of Internal Medicine, Chia Yi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - Yuan-Pin Hung
- Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan City, Taiwan
| | - Tse-Hung Lin
- Department of Internal Medicine, Chang Hua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
| | - Tz-Yan Chang
- Department of Internal Medicine, Chang Hua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
| | - Chin-Fu Hsiao
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Yi-Wen Huang
- Department of Internal Medicine, Chang Hua Hospital, Ministry of Health and Welfare, Changhua, Taiwan
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Wei-Sheng Chung
- Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
- Department of Health Service Administration, China Medical University, Taichung, Taiwan
- Department of Healthcare Administration, Central Taiwan University of Science and Technology, Taichung, Taiwan
| | - Chien-Yu Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- School of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Shu-Hsing Cheng
- Department of Infectious Diseases, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
- School of Public Health, Taipei Medical University, Taipei, Taiwan
- * E-mail:
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11
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Axfors C, Schmitt AM, Janiaud P, van ’t Hooft J, Abd-elsalam S, Abdo EF, Abella BS, Akram J, Amaravadi RK, Angus DC, Arabi YM, Azhar S, Baden LR, Baker AW, Belkhir L, Benfield T, Berrevoets MA, Chen C, Chen T, Cheng S, Cheng C, Chung W, Cohen YZ, Cowan LN, Dalgard O, de Almeida e Val FF, de Lacerda MV, de Melo GC, Derde L, Dubee V, Elfakir A, Gordon AC, Hernandez-cardenas CM, Hills T, Hoepelman AI, Huang Y, Igau B, Jin R, Jurado-camacho F, Khan KS, Kremsner PG, Kreuels B, Kuo C, Le T, Lin Y, Lin W, Lin T, Lyngbakken MN, Mcarthur C, Mcverry BJ, Meza-meneses P, Monteiro WM, Morpeth SC, Mourad A, Mulligan MJ, Murthy S, Naggie S, Narayanasamy S, Nichol A, Novack LA, O’brien SM, Okeke NL, Perez L, Perez-padilla R, Perrin L, Remigio-luna A, Rivera-martinez NE, Rockhold FW, Rodriguez-llamazares S, Rolfe R, Rosa R, Røsjø H, Sampaio VS, Seto TB, Shehzad M, Soliman S, Stout JE, Thirion-romero I, Troxel AB, Tseng T, Turner NA, Ulrich RJ, Walsh SR, Webb SA, Weehuizen JM, Velinova M, Wong H, Wrenn R, Zampieri FG, Zhong W, Moher D, Goodman SN, Ioannidis JP, Hemkens LG. Mortality outcomes with hydroxychloroquine and chloroquine in COVID-19: an international collaborative meta-analysis of randomized trials.. [DOI: 10.1101/2020.09.16.20194571] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
AbstractBackgroundSubstantial COVID-19 research investment has been allocated to randomized clinical trials (RCTs) on hydroxychloroquine/chloroquine, which currently face recruitment challenges or early discontinuation. We aimed to estimate the effects of hydroxychloroquine and chloroquine on survival in COVID-19 from all currently available RCT evidence, published and unpublished. Methods: Rapid meta-analysis of ongoing, completed, or discontinued RCTs on hydroxychloroquine or chloroquine treatment for any COVID-19 patients (protocol: https://osf.io/QESV4/). We systematically identified published and unpublished RCTs by September 14, 2020 (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, PubMed, Cochrane COVID-19 registry). All-cause mortality was extracted (publications/preprints) or requested from investigators and combined in random-effects meta-analyses, calculating odds ratios (ORs) with 95% confidence intervals (CIs), separately for hydroxychloroquine/chloroquine. Prespecified subgroup analyses included patient setting, diagnostic confirmation, control type, and publication status.ResultsSixty-two trials were potentially eligible. We included 16 unpublished trials (1596 patients) and 10 publications/preprints (6317 patients). The combined summary OR on all-cause mortality for hydroxychloroquine was 1.08 (95%CI: 0.99, 1.18; I2=0%; 24 trials; 7659 patients) and for chloroquine 1.77 (95%CI: 0.15, 21.13, I2=0%; 4 trials; 307 patients). We identified no subgroup effects.ConclusionsWe found no benefit of hydroxychloroquine or chloroquine on the survival of COVID-19 patients. For hydroxychloroquine, the confidence interval is compatible with increased mortality (OR 1.18) or negligibly reduced mortality (OR 0.99). Findings have unclear generalizability to outpatients, children, pregnant women, and people with comorbidities.
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12
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Lu YW, Chen TC. Use of trimethoprim-sulfamethoxazole in a patient with G6PD deficiency for treating Pneumocystis jirovecii pneumonia without haemolysis: Case report and literature review. J Clin Pharm Ther 2020; 45:1483-1485. [PMID: 32648956 DOI: 10.1111/jcpt.13220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 05/27/2020] [Accepted: 06/12/2020] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE A fixed dose of trimethoprim-sulphamethoxazole (TMP/SMZ) is the first-line therapy for Pneumocystis jirovecii pneumonia (PJP). Other alternative regiments have shown a suboptimal cure rate. However, TMP/SMZ has been reported to cause haemolyses when administered to patients with G6DP deficiency. PJP might be fatal without treatment. To date, there is still insufficient evidence to manage PJP with TMP/SMZ in G6DP deficiency population. CASE DESCRIPTION We report a G6PD-deficient patient with human immunodeficiency virus (HIV) and PJP infection treated successfully with 21 days of high dose TMP/SMZ without any signs and symptoms of haemolysis. WHAT IS NEW AND CONCLUSION Based on our experience, it is worth to note that despite TMP/SMZ is consider unsafe in patient with pre-existing G6PD-deficiency, it could still be suggested as the initial drug of choice in Taiwanese or southeast Asian population for treating PJP infected HIV patient.
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Affiliation(s)
- Ya-Wen Lu
- Department of Pharmacy, Taichung Hospital, Ministry of Health Welfare, Taichung, Taiwan
| | - Tsung-Chia Chen
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
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Chang HC, Chen TC, Chen HY. A rare case of acute hepatitis with jaundice during treatment of human immunodeficiency virus infection with E/C/F/TAF. Eur J Hosp Pharm 2019. [DOI: 10.1136/ejhpharm-2019-002130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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14
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Chen TC, Tseng HH, Wong LC. Fulminant multicentric Castleman's disease in a patient with well-controlled human immunodeficiency virus infection—lessons from the patient. J Formos Med Assoc 2018; 117:244-246. [DOI: 10.1016/j.jfma.2017.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 06/08/2017] [Accepted: 06/15/2017] [Indexed: 10/19/2022] Open
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15
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Chen TC, Lin JC, Lee RM. Analysis of Deep Drawing Process for Stainless Steel Micro-Channel Array. Materials (Basel) 2017; 10:ma10040423. [PMID: 28772782 PMCID: PMC5506983 DOI: 10.3390/ma10040423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 04/13/2017] [Accepted: 04/15/2017] [Indexed: 11/30/2022]
Abstract
The stainless steel bipolar plate has received much attention due to the cost of graphite bipolar plates. Since the micro-channel of bipolar plates plays the role of fuel flow field, electric connector and fuel sealing, an investigation of the deep drawing process for stainless steel micro-channel arrays is reported in this work. The updated Lagrangian formulation, degenerated shell finite element analysis, and the r-minimum rule have been employed to study the relationship between punch load and stroke, distributions of stress and strain, thickness variations and depth variations of individual micro-channel sections. A micro-channel array is practically formed, with a width and depth of a single micro-channel of 0.75 mm and 0.5 mm, respectively. Fractures were usually observed in the fillet corner of the micro-channel bottom. According to the experimental results, more attention should be devoted to the fillet dimension design of punch and die. A larger die fillet can lead to better formability and a reduction of the punch load. In addition, the micro-channel thickness and the fillet radius have to be taken into consideration at the same time. Finally, the punch load estimated by the unmodified metal forming equation is higher than that of experiments.
