Factors associated with SARS fatality Background/Purpose: Severe acute respiratory syndrome (SARS... more Factors associated with SARS fatality Background/Purpose: Severe acute respiratory syndrome (SARS) has a high fatality rate worldwide. We examined the epidemiologic and clinical factors associated with death for all laboratory-confirmed SARS patients in Taiwan. Methods: Using initial data in medical records reported by hospitals to the Center for Disease Control in Taiwan, we analyzed whether hematological, biochemical and arterial blood gas measures could predict fatality in 346 SARS patients. Results: Both fatalities (n = 73; 21.1%) and survivors had elevated plasma concentration of initial C-reactive protein (CRP), but the mean CRP concentration was higher in fatalities (47.7 ± 43.3 mg/L) than in survivors (24.6 ± 28.2 mg/L). Initial lymphocyte counts were low in both fatalities (814 ± 378/μL) and survivors (1019 ± 480/μL). After controlling for age and sex, multiple logistic regression analysis showed that hematological factors significantly associated with fatality included initial neutrophil count > 7000/ μL (odds ratio [OR] = 6.4), initial CRP concentration > 47.5 mg/L (OR = 5.8) and lactic acid dehydrogenase (LDH) > 593.5 IU/L (OR = 4.2). Factors significantly associated with initial CRP concentration > 47.5 mg/L included dyspnea (OR = 4.3), red blood cell count < 4.1 × 10 6 /μL (OR = 4.3) and serum aspartate aminotransferase > 57 IU/L (OR = 3.1). Conclusion: Initial neutrophil count, CRP and LDH levels are important predictors of mortality from SARS.
Infectious gastroenteritis is a common illness in children. This study investigated the etiology ... more Infectious gastroenteritis is a common illness in children. This study investigated the etiology and clinical manifestations of hospitalized children with symptoms of infectious gastroenteritis in southern Taiwan. We studied 467 consecutive patients with infectious gastroenteritis aged from 2 days to 10 years hospitalized from April 2001 to March 2002. Rotavirus was the most common etiology (57%) of infectious gastroenteritis in these patients. Bacterial infection was noted in 57 cases (12%). Rotavirus was found in 92% of nosocomial infectious gastroenteritis (p < or = 0.001). Bloody stool was a presentation of bacterial infection in 74% of cases and rotavirus gastroenteritis in 8% of cases (p < or = 0.001). The G serotype of rotavirus was identified in 87 patients. Serotype G1 was the most common (51%), followed by G9 (31%). The emergence of serotype G9 strains in rotavirus infection has not been previously reported from Taiwan. Incorporation of G9 rotavirus into vaccines should be considered.
Background: The rate of preterm birth has been increasing worldwide. Most preterm babies are at a... more Background: The rate of preterm birth has been increasing worldwide. Most preterm babies are at an increased risk of central nervous system impairments as well as respiratory and gastrointestinal complications. The aim of this study was to investigate the epidemiologic characteristics of and associated factors contributing to preterm birth in Taiwan. Methods: Information on obstetric antecedents and risk factors for preterm birth in pregnant women was obtained from the National Health Insurance Research (NHIR) database provided by the Taiwan National Health Research Institute. All live births from 2004 to 2013 in Taiwan were included in this study. Results: A total of 130,362 live births from 2004 to 2013 were included in this study. Overall, the average annual rate of preterm births increased by 5.3% (from 3.33% in 2004 to 5.11% in 2013). Multiple logistic regression analyses showed that nulliparous women, multifetal pregnancies, advanced mother age, history of preterm birth, history of maternal drug abuse/dependence, and maternal medical complications were positively associated with an increased risk of preterm birth (all p-values< 0.05). Conclusion: The overall proportion of preterm births increased from 2004 to 2013 in Taiwan. Babies born preterm had a higher risk of developing morbidities and mortalities. The development of a comprehensive program to identify the high-risk group is needed for effective interventions to prevent premature birth.
To determine the patterns of urinary proteins in bladder cancer subjects using pooled urine from ... more To determine the patterns of urinary proteins in bladder cancer subjects using pooled urine from 27 bladder cancer patients. The urine matrix was removed by acetonitrile precipitation followed by molecular weight cutoff. High performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) was used to analyze the urinary proteome. The candidate protein was validated by western blot. A total of 146 urinary proteins were identified. The protein list was screened using bioinformatic tools, and 11 cancer-related urinary proteins were found to be potential tumor markers for bladder cancer. However, only PLK2 was identified with high confidence. This candidate protein was validated by western blot using urine samples from 14 normal subjects and 10 bladder cancer patients. Statistically significant correlations were detected between PLK2 expression and bladder transitional cell carcinoma (TCC) (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Urinary PLK2 had a sensitivity of 80% at a specificity of 64% for bladder TCC in the samples tested. Our results demonstrate overexpression of PLK2 in bladder carcinomas, suggesting a possible role of PLK2 in the pathogenesis of bladder carcinomas. However, the small cohort, preliminary results, and lack of subgroup analysis (such as carcinoma in situ, high grade, and stage) in this study prevent us from drawing definitive conclusions about the diagnostic value of PLK2 in these patients. Further studies directed toward a multitude of possible carcinogenic mechanisms of PLK2 in bladder cancer are warranted.
To evaluate the clinical and epidemiological characteristics of patients with genitourinary (GU) ... more To evaluate the clinical and epidemiological characteristics of patients with genitourinary (GU) tract transitional cell carcinoma (TCC) in an endemic area of blackfoot disease (BFD), the arsenic-exposed group, to compare them with characteristics among other non-BFD endemic areas (unexposed group). In all, 474 patients with pathologically diagnosed GU-TCC were enrolled in the study. All follow-up data were prospectively collected and entered into a database throughout the study period. Statistical analysis was used to determine the association between clinical variables and prognosis, and multivariate regression models were used to assess the association between arseniasis and mortality from GU-TCC. There were no significant differences between the groups in age, sex, tumour stage and grade. However, the exposed group had a significantly higher proportion of females. The overall 5-year survival rate of patients with upper urinary tract (UUT) TCC was 49%, and the two groups had similar 5-year survival rates. The overall 5-year survival rate of patients with urinary bladder (UB) TCC was 68.3%, and there was a statistically significant difference in survival between the groups, with a 5-year survival rate of 58.7% for the exposed and 72.4% for the unexposed group. For patients with early-stage (pTa and pT1) UB cancers, the death rate was five times higher in exposed patients with tumour progression and recurrence after transurethral resection of bladder tumour than in the unexposed group. There was a significantly higher mortality rate for UB-TCC among exposed patients in the area endemic for arseniasis than in those from other non-endemic areas. The arsenic content of artesian-well water might contribute to the increased ratio of female patients with GU-TCC and the unusually high incidence of UUT-TCC in the BFD endemic area in Taiwan.
Sleep quality is directly correlated with overall health and quality of life. Firefighters have a... more Sleep quality is directly correlated with overall health and quality of life. Firefighters have a higher workload and injury rate than those in other occupations. This study investigated the prevalence of and risk factors for poor sleep quality among firefighters in Taiwan. This cross-sectional study was conducted between November 2019 and August 2020. Sociodemographic information of the study participants was collected using a structured self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the subjective sleep quantity and quality of firefighters during the previous month. A t test for continuous variables and χ 2 test for categorical variables were performed for univariate analysis. Logistic regression analysis was conducted for multivariate analysis. Eight hundred eighty-nine firefighters completed the questionnaire during the study period, with a response rate of 88.9%. Among them, 447 (50.3%) reported poor sleep quality. Logistic regression analysis showed that female sex, longer work duration (&gt;5 years) for firefighters, on-call shift work, and no leisure-time physical activity (LTPA) was significantly correlated with an increased risk of poor sleep quality. Advanced analysis of partaking in LTPA revealed that high-intensity LTPA is significantly associated with higher rates of poor sleep quality. In contrast, adequate rest after LTPA correlated with lower rates of poor sleep quality. Firefighters are at higher risk of poor sleep quality. Emphasis should be placed on firefighters’ regular LTPA, particularly when experiencing sleep problems.