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Affiliation(s)
- Tsung-Chia Chen
- Department of Mechanical Engineering, National Chin-Yi University of Technology, Taichung City 411, Taiwan.
| | - Jiang-Cheng Lin
- Department of Mechanical Engineering, National Chin-Yi University of Technology, Taichung City 411, Taiwan.
| | - Rong-Mao Lee
- Department of Mechanical Engineering, National Chin-Yi University of Technology, Taichung City 411, Taiwan.
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Chen TC, Wang JH, Tsai TC. Repeated episodes of acute stroke as manifestation of neurosyphilis in a well-controlled human immunodeficiency virus-infected patient-Successful treatment with ceftriaxone. J Formos Med Assoc 2017; 116:725-726. [PMID: 28190667 DOI: 10.1016/j.jfma.2017.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 01/12/2017] [Indexed: 11/17/2022] Open
Affiliation(s)
- Tsung-Chia Chen
- Division of Infectious Diseases, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Jen-Hsien Wang
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
| | - Tzung-Chang Tsai
- Department of Neurology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
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Damas F, Nosaka K, Libardi CA, Chen TC, Ugrinowitsch C. Susceptibility to Exercise-Induced Muscle Damage: a Cluster Analysis with a Large Sample. Int J Sports Med 2016; 37:633-40. [PMID: 27116346 DOI: 10.1055/s-0042-100281] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We investigated the responses of indirect markers of exercise-induced muscle damage (EIMD) among a large number of young men (N=286) stratified in clusters based on the largest decrease in maximal voluntary contraction torque (MVC) after an unaccustomed maximal eccentric exercise bout of the elbow flexors. Changes in MVC, muscle soreness (SOR), creatine kinase (CK) activity, range of motion (ROM) and upper-arm circumference (CIR) before and for several days after exercise were compared between 3 clusters established based on MVC decrease (low, moderate, and high responders; LR, MR and HR). Participants were allocated to LR (n=61), MR (n=152) and HR (n=73) clusters, which depicted significantly different cluster centers of 82%, 61% and 42% of baseline MVC, respectively. Once stratified by MVC decrease, all muscle damage markers were significantly different between clusters following the same pattern: small changes for LR, larger changes for MR, and the largest changes for HR. Stratification of individuals based on the magnitude of MVC decrease post-exercise greatly increases the precision in estimating changes in EIMD by proxy markers such as SOR, CK activity, ROM and CIR. This indicates that the most commonly used markers are valid and MVC orchestrates their responses, consolidating the role of MVC as the best EIMD indirect marker.
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Affiliation(s)
- F Damas
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - K Nosaka
- Biomedical and Health Sciences, School of Exercise, Edith Cowan University, Joondalup, Australia
| | - C A Libardi
- Department of Physical Education, Federal University of São Carlos - UFSCar, São Carlos, Brazil
| | - T C Chen
- Department of Physical Education, National Taiwan Normail University, Taipei City, Taiwan
| | - C Ugrinowitsch
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Chen TC, Ho MW, Chien WC, Lin HH. Disseminated Scedosporium apiospermum infection in a near-drowning patient. J Formos Med Assoc 2016; 115:213-4. [DOI: 10.1016/j.jfma.2015.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 02/03/2015] [Accepted: 02/16/2015] [Indexed: 02/05/2023] Open
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Wan KS, Wu WF, Chen TC, Wu CS, Hung CW, Chang YS. Comparison of amoxicillin + clavulanate with or without intranasal fluticasone for the treatment of uncomplicated acute rhinosinusitis in children. Minerva Pediatr 2015; 67:489-494. [PMID: 26530491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM Intranasal corticosteroids (INS) have been proven effective in controlling postnasal drip, decreasing inflammatory response, reducing nasal swelling, and increasing aeration of the sinuses such that INS are recommended as treatment of sinusitis. METHODS Fifty children with acute rhinosinusitis, 50 children with acute rhiniosinusitis and allergic rhinitis (AR), and 20 rhiniosinusitis children as control were selected for investigation. Each group had a single-blind treatment of three types: with coamoxiclav only, with coamoxiclav plus INS, and with matched placebo (without antibiotics and INS) for two weeks. Nasal symptoms were then evaluated. The outcome was measured by using major symptom score (MSS) after treatment for 14 days. RESULTS Therapeutic effectiveness was 92% in rhinosinusitis patients treated with co-amoxiclav and 84% in those treated with co-amoxiclav plus INS. Among patients with sinusitis combined with AR, therapeutic efficacy was 88% for those treated with co-amoxiclav and 96% for those treated with co-amoxiclav plus INS. Only 30% of the symptoms were reduced in the placebo group. CONCLUSION There are no statistical differences in the acute sinusitis group treated with co-amoxiclav with or without INS. In the sinusitis with AR group, the efficacy of co-amoxiclav with INS is higher than in children treated with co-amoxiclav alone.
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Affiliation(s)
- K S Wan
- Department of Pediatrics, Taipei City Hospital, Renai Branch, Taiwan -
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Wu H, de Boer JF, Chen L, Chen TC. Correlation of localized glaucomatous visual field defects and spectral domain optical coherence tomography retinal nerve fiber layer thinning using a modified structure-function map for OCT. Eye (Lond) 2015; 29:525-33. [PMID: 25633881 DOI: 10.1038/eye.2014.317] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 11/30/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To study the correlation between glaucomatous visual field (VF) defects assessed by standard automated perimetry (SAP) and peripapillary retinal nerve fiber layer (RNFL) thinning measured by spectral domain optical coherence tomography (OCT) using a modified OCT-based peripapillary RNFL structure-function map. PATIENTS AND METHODS Perimetric glaucoma patients and age-matched normal control subjects were recruited from a university hospital clinic. All eyes underwent testing with the Spectralis spectral domain OCT and SAP on the same day. An OCT-based correspondence map, which correlated VF areas with peripapillary RNFL sectors was created to evaluate the relationship between glaucomatous RNFL thinning and VF loss in six nerve fiber layer bundle areas. Correlations of RNFL thinning with corresponding VF defects were examined using Spearman rank-order correlations. To demonstrate the association between localized VF defects and RNFL thickness, the theoretical curves were made according to an established log-linear model. The measured RNFL thickness values and VF defects were presented in the same scatterplot for each sector. RESULTS Fifty-six glaucoma patients and 85 normal subjects were included in the study. Significant association between localized VF loss and RNFL thinning was found in corresponding areas. Data from the current study fit well with established log-linear models, which compare RNFL thickness values with VF defects. CONCLUSION Analysis of RNFL thinning in eyes with localized glaucomatous VF defects showed good structure-function correlation in a new OCT-based structure-function correspondence map.