Kaohsiung Journal of Medical Sciences, Feb 1, 2013
Premenstrual syndrome (PMS) can impact an individual&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;... more Premenstrual syndrome (PMS) can impact an individual&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s interpersonal relationships, social interactions, productivity, lifestyle, school performance and emotional well-being. This study was designed to explore the factors associated with PMS in new female university students in Taiwan. The test battery included a self-administered structured questionnaire, the five-item brief symptoms rating scale, the Pittsburgh Sleep Quality Index and the Chinese Premenstrual Symptom Questionnaire. Additionally, details of the participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; lifestyles and family and personal histories of physical illness were recorded. Serum lipids were also measured. Of all the participants (N = 1699), 39.85% were defined as having PMS. Using logistical regression analysis, we found a positive relationship between PMS and consuming more foods containing egg yolk, greater alcohol intake, poorer sleep quality, higher likelihood of psychiatric morbidity, family history of dyslipidemia, and a higher serum cholesterol level. The results show that PMS is prevalent among new female university students and that lifestyle and nutritional/metabolic factors may play a role in this disorder.
Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (S... more Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has emerged as a global health concern. This study aimed to review the epidemiology and pathophysiology of COVID-19 and provide evidence for the implementation of control measures. We utilized several online databases, including MEDLINE (National Library of Medicine, Bethesda, Maryland, USA), PubMed, EMBASE, Web of Science, and Google Scholar, to collect relevant published papers using a combination of the following keywords: “COVID-19,” “SARS-CoV-2,” “novel coronavirus,” “epidemiology,” and “pathophysiology.” The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used in this study. Globally, approximately 3–46% of patients with SARS-CoV-2 infection experience gastrointestinal symptoms. The clinical spectrum of COVID-19 is wide, ranging from mild to severe, and even fatal. COVID-19 was initially reported as a respiratory tract disease; however, gastrointestinal symptoms have only recently been reported. COVID-19 Patients with gastrointestinal symptoms may have more severe clinical manifestations and poor prognosis. This study highlights the need to better understand the mechanisms involved in the development of gastrointestinal symptoms in patients with COVID-19 to prevent the further spread of this pathogen.
The goals of this study were to examine trends, risk factors, and survival rates of people diagno... more The goals of this study were to examine trends, risk factors, and survival rates of people diagnosed with HIV=AIDS. We used national surveillance data reported to the Taiwan Center for Disease Control (Taiwan CDC). The subjects of this study were all confirmed HIV and AIDS cases in Taiwan. From 1990 through 2005, the number of people that have been reported to have HIV=AIDS is 9961. Among individuals with HIV=AIDS, the male-to-female ratio was 11:1, the median age was 32 years. The number of HIV and AIDS diagnoses increased significantly for both men and women during the study period. The number of HIV cases among men who have sex with men (MSM) increased from 24 in 1990 to 527 in 2005, while diagnoses among injection drug users (IDUs) rose rapidly from 3 in 1990 to 2450 in 2005. The incidence-to-prevalence ratio (IPR) has risen sharply in recent years and has exceeded the epidemic threshold (IPR(t) ¼ 0.1) for IDUs, indicating a growing epidemic. The corresponding hazard ratios for the highly active antiretroviral therapy (HAART) era versus pre-HAART era in the earlier and late HIV diagnosis groups were 0.45 (95% confidence interval [CI] 0.36-0.54) and 0.39 (95% CI 0.31-0.49), respectively. There was no significant difference in the survival rate of HIV testers. The increasing number of HIV infection places Taiwan among the worst IDU-concentrated epidemic areas in Asia. HIV intervention and prevention strategies, especially targeting IDUs, are urgently needed to reduce the ongoing spread of HIV infections in Taiwan.
Environmental Health and Preventive Medicine, Oct 31, 2020
Occupational noise-induced hearing loss (ONIHL) is the most prevalent occupational disease in the... more Occupational noise-induced hearing loss (ONIHL) is the most prevalent occupational disease in the world. The goal of this study was to review the epidemiology, pathogenesis, and preventive measures of ONIHL among workers and provide evidence for the implementation of control measures. Literature studies were identified from the MEDL INE, PubMed, Embase, Web of Science, and Google Scholar using the search terms "noise-induced hearing loss" "prevalence", "pathogenesis", and "preventive measures". The articles reviewed in this report were limited from 2000 to 2020. Articles that were not published in the English language, manuscripts without an abstract, and opinion articles were excluded. After a preliminary screening, all of the articles were reviewed and synthesized to provide an overview of the current status of ONIHL among workers. The mechanism of ONIHL among workers is a complex interaction between environmental and host factors (both genetic and acquired factors). The outcomes of noise exposure are different among individual subjects. Clinical trials are currently underway to evaluate the treatment effect of antioxidants on ONIHL. Noise exposure may contribute to temporary or permanent threshold shifts; however, even temporary threshold shifts may predispose an individual to eventual permanent hearing loss. Noise prevention programs are an important preventive measure in reducing the morbidity of ONIHL among workers.
International Journal of Environmental Research and Public Health, Mar 5, 2020
Mumps is an important childhood infectious disease caused by mumps virus (MuV). We reviewed the e... more Mumps is an important childhood infectious disease caused by mumps virus (MuV). We reviewed the epidemiology, pathogenesis, and vaccine development of mumps. Previous studies were identified using the key words "mumps" and "epidemiology", "pathogenesis" or "vaccine" in MEDLINE, PubMed, Embase, Web of Science, and Google Scholar. We excluded the articles that were not published in the English language, manuscripts without abstracts, and opinion articles from the review. The number of cases caused by MuV decreased steeply after the introduction of the mumps vaccine worldwide. In recent years, a global resurgence of mumps cases in developed countries and cases of aseptic meningitis caused by some mumps vaccine strains have renewed the importance of MuV infection worldwide. The performance of mumps vaccination has become an important issue for controlling mumps infections. Vaccine development and routine vaccination are still effective measures to globally reduce the incidence of mumps infections. During outbreaks, a third of MMR vaccine is recommended for groups of persons determined by public authorities.
Factors associated with SARS fatality Background/Purpose: Severe acute respiratory syndrome (SARS... more Factors associated with SARS fatality Background/Purpose: Severe acute respiratory syndrome (SARS) has a high fatality rate worldwide. We examined the epidemiologic and clinical factors associated with death for all laboratory-confirmed SARS patients in Taiwan. Methods: Using initial data in medical records reported by hospitals to the Center for Disease Control in Taiwan, we analyzed whether hematological, biochemical and arterial blood gas measures could predict fatality in 346 SARS patients. Results: Both fatalities (n = 73; 21.1%) and survivors had elevated plasma concentration of initial C-reactive protein (CRP), but the mean CRP concentration was higher in fatalities (47.7 ± 43.3 mg/L) than in survivors (24.6 ± 28.2 mg/L). Initial lymphocyte counts were low in both fatalities (814 ± 378/μL) and survivors (1019 ± 480/μL). After controlling for age and sex, multiple logistic regression analysis showed that hematological factors significantly associated with fatality included initial neutrophil count > 7000/ μL (odds ratio [OR] = 6.4), initial CRP concentration > 47.5 mg/L (OR = 5.8) and lactic acid dehydrogenase (LDH) > 593.5 IU/L (OR = 4.2). Factors significantly associated with initial CRP concentration > 47.5 mg/L included dyspnea (OR = 4.3), red blood cell count < 4.1 × 10 6 /μL (OR = 4.3) and serum aspartate aminotransferase > 57 IU/L (OR = 3.1). Conclusion: Initial neutrophil count, CRP and LDH levels are important predictors of mortality from SARS.