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Affiliation(s)
- H Wu
- 1] Glaucoma Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA [2] Department of Ophthalmology, Peking University People's Hospital, Beijing, China [3] Key Laboratory of Vision Loss and Restoration, Ministry of Education, Beijing, China
| | - J F de Boer
- Department of Physics and Astronomy, VU University, Amsterdam, The Netherlands
| | - L Chen
- 1] Eye & ENT Hospital, Department of Ophthalmology & Vision Science, Shanghai Medical School, Fudan University, Shanghai, China [2] Department of Ophthalmology, University of Hong Kong, Hong Kong, China
| | - T C Chen
- Glaucoma Service, Massachusetts Eye and Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
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Chen CS, Lai YT, Chen TC, Chen CH, Lee JF, Hsu CW, Kao HM. Synthesis and characterization of Pt nanoparticles with different morphologies in mesoporous silica SBA-15 for methanol oxidation reaction. Nanoscale 2014; 6:12644-12654. [PMID: 25198619 DOI: 10.1039/c4nr03624g] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Mesoporous SBA-15 silica materials functionalized with and without carboxylic acid groups were used to effectively control the morphology of Pt crystals, and the materials thus obtained were applied to methanol oxidation reactions. The Pt particles aggregated to form long spheroids inside the channels in pure SBA-15. When carboxylic acid groups were utilized, the SBA-15(-COOH) material facilitated the formation of higher Pt surface area, smaller Pt nanoparticles and nearly spherical shape due to the strong interaction between Pt(4+) ions and carboxylic acid on SBA-15. The Pt(4+) ions on the SBA-15(-COOH) material can be directly transformed to reduced Pt particles during calcination. The methanol oxidation activity on a Pt surface is strongly dependent on the shape of Pt particles. The near-spherical Pt nanoparticles on the SBA-15(-COOH) exhibited higher catalytic activity during methanol oxidation than Pt catalysts on unmodified SBA-15. The near-spherical Pt particles on the SBA-15(-COOH) contained large numbers of terrace sites on their surfaces, which led to high efficiency during methanol oxidation.
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Affiliation(s)
- C S Chen
- Center for General Education, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan Tao-Yuan, Taiwan 333, Republic of China.
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Lang HC, Chen TC, Chen CH. The Cost Comparison Of Drug-Eluting Stents (Des) And Bare-Metal Stents (Bms) - A Retrospective Cohort Matched Study. Value Health 2014; 17:A481. [PMID: 27201407 DOI: 10.1016/j.jval.2014.08.1396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- H C Lang
- National Yang-Ming University, Taipei, Taiwan
| | - T C Chen
- National Yang-Ming University, Taipei, Taiwan
| | - C H Chen
- Taipei Veterans General Hospital, Taipei, Taiwan
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Lee KH, Lee YT, Chen TC, Yeh CC, Chen JY, Liu LY, Chi CH. Effects of sheng hua tang on uterine involution and ovarian activity in postpartum dairy cows. Asian-Australas J Anim Sci 2014; 26:1247-54. [PMID: 25049906 PMCID: PMC4093405 DOI: 10.5713/ajas.2013.13042] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Revised: 05/16/2013] [Accepted: 04/08/2013] [Indexed: 11/27/2022]
Abstract
The effects of Sheng Hua Tang (SHT) on uterine involution and ovarian activity were investigated in postpartum dairy cows. SHT (70 g) was given to dairy cows (n = 10) to evaluate its effects for five days from the first postpartum day. Postpartum cows fed with a basal diet without SHT were used as the control group (n = 10). Ultrasounds and blood tests were recorded for four weeks from postpartum day seven with a 3-d interval. The results showed that the areas and diameters of endometria were significantly (p<0.01) reduced in the group that received SHT compared to the control group on the seventh postpartum day. The group that received SHT had an intrauterine fluid volume mean of 1.2±0.6 cm(3), which was significantly lower than that of the control group, 2.3±0.8 cm(3) (p<0.01) on the 13th postpartum day. In addition, the uterine tension score was a mean of 1.0±0.0 in the group that received SHT, which was also significantly lower than that of the control group, 1.5±0.5 (p<0.01) on the 19th postpartum day. Taken together, the Chinese herbal medicine remedy, SHT, promoted uterine involution and ovarian activity in postpartum dairy cows.
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Affiliation(s)
- K H Lee
- Department of Veterinary Medicine, National Taiwan University, Taipei, 10617, Taiwan
| | - Y T Lee
- Department of Veterinary Medicine, National Taiwan University, Taipei, 10617, Taiwan
| | - T C Chen
- Department of Veterinary Medicine, National Taiwan University, Taipei, 10617, Taiwan
| | - C C Yeh
- Department of Veterinary Medicine, National Taiwan University, Taipei, 10617, Taiwan
| | - J Y Chen
- Department of Veterinary Medicine, National Taiwan University, Taipei, 10617, Taiwan
| | - L Y Liu
- Department of Veterinary Medicine, National Taiwan University, Taipei, 10617, Taiwan
| | - C H Chi
- Department of Veterinary Medicine, National Taiwan University, Taipei, 10617, Taiwan
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Chen TC, Chou LT, Huang CC, Lai AB, Wang JH. Isolated tuberculous liver abscess in an immunocompetent adult patient: A case report and literature review. J Microbiol Immunol Infect 2013; 49:455-8. [PMID: 24231587 DOI: 10.1016/j.jmii.2013.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Revised: 08/20/2013] [Accepted: 09/11/2013] [Indexed: 02/01/2023]
Abstract
Tuberculous liver abscess is a rare disease entity even in endemic areas of Mycobacterium tuberculosis. It is usually accompanied by pulmonary tuberculosis or enteric tuberculosis. Further, an isolated tuberculous liver abscess is extremely rare. The disease is diagnosed by laparotomy or postmortem autopsy in most cases, and some authors adopted a 9-month antituberculosis regimen. We herein report a case of an isolated tuberculous liver abscess that initially manifested as persistent fever and general malaise, which was diagnosed by liver biopsy and treated successfully with a 6-month antituberculosis regimen and percutaneous abscess drainage.
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Affiliation(s)
- Tsung-Chia Chen
- Division of Infectious Diseases, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Infection Control Committee, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Ling-Tai Chou
- Division of Gastroenterology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Chen-Cheng Huang
- Division of Chest Medicine, Department of Internal Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - An-Bang Lai
- Department of Radiology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan
| | - Jen-Hsien Wang
- Division of Infectious Diseases, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
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Chen TC, Chang SW, Wang TY. Moxifloxacin modifies corneal fibroblast-to-myofibroblast differentiation. Br J Pharmacol 2013; 168:1341-54. [PMID: 23072440 DOI: 10.1111/bph.12015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 09/24/2012] [Accepted: 09/28/2012] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND AND PURPOSE Fibroblast-to-myofibroblast differentiation is associated with scarring, an important issue in corneal surgery. Moxifloxacin (MOX), commonly applied to prevent post-operative infection, would benefit more if it modifies fibroblast-to-myofibroblast differentiation other than antimicrobial activity. Our purpose was to explore whether MOX has anti-fibrotic effect in human corneal fibroblasts (HCFs). EXPERIMENTAL APPROACH HCFs were incubated in MOX-containing medium concurrently with TGF-β1 (co-treatment), before (pretreatment) or after (post-treatment) adding TGF-β1. HCF contractility was evaluated with a type I collagen gel contraction assay. Expression of α-smooth muscle actin (α-SMA), Smad2, phospho-Smad2-Ser467, Smad4 and Smad7 was determined by immunoblotting. Formation of α-SMA-positive filaments and distribution of active Smad2 were observed under confocal microscopy. Expression of TGF-β receptor types I (TGFBR1) and II (TGFBR2) was assessed with flow cytometry. KEY RESULTS MOX did not affect gel contractility or α-SMA filament formation in HCFs without TGF-β1 stimulation. MOX did, however, retard HCF-containing gel contractility and α-SMA filament formation following TGF-β1 stimulation in the pretreatment and co-treatment groups but not in the post-treatment group. MOX blocked the expression of Smad2, phospho-Smad2-Ser467 and TGFBR1 under TGF-β1 incubation. Additionally, MOX enhanced Smad7 expression in TGF-β1-incubated HCFs, but did not interfere with TGF-β-triggered Smad2 nuclear translocation or Smad4 expression. CONCLUSIONS AND IMPLICATIONS MOX inhibited TGF-β-induced fibroblast-to-myofibroblast differentiation via blocking TGFBR1 and enhancing Smad7 expression. MOX should be used before or during surgery to achieve these effects. These results suggest a de novo mechanism by which MOX participates in corneal wound healing.