Infectious gastroenteritis is a common illness in children. This study investigated the etiology ... more Infectious gastroenteritis is a common illness in children. This study investigated the etiology and clinical manifestations of hospitalized children with symptoms of infectious gastroenteritis in southern Taiwan. We studied 467 consecutive patients with infectious gastroenteritis aged from 2 days to 10 years hospitalized from April 2001 to March 2002. Rotavirus was the most common etiology (57%) of infectious gastroenteritis in these patients. Bacterial infection was noted in 57 cases (12%). Rotavirus was found in 92% of nosocomial infectious gastroenteritis (p < or = 0.001). Bloody stool was a presentation of bacterial infection in 74% of cases and rotavirus gastroenteritis in 8% of cases (p < or = 0.001). The G serotype of rotavirus was identified in 87 patients. Serotype G1 was the most common (51%), followed by G9 (31%). The emergence of serotype G9 strains in rotavirus infection has not been previously reported from Taiwan. Incorporation of G9 rotavirus into vaccines should be considered.
Background: The rate of preterm birth has been increasing worldwide. Most preterm babies are at a... more Background: The rate of preterm birth has been increasing worldwide. Most preterm babies are at an increased risk of central nervous system impairments as well as respiratory and gastrointestinal complications. The aim of this study was to investigate the epidemiologic characteristics of and associated factors contributing to preterm birth in Taiwan. Methods: Information on obstetric antecedents and risk factors for preterm birth in pregnant women was obtained from the National Health Insurance Research (NHIR) database provided by the Taiwan National Health Research Institute. All live births from 2004 to 2013 in Taiwan were included in this study. Results: A total of 130,362 live births from 2004 to 2013 were included in this study. Overall, the average annual rate of preterm births increased by 5.3% (from 3.33% in 2004 to 5.11% in 2013). Multiple logistic regression analyses showed that nulliparous women, multifetal pregnancies, advanced mother age, history of preterm birth, history of maternal drug abuse/dependence, and maternal medical complications were positively associated with an increased risk of preterm birth (all p-values< 0.05). Conclusion: The overall proportion of preterm births increased from 2004 to 2013 in Taiwan. Babies born preterm had a higher risk of developing morbidities and mortalities. The development of a comprehensive program to identify the high-risk group is needed for effective interventions to prevent premature birth.
To determine the patterns of urinary proteins in bladder cancer subjects using pooled urine from ... more To determine the patterns of urinary proteins in bladder cancer subjects using pooled urine from 27 bladder cancer patients. The urine matrix was removed by acetonitrile precipitation followed by molecular weight cutoff. High performance liquid chromatography coupled with electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) was used to analyze the urinary proteome. The candidate protein was validated by western blot. A total of 146 urinary proteins were identified. The protein list was screened using bioinformatic tools, and 11 cancer-related urinary proteins were found to be potential tumor markers for bladder cancer. However, only PLK2 was identified with high confidence. This candidate protein was validated by western blot using urine samples from 14 normal subjects and 10 bladder cancer patients. Statistically significant correlations were detected between PLK2 expression and bladder transitional cell carcinoma (TCC) (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Urinary PLK2 had a sensitivity of 80% at a specificity of 64% for bladder TCC in the samples tested. Our results demonstrate overexpression of PLK2 in bladder carcinomas, suggesting a possible role of PLK2 in the pathogenesis of bladder carcinomas. However, the small cohort, preliminary results, and lack of subgroup analysis (such as carcinoma in situ, high grade, and stage) in this study prevent us from drawing definitive conclusions about the diagnostic value of PLK2 in these patients. Further studies directed toward a multitude of possible carcinogenic mechanisms of PLK2 in bladder cancer are warranted.
To evaluate the clinical and epidemiological characteristics of patients with genitourinary (GU) ... more To evaluate the clinical and epidemiological characteristics of patients with genitourinary (GU) tract transitional cell carcinoma (TCC) in an endemic area of blackfoot disease (BFD), the arsenic-exposed group, to compare them with characteristics among other non-BFD endemic areas (unexposed group). In all, 474 patients with pathologically diagnosed GU-TCC were enrolled in the study. All follow-up data were prospectively collected and entered into a database throughout the study period. Statistical analysis was used to determine the association between clinical variables and prognosis, and multivariate regression models were used to assess the association between arseniasis and mortality from GU-TCC. There were no significant differences between the groups in age, sex, tumour stage and grade. However, the exposed group had a significantly higher proportion of females. The overall 5-year survival rate of patients with upper urinary tract (UUT) TCC was 49%, and the two groups had similar 5-year survival rates. The overall 5-year survival rate of patients with urinary bladder (UB) TCC was 68.3%, and there was a statistically significant difference in survival between the groups, with a 5-year survival rate of 58.7% for the exposed and 72.4% for the unexposed group. For patients with early-stage (pTa and pT1) UB cancers, the death rate was five times higher in exposed patients with tumour progression and recurrence after transurethral resection of bladder tumour than in the unexposed group. There was a significantly higher mortality rate for UB-TCC among exposed patients in the area endemic for arseniasis than in those from other non-endemic areas. The arsenic content of artesian-well water might contribute to the increased ratio of female patients with GU-TCC and the unusually high incidence of UUT-TCC in the BFD endemic area in Taiwan.