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Affiliation(s)
- T C Chen
- Department of Ophthalmology, Far Eastern Memorial Hospital, Banqiao District, New Taipei City, Taiwan
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Lin SY, Lee KM, Chen TC, Lien CT, Lu PL. A swollen knee in a 77-year-old lung cancer patient receiving antimicrobial therapy for pneumonia. Clin Infect Dis 2013; 56:1778, 1838-9. [PMID: 23690369 DOI: 10.1093/cid/cit131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Jiwani AZ, Rhee DJ, Brauner SC, Gardiner MF, Chen TC, Shen LQ, Chen SH, Grosskreutz CL, Chang KK, Kloek CE, Greenstein SH, Borboli-Gerogiannis S, Pasquale DL, Chaudhry S, Loomis S, Wiggs JL, Pasquale LR, Turalba AV. Effects of caffeinated coffee consumption on intraocular pressure, ocular perfusion pressure, and ocular pulse amplitude: a randomized controlled trial. Eye (Lond) 2012; 26:1122-30. [PMID: 22678051 DOI: 10.1038/eye.2012.113] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To examine the effects of caffeinated coffee consumption on intraocular pressure (IOP), ocular perfusion pressure (OPP), and ocular pulse amplitude (OPA) in those with or at risk for primary open-angle glaucoma (POAG). METHODS We conducted a prospective, double-masked, crossover, randomized controlled trial with 106 subjects: 22 with high tension POAG, 18 with normal tension POAG, 20 with ocular hypertension, 21 POAG suspects, and 25 healthy participants. Subjects ingested either 237 ml of caffeinated (182 mg caffeine) or decaffeinated (4 mg caffeine) coffee for the first visit and the alternate beverage for the second visit. Blood pressure (BP) and pascal dynamic contour tonometer measurements of IOP, OPA, and heart rate were measured before and at 60 and 90 min after coffee ingestion per visit. OPP was calculated from BP and IOP measurements. Results were analysed using paired t-tests. Multivariable models assessed determinants of IOP, OPP, and OPA changes. RESULTS There were no significant differences in baseline IOP, OPP, and OPA between the caffeinated and decaffeinated visits. After caffeinated as compared with decaffeinated coffee ingestion, mean mm Hg changes (± SD) in IOP, OPP, and OPA were as follows: 0.99 (± 1.52, P<0.0001), 1.57 (± 6.40, P=0.0129), and 0.23 (± 0.52, P<0.0001) at 60 min, respectively; and 1.06 (± 1.67, P<0.0001), 1.26 (± 6.23, P=0.0398), and 0.18 (± 0.52, P=0.0006) at 90 min, respectively. Regression analyses revealed sporadic and inconsistent associations with IOP, OPP, and OPA changes. CONCLUSION Consuming one cup of caffeinated coffee (182 mg caffeine) statistically increases, but likely does not clinically impact, IOP and OPP in those with or at risk for POAG.
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Affiliation(s)
- A Z Jiwani
- Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA
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Farraye FA, Nimitphong H, Stucchi A, Dendrinos K, Boulanger AB, Vijjeswarapu A, Tanennbaum A, Biancuzzo R, Chen TC, Holick MF. Use of a novel vitamin D bioavailability test demonstrates that vitamin D absorption is decreased in patients with quiescent Crohn's disease. Inflamm Bowel Dis 2011; 17:2116-21. [PMID: 21910173 DOI: 10.1002/ibd.21595] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 11/03/2010] [Indexed: 12/13/2022]
Abstract
BACKGROUND Vitamin D deficiency is a common problem in patients with Crohn's disease (CD). The aim of this study was to determine the ability of normal subjects and patients with quiescent CD to absorb vitamin D(2) using a novel vitamin D bioavailability test. In addition, we evaluated whether the location of disease or previous surgery had any influence on the bioavailability of vitamin D(2) in CD patients. METHODS Ten normal subjects (50% female) and 37 CD patients with quiescent disease (51% female) were included in this study. Subjects who recently received any vitamin D(2) were excluded. The vitamin D bioavailability test was performed in all subjects. After a baseline blood draw, all subjects were then given a single 50,000 IU oral dose of vitamin D(2) in a capsule formulation and had their blood drawn 12 hours later to determine serum vitamin D(2), which reflected their vitamin D(2) absorption capacity. RESULTS Forty-two percent and 29% of CD patients were found to be either vitamin D-deficient (25-hydroxyvitamin D [25(OH)D] ≤20 ng/mL] or insufficient [25(OH)D 21-29 ng/mL], respectively. Twelve hours after ingesting 50,000 IU vitamin D(2) , vitamin D(2) levels rose from a baseline of 0.7 ± 0.7 ng/mL (mean ± SEM) to 49.8 ± 3.0 ng/mL in normal subjects. In CD patients, baseline vitamin D(2) levels rose from 0 ng/mL to 34.8 ± 2.8 ng/mL. CD patients had on average a 30% decrease in their ability to absorb vitamin D(2) (P = 0.01). Moreover, we found a wide variability of vitamin D(2) bioavailability in CD patients. Analysis of variance (ANOVA) revealed no statistical difference of vitamin D(2) bioavailability between patients in the CD subgroup stratified by the location of disease, the type of surgery, and receiving or not receiving surgery. CONCLUSIONS More than 70% of the patients with quiescent CD were vitamin D-deficient or insufficient. The ability to absorb vitamin D(2) in CD patients is unpredictable and the only way to determine this is to perform a vitamin D bioavailability test. Use of this test may guide clinicians in administering the appropriate therapeutic dose of vitamin D for treating vitamin D deficiency in patients with CD.