Sleep quality is directly correlated with overall health and quality of life. Firefighters have a... more Sleep quality is directly correlated with overall health and quality of life. Firefighters have a higher workload and injury rate than those in other occupations. This study investigated the prevalence of and risk factors for poor sleep quality among firefighters in Taiwan. This cross-sectional study was conducted between November 2019 and August 2020. Sociodemographic information of the study participants was collected using a structured self-administered questionnaire. The Chinese version of the Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the subjective sleep quantity and quality of firefighters during the previous month. A t test for continuous variables and χ 2 test for categorical variables were performed for univariate analysis. Logistic regression analysis was conducted for multivariate analysis. Eight hundred eighty-nine firefighters completed the questionnaire during the study period, with a response rate of 88.9%. Among them, 447 (50.3%) reported poor sleep quality. Logistic regression analysis showed that female sex, longer work duration (&gt;5 years) for firefighters, on-call shift work, and no leisure-time physical activity (LTPA) was significantly correlated with an increased risk of poor sleep quality. Advanced analysis of partaking in LTPA revealed that high-intensity LTPA is significantly associated with higher rates of poor sleep quality. In contrast, adequate rest after LTPA correlated with lower rates of poor sleep quality. Firefighters are at higher risk of poor sleep quality. Emphasis should be placed on firefighters’ regular LTPA, particularly when experiencing sleep problems.
Kaohsiung Journal of Medical Sciences, Feb 1, 2013
Premenstrual syndrome (PMS) can impact an individual&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;... more Premenstrual syndrome (PMS) can impact an individual&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s interpersonal relationships, social interactions, productivity, lifestyle, school performance and emotional well-being. This study was designed to explore the factors associated with PMS in new female university students in Taiwan. The test battery included a self-administered structured questionnaire, the five-item brief symptoms rating scale, the Pittsburgh Sleep Quality Index and the Chinese Premenstrual Symptom Questionnaire. Additionally, details of the participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; lifestyles and family and personal histories of physical illness were recorded. Serum lipids were also measured. Of all the participants (N = 1699), 39.85% were defined as having PMS. Using logistical regression analysis, we found a positive relationship between PMS and consuming more foods containing egg yolk, greater alcohol intake, poorer sleep quality, higher likelihood of psychiatric morbidity, family history of dyslipidemia, and a higher serum cholesterol level. The results show that PMS is prevalent among new female university students and that lifestyle and nutritional/metabolic factors may play a role in this disorder.
Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (S... more Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has emerged as a global health concern. This study aimed to review the epidemiology and pathophysiology of COVID-19 and provide evidence for the implementation of control measures. We utilized several online databases, including MEDLINE (National Library of Medicine, Bethesda, Maryland, USA), PubMed, EMBASE, Web of Science, and Google Scholar, to collect relevant published papers using a combination of the following keywords: “COVID-19,” “SARS-CoV-2,” “novel coronavirus,” “epidemiology,” and “pathophysiology.” The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used in this study. Globally, approximately 3–46% of patients with SARS-CoV-2 infection experience gastrointestinal symptoms. The clinical spectrum of COVID-19 is wide, ranging from mild to severe, and even fatal. COVID-19 was initially reported as a respiratory tract disease; however, gastrointestinal symptoms have only recently been reported. COVID-19 Patients with gastrointestinal symptoms may have more severe clinical manifestations and poor prognosis. This study highlights the need to better understand the mechanisms involved in the development of gastrointestinal symptoms in patients with COVID-19 to prevent the further spread of this pathogen.
The goals of this study were to examine trends, risk factors, and survival rates of people diagno... more The goals of this study were to examine trends, risk factors, and survival rates of people diagnosed with HIV=AIDS. We used national surveillance data reported to the Taiwan Center for Disease Control (Taiwan CDC). The subjects of this study were all confirmed HIV and AIDS cases in Taiwan. From 1990 through 2005, the number of people that have been reported to have HIV=AIDS is 9961. Among individuals with HIV=AIDS, the male-to-female ratio was 11:1, the median age was 32 years. The number of HIV and AIDS diagnoses increased significantly for both men and women during the study period. The number of HIV cases among men who have sex with men (MSM) increased from 24 in 1990 to 527 in 2005, while diagnoses among injection drug users (IDUs) rose rapidly from 3 in 1990 to 2450 in 2005. The incidence-to-prevalence ratio (IPR) has risen sharply in recent years and has exceeded the epidemic threshold (IPR(t) ¼ 0.1) for IDUs, indicating a growing epidemic. The corresponding hazard ratios for the highly active antiretroviral therapy (HAART) era versus pre-HAART era in the earlier and late HIV diagnosis groups were 0.45 (95% confidence interval [CI] 0.36-0.54) and 0.39 (95% CI 0.31-0.49), respectively. There was no significant difference in the survival rate of HIV testers. The increasing number of HIV infection places Taiwan among the worst IDU-concentrated epidemic areas in Asia. HIV intervention and prevention strategies, especially targeting IDUs, are urgently needed to reduce the ongoing spread of HIV infections in Taiwan.
Environmental Health and Preventive Medicine, Oct 31, 2020
Occupational noise-induced hearing loss (ONIHL) is the most prevalent occupational disease in the... more Occupational noise-induced hearing loss (ONIHL) is the most prevalent occupational disease in the world. The goal of this study was to review the epidemiology, pathogenesis, and preventive measures of ONIHL among workers and provide evidence for the implementation of control measures. Literature studies were identified from the MEDL INE, PubMed, Embase, Web of Science, and Google Scholar using the search terms "noise-induced hearing loss" "prevalence", "pathogenesis", and "preventive measures". The articles reviewed in this report were limited from 2000 to 2020. Articles that were not published in the English language, manuscripts without an abstract, and opinion articles were excluded. After a preliminary screening, all of the articles were reviewed and synthesized to provide an overview of the current status of ONIHL among workers. The mechanism of ONIHL among workers is a complex interaction between environmental and host factors (both genetic and acquired factors). The outcomes of noise exposure are different among individual subjects. Clinical trials are currently underway to evaluate the treatment effect of antioxidants on ONIHL. Noise exposure may contribute to temporary or permanent threshold shifts; however, even temporary threshold shifts may predispose an individual to eventual permanent hearing loss. Noise prevention programs are an important preventive measure in reducing the morbidity of ONIHL among workers.
International Journal of Environmental Research and Public Health, Mar 5, 2020
Mumps is an important childhood infectious disease caused by mumps virus (MuV). We reviewed the e... more Mumps is an important childhood infectious disease caused by mumps virus (MuV). We reviewed the epidemiology, pathogenesis, and vaccine development of mumps. Previous studies were identified using the key words "mumps" and "epidemiology", "pathogenesis" or "vaccine" in MEDLINE, PubMed, Embase, Web of Science, and Google Scholar. We excluded the articles that were not published in the English language, manuscripts without abstracts, and opinion articles from the review. The number of cases caused by MuV decreased steeply after the introduction of the mumps vaccine worldwide. In recent years, a global resurgence of mumps cases in developed countries and cases of aseptic meningitis caused by some mumps vaccine strains have renewed the importance of MuV infection worldwide. The performance of mumps vaccination has become an important issue for controlling mumps infections. Vaccine development and routine vaccination are still effective measures to globally reduce the incidence of mumps infections. During outbreaks, a third of MMR vaccine is recommended for groups of persons determined by public authorities.
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Papers by Kow-tong Chen