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Affiliation(s)
- F A Farraye
- Center for Digestive Disorders, Section of Gastroenterology, Department of Medicine, Boston Medical Center, Boston, Massachusetts, USA
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Chen TC, Lin PC, Chi CY, Ho CM, Chou CH, Ho MW, Wang JH, Jeng LB. Infection in liver transplant recipients—Analysis of 68 cases at teaching hospital in Taiwan. Journal of Microbiology, Immunology and Infection 2011; 44:303-9. [DOI: 10.1016/j.jmii.2011.01.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2010] [Revised: 07/04/2010] [Accepted: 08/13/2010] [Indexed: 11/29/2022]
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Ghosh A, Joo NE, Chen TC, Kapila YL. Proapoptotic fibronectin fragment induces the degradation of ubiquitinated p53 via proteasomes in periodontal ligament cells. J Periodontal Res 2010; 45:481-7. [PMID: 20337881 DOI: 10.1111/j.1600-0765.2009.01261.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND AND OBJECTIVE The extracellular matrix (ECM) plays a key role in signaling necessary for tissue remodeling and cell survival. However, signals from the ECM altered by disease, e.g. inflammatory diseases such as periodontitis and arthritis, may lead to apoptosis or programmed cell death of resident cells. Previously, we found that a disease-associated fibronectin fragment triggers apoptosis of primary human periodontal ligament cells via a novel apoptotic pathway in which the tumor suppressor, p53, is transcriptionally downregulated. MATERIAL AND METHODS We used immunofluorescence, transfection assays, western blotting and ELISAs to show that p53 is degraded by a proteasomal pathway in response to a proapoptotic disease-associated fibronectin fragment. RESULTS We found that in these apoptotic conditions, p53 is further downregulated by post-translational ubiquitination and subsequent targeting to proteasomes for degradation. Pretreatment of cells with the proteasomal inhibitors MG132 and lactacystin rescued the cells from apoptosis. The p53 levels in cells transfected with ubiquitin small interfering RNA were resistant to degradation induced by the proapoptotic fibronectin fragment, showing that ubiquitination is important for the proapoptotic fibronectin fragment-induced degradation of p53. CONCLUSION These data show that a proapoptotic fibronectin matrix induces ubiquitination and degradation of p53 in the proteasome as part of a novel mechanism of apoptosis associated with inflammatory diseases.
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Affiliation(s)
- A Ghosh
- Department of Periodontics and Oral Medicine, University of Michigan, School of Dentistry, Ann Arbor, MI 48109, USA
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Chen CC, Huang CH, Cheng YH, Chen TC, Yeh SD, Chang CA. First Report of Capsicum chlorosis virus Infecting Amaryllis and Blood Lily in Taiwan. Plant Dis 2009; 93:1346. [PMID: 30759525 DOI: 10.1094/pdis-93-12-1346a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Capsicum chlorosis virus (CaCV), a thrips-transmitted, tentative species in the genus Tospovirus, family Bunyaviridae, was first identified in solanaceous crops, but also infects several ornamental crops such as orchid (4), gloxinia (3), and calla lily (1). From 2005 to 2007, virus-like yellow ringspots were observed on the leaves of amaryllis (Hippeastrum hybridum Hort.) and blood lily (Haemanthus multiflorus Martyn.) plants cultured in screenhouses and a private garden, respectively. Three of several hundred amaryllis plants in screenhouses from two places were observed as showing yellow ringspot symptoms and one of six blood lily plants was observed as showing similar yellow ringspot symptoms. Sap extracts from symptomatic leaves were inoculated to Chenopodium quinoa Willd. and the resulting local lesions were passaged three successive times to C. quinoa for virus isolation. Using the tospovirus genus-specific primers gL3637 and gL4435c designed from the conserved region in the L RNA (2), DNA fragments of the expected size of 800 bp were amplified by reverse transcription (RT)-PCR from field samples and local lesions from C. quinoa. Extracts from the diseased plants and local lesions of C. quinoa reacted strongly with antiserum against the nucleocapsid (N) protein of CaCV in ELISA and western blotting. To confirm the identity of this virus, we amplified the N gene from three amaryllis and one blood lily source using primer pair WN2328 and WN3534 designed from the S RNA of Watermelon silver mottle virus (1), and these products were cloned and sequenced. The sequence from each virus isolate was determined from three independent clones. The nucleotide and deduced amino acid sequences of N genes for the blood lily isolate (GenBank Accession No. EF101344) and three amaryllis isolates (GenBank Accession Nos. EF101343, EF137177, and FJ185170) had identities greater than 97% with that of a CaCV isolate infecting Capsicum spp. found in Australia (GenBank Accession No. AY036057). Phylogenetic analysis using maximum parsimony showed that these sequences clustered with CaCV. These results show that the virus identified from amaryllis and blood lily that were expressing yellow ringspot symptoms are isolates of CaCV. To our knowledge, this is the first report of CaCV naturally infecting amaryllis and blood lily and it could become an important threat to ornamental production in Taiwan. References: (1) C. C. Chen et al. Plant Dis. 91:1201, 2007. (2) F. H. Chu et al. Phytopathology 91:361, 2001. (3) H. T. Hsu et al. J. Gen. Plant Pathol. 66:167, 2000. (4) Y. X. Zheng et al. Eur. J. Plant Pathol. 120:199, 2008.
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Affiliation(s)
- C C Chen
- Division of Plant Pathology, Agricultural Research Institute, Wufeng, Taichung, Taiwan
| | - C H Huang
- Division of Plant Pathology, Agricultural Research Institute, Wufeng, Taichung, Taiwan
| | - Y H Cheng
- Division of Plant Pathology, Agricultural Research Institute, Wufeng, Taichung, Taiwan
| | - T C Chen
- Department of Biotechnology, Asia University, Wufeng, Taichung, Taiwan
| | - S D Yeh
- Department of Plant Pathology, National Chung Hsing University, Taichung, Taiwan
| | - C A Chang
- Graduate Institute of Biochemical Science and Technology, Chaoyang University of Technology, Wufeng, Taichung, Taiwan
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Chen WS, Chen CH, Lin KC, Tsai CY, Liao HT, Wang HB, Chen YK, Yang AH, Chen TC, Chou CT. Immunohistological features of hip synovitis in ankylosing spondylitis with advanced hip involvement. Scand J Rheumatol 2009; 38:154-5. [PMID: 19165649 DOI: 10.1080/03009740802409504] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Yi K, Mujat M, Park BH, Sun W, Miller JW, Seddon JM, Young LH, de Boer JF, Chen TC. Spectral domain optical coherence tomography for quantitative evaluation of drusen and associated structural changes in non-neovascular age-related macular degeneration. Br J Ophthalmol 2008; 93:176-81. [PMID: 18697811 PMCID: PMC2628537 DOI: 10.1136/bjo.2008.137356] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Background/aims: To demonstrate how spectral domain optical coherence tomography (SDOCT) can better evaluate drusen and associated anatomical changes in eyes with non-neovascular age-related macular degeneration (AMD) compared with time domain optical coherence tomography (TDOCT). Methods: Images were obtained from three eyes of three patients with AMD using an experimental SDOCT system. Both a titanium–sapphire (Ti:sapphire) laser and a superluminescent diode (SLD) were used as a broadband light source to achieve cross-sectional images of the retina. A qualitative and quantitative analysis was performed for structural changes associated with non-neovascular AMD. An automated algorithm was developed to analyse drusen area and volume from SDOCT images. TDOCT was performed using the fast macular scan (StratusOCT, Carl Zeiss Meditec, Dublin, California). Results: SDOCT images can demonstrate structural changes associated with non-neovascular AMD. A new SDOCT algorithm can determine drusen area, drusen volume and proportion of drusen. Conclusions: With new algorithms to determine drusen area and volume and its unprecedented simultaneous ultra-high speed ultra-high resolution imaging, SDOCT can improve the evaluation of structural abnormalities in non-neovascular AMD.
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Affiliation(s)
- K Yi
- Harvard Medical School, Boston, Massachusetts, USA
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Abstract
Fourteen successful results in 16 cases of microsurgical reconstruction of uni- and bilateral hand amputations are reported. Metacarpal reconstruction included the use of titanium alloy for artificial metacarpi, autogenous metatarsals, and autogenous iliac bone grafts. Uni- and bilateral single and multiple donor toes were used in various combinations. Basic hand function and functional sensibility were restored in 14 of 16 cases. There was minimal donor site functional impairment.
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Chen CC, Huang CH, Chen TC, Yeh SD, Cheng YH, Hsu HT, Chang CA. First Report of Capsicum chlorosis virus Causing Yellow Stripes on Calla Lilies in Taiwan. Plant Dis 2007; 91:1201. [PMID: 30780672 DOI: 10.1094/pdis-91-9-1201c] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Tomato spotted wilt virus (TSWV) and Calla lily chlorotic spot virus (CCSV) are two recognized species of the Tospovirus genus in the family Bunyaviridae infecting calla lily (Zantedeschia spp.). During 2005, 15 virus isolates were collected from different calla lily plants exhibiting yellow stripes on their leaves in Ho-Li, a major calla lily-production township in Taiwan. After three successive local lesion passages on Chenopodium quinoa Willd., diseased leaf tissues individually infected by these isolates were preserved in liquid nitrogen and used for subsequent identification studies. Using the tospovirus genus-specific primers gL3637 and gL4435c designed from the L RNA, an 800-bp DNA fragment was amplified in reverse transcription-PCR from all 15 isolates. Moreover, leaf extracts of the diseased calla lilies and the C. quinoa plants inoculated with the 15 virus isolates reacted with antisera against the nucleocapsid proteins (NP) of Capsicum chlorosis virus (CaCV)-gloxinia and Watermelon silver mottle virus (WSMoV), but not to monoclonal antibodies against the NP of TSWV, CCSV, Peanut chlorotic fan-spot virus (PCFV), or Impatiens necrotic spot virus (INSV) in indirect ELISA. These results indicate that the 15 virus isolates are tospoviruses belonging to the WSMoV serogroup. Additionally, we amplified and sequenced the full-length N gene from these tospovirus isolates using primers WN2328 (5'-CCATTGGTTTGCCTCCG-3') and WN3534 (5'-CGTCGACAGAGCAATCGAGGC-3') designed from the S RNA of WSMoV. The deduced amino acid sequences of the N protein from these 15 tospovirus isolates showed a greater than 92% identity to that of CaCV (GenBank Accession No. NC-008301). Furthermore, results of phylogenetic analysis of the 15 isolates on the basis of amino acids sequences, both genetic distance and parsimony trees indicated that they were all genetically clustered within CaCV using INSV, TSWV, and WSMoV as outgroups. The results indicate that the virus causing yellow stripes in calla lilies is a strain of CaCV. To our knowledge, this is the first evidence that CaCV can naturally infect calla lilies and cause yellow stripe symptoms. Reference: (1) F.-H. Chu et al. Phytopathology 91:361, 2001.
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Affiliation(s)
- C C Chen
- Division of Plant Pathology, Agricultural Research Institute, Wufeng, Taichung, Taiwan
| | - C H Huang
- Division of Plant Pathology, Agricultural Research Institute, Wufeng, Taichung, Taiwan
| | - T C Chen
- Department of Biotechnology and Bioinformatics, Asia University, Wufeng, Taichung, Taiwan
| | - S D Yeh
- Department of Plant Pathology, National Chung Hsing University, Taichung, Taiwan
| | - Y H Cheng
- Division of Plant Pathology, Agricultural Research Institute, Wufeng, Taichung, Taiwan
| | - H T Hsu
- Floral and Nursery Plant Research Unit, U.S. National Arboretum, ARS, USDA, Beltsville. MD
| | - C A Chang
- Division of Plant Pathology, Agricultural Research Institute, Wufeng, Taichung, Taiwan
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Molnár I, Stark N, Lovato J, Powell BL, Cruz J, Hurd DD, Mathieu JS, Chen TC, Holick MF, Cambra S, McQuellon RP, Schwartz GG. Treatment of low-risk myelodysplastic syndromes with high-dose daily oral cholecalciferol (2000-4000 IU vitamin D(3)). Leukemia 2007; 21:1089-92. [PMID: 17344922 DOI: 10.1038/sj.leu.2404601] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Chen TC, Persons KS, Zheng S, Mathieu J, Holick MF, Lee YF, Bao B, Arai MA, Kittaka A. Evaluation of C-2-substituted 19-nor-1alpha,25-dihydroxyvitamin D3 analogs as therapeutic agents for prostate cancer. J Steroid Biochem Mol Biol 2007; 103:717-20. [PMID: 17207993 DOI: 10.1016/j.jsbmb.2006.12.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
1alpha,25-Dihydroxyvitamin D(3) (1alpha,25(OH)(2)D(3)) is known to inhibit the proliferation and invasiveness of prostate cancer cells. However, 1alpha,25(OH)(2)D(3) can cause hypercalcemia and is not suitable as a therapeutic agent. 19-Nor-vitamin D derivatives are known to be less calcemic when administered systemically. In order to develop more potent anti-cancer agents with less calcemic side effect, we therefore utilized (3)H-thymidine incorporation as an index for cell proliferation and examined the antiproliferative activities of nine C-2-substituted 19-nor-1alpha,25(OH)(2)D(3) analogs in the immortalized PZ-HPV-7 normal prostate cell line. Among the nine analogs we observed that the substitution with 2alpha- or 2beta-hydroxypropyl group produced two analogs having antiproliferative potency that is approximately 500- to 1000-fold higher than 1alpha,25(OH)(2)D(3). The (3)H-thymidine incorporation data were supported by the cell counting data after cells were treated with 1alpha,25(OH)(2)D(3), 19-nor-2alpha-(3-hydroxypropyl)-1alpha,25(OH)(2)D(3) or 19-nor-2beta-(3-hydroxypropyl)-1alpha,25(OH)(2)D(3) for 7 days. 19-Nor-2alpha-(3-hydroxypropyl)-1alpha,25(OH)(2)D(3) and 19-nor-2beta-(3-hydroxypropyl)-1alpha,25(OH)(2)D(3) were also shown to be about 10-fold more active than 1alpha,25(OH)(2)D(3) in cell invasion studies using prostate cancer cells. In conclusion, a substitution at the C-2 position of 19-nor-1alpha,25(OH)(2)D(3) molecule with a hydroxypropyl group greatly increased the antiproliferative and anti-invasion potencies. Thus, these two analogs could be developed to be effective therapeutic agents for treating early and late stages of prostate cancer.
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Affiliation(s)
- T C Chen
- Boston University School of Medicine, 715 Albany Street, Boston, MA 02118, USA.
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Istfan NW, Person KS, Holick MF, Chen TC. 1alpha,25-Dihydroxyvitamin D and fish oil synergistically inhibit G1/S-phase transition in prostate cancer cells. J Steroid Biochem Mol Biol 2007; 103:726-30. [PMID: 17223546 DOI: 10.1016/j.jsbmb.2006.12.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Laboratory and epidemiological studies have indicated that 1alpha,25-dihydroxyvitamin D(3) [1alpha,25(OH)(2)D(3)] and dietary omega3-polyunsaturated fatty acids (PUFAs) are capable of inhibiting prostate cancer at the initiation and progression stages. The objective of this study is to investigate the influence of 1alpha,25(OH)(2)D(3) and PUFAs in the form of fish oil applied alone or in combination on cell cycle kinetics in the exponentially growing androgen-dependent and -independent prostate cancer cells. Our data indicate that the high passage androgen-independent cell line, LNCaP-c115 had a much greater inhibitory response at the level of the G(1)/S-phase transition in response to fish oil treatment than androgen-dependent low passage LNCaP-c38 cells. When LNCaP-c38 and LNCaP-c115 cells were treated with fish oil (50mug/ml), 1alpha,25(OH)(2)D(3) (10(-8)M) or fish oil (50mug/ml)+1alpha,25(OH)(2)D(3) (10(-8)M), a synergistic growth inhibitory effect was observed with 1alpha,25(OH)(2)D(3)+fish oil group in LNCaP-c115 cell line at the levels of the G(1)/S-phase transition and cell division. This interaction appears to be specific for androgen-independent prostate cancer cell lines. Based on these results, we hypothesize that dietary components, such as omega3PUFAs and Vitamin D, have the potential to delay the progression of prostate cancer cells to an aggressive and un-treatable state.
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Affiliation(s)
- N W Istfan
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, MA 02118, USA.
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Lu Z, Chen TC, Zhang A, Persons KS, Kohn N, Berkowitz R, Martinello S, Holick MF. An evaluation of the vitamin D3 content in fish: Is the vitamin D content adequate to satisfy the dietary requirement for vitamin D? J Steroid Biochem Mol Biol 2007; 103:642-4. [PMID: 17267210 PMCID: PMC2698592 DOI: 10.1016/j.jsbmb.2006.12.010] [Citation(s) in RCA: 122] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2006] [Indexed: 10/23/2022]
Abstract
It has been suggested that the major source of vitamin D should come from dietary sources and not sun exposure. However, the major fortified dietary source of vitamin D is milk which often does not contain at least 80% of what is stated on the label. Fish has been touted as an excellent source of vitamin D especially oily fish including salmon and mackerel. Little is known about the effect of various cooking conditions on the vitamin D content in fish. We initiated a study and evaluated the vitamin D content in several species of fish and also evaluated the effect of baking and frying on the vitamin D content. Surprisingly, farmed salmon had approximately 25% of the vitamin D content as wild salmon had. The vitamin D content in fish varied widely even within species. These data suggest that the tables that list the vitamin D content are out-of-date and need to be re-evaluated.
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Affiliation(s)
- Z Lu
- Vitamin D, Skin, and Bone Research Laboratory, Departments of Medicine and Physiology and Biophysics, 715 Albany Street, Boston University Medical Center, Boston, MA 02118, USA
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Perera TA, Downes TP, Meyer SS, Crawford TM, Cheng ES, Chen TC, Cottingham DA, Sharp EH, Silverberg RF, Finkbeiner FM, Fixsen DJ, Logan DW, Wilson GW. Optical performance of frequency-selective bolometers. Appl Opt 2006; 45:7643-51. [PMID: 17068598 DOI: 10.1364/ao.45.007643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Frequency-selective bolometers (FSBs) are a new type of detector for millimeter and submillimeter wavelengths that are transparent to all but a narrow range of frequencies as set by characteristics of the absorber itself. Therefore stacks of FSBs tuned to different frequencies provide a low-loss compact method for utilizing a large fraction of the light collected by a telescope. Tests of prototype FSBs indicate that the absorption spectra are well predicted by models, that peak absolute absorption efficiencies of the order of 50% are attainable, and that their out-of-band transmission is high.
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Affiliation(s)
- T A Perera
- Kavli Institute for Cosmological Physics, University of Chicago, Chicago, IL 60637, USA.
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Abstract
This study compared changes in indirect markers of muscle damage following eccentric exercise of the elbow flexors among the exercises consisting of different number of eccentric actions. Sixty male athletes were placed into one of the six groups (n=10 per group) based on the number of eccentric actions for the first (ECC1) and second exercise bouts (ECC2). Single bout groups (30, 50, and 70) performed ECC1 only, and repeated bout groups (30-30, 50-50, and 70-70) performed ECC2 3 days after ECC1. Another 10 male athletes performed different number of eccentric actions for ECC1 (30) and ECC2 (70) separated by 3 days (30-70). Changes in maximal isometric strength (MVC), range of motion (ROM), upper arm circumference (CIR), serum creatine kinase activity, myoglobin, and nitric oxide concentrations and muscle soreness for 10 days following ECC1 were compared among groups by two-way repeated measures ANOVA. Changes in MVC, ROM, and CIR following ECC1 were significantly (P<0.05) smaller for the groups that performed 30 eccentric actions compared with other groups. No significant differences between 30 and 30-30, 50 and 50-50, and 70 and 70-70 were evident for the changes in the measures for 10 days following ECC1 except for the acute decreases in MVC and ROM immediately after ECC2 for the repeated bout groups. The 30-30 and 30-70 groups showed similar changes in all criterion measures. It is concluded that recovery from eccentric exercise is not retarded by the second bout of eccentric exercise regardless of the number of eccentric actions.
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Affiliation(s)
- T C Chen
- Department of Physical Education, National Chiayi University, Chiayi County, Taiwan.
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Lin YH, Chen CP, Chen TC, Liang SJ, Hsu CS. Familial occurrence of isolated Dandy-Walker variant in two consecutive male fetuses. Genet Couns 2006; 17:461-3. [PMID: 17375534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
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Cense B, Chen TC, Nassif N, Pierce MC, Yun SH, Park BH, Bouma BE, Tearney GJ, de Boer JF. Ultra-high speed and ultra-high resolution spectral-domain optical coherence tomography and optical Doppler tomography in ophthalmology. Bull Soc Belge Ophtalmol 2006:123-32. [PMID: 17265794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
We present ultra-high resolution optical coherence tomography (OCT) structural intensity and optical Doppler tomography (ODT) flow velocity images of the human retina in vivo. The ultra-high speed OCT system is based on Spectral Domain or Fourier Domain technology, which provides a sensitivity advantage over conventional OCT of more than 2 orders of magnitude. This sensitivity improvement allows video rate OCT and ODT cross sectional imaging of retinal structures. Images will be presented with axial resolutions of 6 and 3.5 microns. We observed small features in the inner and outer plexiform layers, which are believed to be small blood vessels. Flow velocity images will be presented showing pulsatile flow in retinal arteries and veins.
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Affiliation(s)
- B Cense
- Harvard Medical School, Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA 02114, USA
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Cense B, Chen TC, de Boer JF. In vivo thickness and birefringence determination of the human retinal nerve fiber layer using polarization-sensitive optical coherence tomography. Bull Soc Belge Ophtalmol 2006:109-21. [PMID: 17265793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Thinning of the retinal nerve fiber layer and changes in retinal nerve fiber layer birefringence may both precede clinically detectable glaucomatous vision loss. We present in vivo thickness and depth-resolved birefringence measurements of the human retinal nerve fiber layer (RNFL) by use of polarization-sensitive optical coherence tomography (PS-OCT). Using a fiber-based PS-OCT setup real-time images of the human retina in vivo were recorded, co-registered with retinal video images of the location of PS-OCT scans. PS-OCT scans around the optic nerve head (ONH) of two healthy young volunteers were made using 10 concentric circles of increasing radius. Both the mean retinal nerve fiber layer thickness and mean retinal nerve fiber birefringence for each of 48 sectors on a circle were determined. The retinal nerve fiber layer thickness and birefringence varied as a function of sector around the ONH. Measured double pass phase retardation per unit depth values around the ONH range between 0.10 and 0.35 degrees/microm. The retinal nerve fiber layer becomes thinner with increasing distance from the ONH. In contrast, the birefringence does not vary significantly with increasing distance from the ONH.
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Affiliation(s)
- B Cense
- Harvard Medical School, Wellman Center for Photomedicine, MGH, Boston, MA 02114, USA
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Chen CC, Chen TC, Lin YH, Yeh SD, Hsu HT. A Chlorotic Spot Disease on Calla Lilies (Zantedeschia spp.) Is Caused by a Tospovirus Serologically but Distantly Related to Watermelon silver mottle virus. Plant Dis 2005; 89:440-445. [PMID: 30795418 DOI: 10.1094/pd-89-0440] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A new tospovirus, Calla lily chlorotic spot virus (CCSV), was isolated from calla lilies (Zantedeschia spp.) in Taiwan. Chlorotic spots, ranging from light green to yellow, appear on the middle leaves of the affected plants. Virions measuring 75 to 105 nm, similar in size to tospovirus particles, were present in crude extracts and ultrathin sections of diseased leaves. Of 35 plant species inoculated mechanically, 24, including wax gourd (Benincasa hispida) and zucchini squash (Cucurbita pepo), were susceptible to the virus. CCSV was transmitted from infected wax gourd by Thrips palmi to healthy wax gourd and zucchini squash. The virus was weakly related to Watermelon silver mottle virus (WSMoV) in enzyme-linked immunosorbent assay (ELISA) and western blot tests. WSMoV-specific N gene primers, however, failed to produce DNA fragments from total RNA extracts of CCSV-infected plants in reverse transcription-polymerase chain reaction (RT-PCR). Results of RT-PCR show that the conserved regions of the L genes of tospoviruses are present in CCSV.
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Affiliation(s)
- C C Chen
- Department of Plant Protection, Taichung District Agricultural Improvement Station, Changhua, Taiwan
| | - T C Chen
- Department of Plant Pathology, National Chung Hsing University, Taichung, 40227 Taiwan
| | - Y H Lin
- Department of Plant Pathology, National Chung Hsing University, Taichung, 40227 Taiwan
| | - S D Yeh
- Department of Plant Pathology, National Chung Hsing University, Taichung, 40227 Taiwan
| | - H T Hsu
- Floral and Nursery Plants Research Unit, U.S. Department of Agriculture, Agricultural Research Service, Beltsville, MD 20705, USA
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Chen TC, Chung FR, Lee CH, Huang SC, Chen JB, Hsu KT. Successful treatment of crescentic glomerulonephritis associated with adult-onset Henoch-Schoenlein purpura by double-filtration plasmapheresis. Clin Nephrol 2004; 61:213-6. [PMID: 15077873 DOI: 10.5414/cnp61213] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Henoch-Schoenlein purpura (HSP) crescentic glomerulonephritis with acute renal failure in adults is extremely rare. The condition carries a grave renal outcome if it is not appropriately managed. Oral corticosteroids, intravenous methylprednisolone pulse therapy and plasmapheresis with concomitant plasma replacement have been used alone or in various combinations to treat patients with HSP nephritis, yet the effects are uncertain. We describe a 33-year-old man with oliguric acute renal failure in the setting of HSP crescentic glomerulonephritis that is refractory to intravenous methylprednisolone pulse therapy (1,000 mg/day for 3 days) with maintained oral prednisolone (1 mg/kg/day) and oral cyclophosphamide (2 mg/kg/day) for 3 weeks, resulting in successful recovery of renal function after 9 sessions of simple double-filtration plasmapheresis treatment without concomitant plasma replacement. There was no recurrence of vasculitic events within 18 months. In this case, we emphasize that simple double-filtration plasmapheresis without concomitant plasma replacement is an effective and safe modality therapy for adult patients with HSP crescentic glomerulonephritis and acute renal failure, especially when conventional therapy has failed.
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Affiliation(s)
- T C Chen
- Division of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital Kaohsiung, Kaohsiung, Taiwan
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Chen TC. Proposed diagnostic flow chart for cervical smears. Diagn Cytopathol 2004; 30:212-5. [PMID: 14986305 DOI: 10.1002/dc.20033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Affiliation(s)
- T C Chen
- Harvard Medical School, Massachusetts Eye and Ear Infirmary, Glaucoma Service, 243 Charles Street, Boston, MA 02114, USA.
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Abstract
Biliary papillary neoplasia of the liver characterized by intraductal papillary growth of neoplastic biliary epithelia with a fine fibrovascular stalk has been sporadically reported, and includes intraductal growing cholangiocarcinoma and biliary papillomatosis. In addition, biliary papillary dysplasia and in situ and microinvasive carcinoma with papillary configuration reported in hepatolithiasis and in other chronic biliary diseases, could be included in this category. Usually, they arise in the intrahepatic large bile ducts, and the neoplastic and non-neoplastic parts of the intrahepatic biliary tree show saccular and segmental dilatation with mucin hypersecretion. This neoplasia frequently shows intraductal spreading and peribiliary glandular involvement. Acute repeated episodes of cholangitis or obstructive jaundice are a frequent clinical manifestation. Gastroenteric metaplasia with aberrant expression of cytokeratin 20, MUC2, MUC5AC, and/or MUC6, is frequent in the neoplastic parts, and biliary epithelial dysplasia with such metaplasia may give rise to in situ and then invasive carcinoma in hepatolithiasis. Interestingly, this type tends to contain foci of mucinous carcinoma elements, and this element may be predominant (mucinous carcinoma). Some may progress to "mucinous biliary cystadenocarcinoma" without ovarian mesenchymal stroma and with intraluminal continuous growth into the neighboring bile duct lumens. Interestingly, the biliary papillary neoplasm resembles histologically, phenotypically and clinically intraductal papillary mucinous neoplasm of the pancreas which is now being established as an infrequent, slow-growing pancreatic neoplasm. Recognition of such biliary papillary neoplasm with respect to the pancreatic equivalent may lead to a better understanding and further studies of the intrahepatic biliary neoplasm.
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Affiliation(s)
- Y Nakanuma
- Department of Human Pathology, Kanazawa University Graduate School of Medicine, Japan.
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Hung-Lung C, Chen TC, Tsai MC, Chen YL. Adsorption characteristics of benzene on biosolid adsorbent. Water Sci Technol 2003; 47:83-87. [PMID: 12578178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
This study selected biosolids from a petrochemical wastewater treatment plant as the raw material. The sludge was immersed in 0 to 5 mol l(-1) of ZnCl2 solutions and pyrolyzed at different temperatures. When the sludge was pyrolyzed for 30 min at temperatures of 400, 500, 600, and 700 degrees C, the corresponding surface area of the biosolid adsorbent was 46, 401, 921, and 727 m2/g, respectively. Pore size analysis indicated that the mesopore (20 to 500 A) contributed more than the macropore and micropore in the sludge pyrolytic residue. When the benzene influent concentration was 800 ppmv, the adsorption capacity ranged from 59 to 164 mg/g for different biosolid adsorbents. A larger BET surface area and smaller average pore diameter yielded a larger benzene adsorption capacity.
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Affiliation(s)
- C Hung-Lung
- Department of Environmental Engineering, Fooyin Institute of Technology, Kaoshsiung Hsien, 831, Chinese Taiwan
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