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1.
BMJ Open ; 14(5): e080858, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38719315

RESUMO

OBJECTIVES: To evaluate whether nephrotic syndrome (NS) and further corticosteroid (CS) use increase the risk of osteoporosis in Asian population during the period January 2000-December 2010. DESIGN: Nationwide population-based retrospective cohort study. SETTING: All healthcare facilities in Taiwan. PARTICIPANTS: A total of 28 772 individuals were enrolled. INTERVENTIONS: 26 614 individuals with newly diagnosed NS between 2000 and 2010 were identified and included in out study. 26 614 individuals with no NS diagnosis prior to the index date were age matched as controls. Diagnosis of osteoporosis prior to the diagnosis of NS or the same index date was identified, age, sex and NS-associated comorbidities were adjusted. PRIMARY OUTCOME MEASURE: To identify risk differences in developing osteoporosis among patients with a medical history of NS. RESULTS: After adjusting for covariates, osteoporosis risk was found to be 3.279 times greater in the NS cohort than in the non-NS cohort, when measured over 11 years after NS diagnosis. Stratification revealed that age older than 18 years, congestive heart failure, hyperlipidaemia, chronic kidney disease, liver cirrhosis and NS-related disease including diabetes mellitus, hepatitis B infection, hepatitis C infection, lymphoma and hypothyroidism, increased the risk of osteoporosis in the NS cohort, compared with the non-NS cohort. Additionally, osteoporosis risk was significantly higher in NS patients with CS use (adjusted HR (aHR)=3.397). The risk of osteoporosis in NS patients was positively associated with risk of hip and vertebral fracture (aHR=2.130 and 2.268, respectively). A significant association exists between NS and subsequent risk for osteoporosis. CONCLUSION: NS patients, particularly those treated with CS, should be evaluated for subsequent risk of osteoporosis.


Assuntos
Síndrome Nefrótica , Osteoporose , Humanos , Taiwan/epidemiologia , Osteoporose/epidemiologia , Osteoporose/complicações , Feminino , Estudos Retrospectivos , Masculino , Pessoa de Meia-Idade , Síndrome Nefrótica/epidemiologia , Síndrome Nefrótica/complicações , Adulto , Idoso , Fatores de Risco , Comorbidade , Adulto Jovem , Adolescente , Corticosteroides/efeitos adversos
2.
Org Lett ; 24(16): 2993-2997, 2022 04 29.
Artigo em Inglês | MEDLINE | ID: mdl-35442699

RESUMO

A novel unprecedented triphenylphosphine-mediated [4 + 3] annulation reaction of 2-benzylidene indane-1,3-diones and -diynoates through initial phosphine α-addition was discovered and found to result in biologically interesting indeno[1,2-b]oxepin-4-ylidenes in up to 75% yield. The seven-membered separable Z and E isomeric oxepins were confirmed using single-crystal X-ray diffraction.


Assuntos
Oxepinas , Fosfinas , Oxepinas/química , Fosfinas/química
3.
PLoS One ; 15(7): e0235607, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32614909

RESUMO

Global climate change has led to a significant increase in temperature over the last century and has been associated with significant increases in the severity and frequency of heat injury (HI). The consequences of HI included dehydration and rhabdomyolysis, leading to acute kidney injury, which is now recognized as a clear risk factor for chronic kidney disease (CKD). We aimed to investigate the effects of HI on the risk of CKD. This nationwide longitudinal population-based retrospective cohort study utilized the Taiwan National Health Insurance Research Database (NHIRD) data. We enrolled patients with HI who were followed in NHIRD system between 2000 and 2013.We excluded patients diagnosed with CKD or genital-urinary system-related disease before the date of the new HI diagnosis. The control cohort consisted of individuals without HI history. The patients and control cohort were selected by 1:4 matching according to the following baseline variables: sex, age, index year, and comorbidities. The outcome measure was CKD diagnosis. In total, 815 patients diagnosed with HI were identified. During the 13 year observation period, we identified 72 CKD events (8.83%) in the heat stroke group and 143 (4.38%) CKD events in the control group. Patients with heat stroke had an increased risk of CKD than the control patients (adjusted HR = 4.346, P < 0.001) during the follow-up period. The risk of end-stage renal disease was also significantly increased in the heat stroke group than in the control group (adjusted hazards ratio: 9.078, p < 0.001). HI-related CKD may represent one of the first epidemics due to global warming. When compared to those without HI, patients with HI have an increased CKD risk.


Assuntos
Golpe de Calor/patologia , Insuficiência Renal Crônica/diagnóstico , Adulto , Bases de Dados Factuais , Feminino , Golpe de Calor/complicações , Temperatura Alta , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/patologia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/patologia , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Adulto Jovem
4.
BMC Womens Health ; 20(1): 52, 2020 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164632

RESUMO

BACKGROUND: Acute water intoxication after hysteroscopy is a rare, life-threatening condition, often accompanied with delayed diagnosis owing to masked symptoms because of general anesthesia. CASE PRESENTATION: Herein we presented a 39-year-old female who presented with cardiac arrest after hysteroscopic myomectomy because of acute water intoxication and survived after extracorporeal membrane oxygenation, continuous venous-venous hemofiltration, and aggressive high sodium fluid resuscitation. CONCLUSION: Failure to recognize and treat this condition appropriately may lead to potentially lethal cardiopulmonary complications.


Assuntos
Oxigenação por Membrana Extracorpórea , Parada Cardíaca/etiologia , Hipocinesia/diagnóstico por imagem , Complicações Intraoperatórias , Edema Pulmonar/diagnóstico por imagem , Irrigação Terapêutica/efeitos adversos , Miomectomia Uterina/efeitos adversos , Neoplasias Uterinas/cirurgia , Intoxicação por Água/complicações , Adulto , Terapia de Substituição Renal Contínua/métodos , Ecocardiografia , Feminino , Humanos , Histeroscopia , Gravidez , Tomografia Computadorizada por Raios X , Água , Intoxicação por Água/terapia
5.
Eur J Intern Med ; 59: 97-103, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30297250

RESUMO

The purpose of this study is to determine the relationship between heat stroke and ischemic heart disease (IHD), in a nationwide population using a longitudinal approach. We retrospectively examined the data from the National Health Insurance Research Database (NHIRD) in Taiwan, for patients examined between 2000 and 2013. In total, 628 patients with a heat stroke episode were enrolled and matched with 1256 patients without any history of a heat stroke episode by propensity score matching at a ratio of 1:2. The mean follow-up years of the heat stroke group was 11.89 years and the mean follow up of the control group was 11.51 years. An association between heat stroke episodes and IHD (log-rank p < .001) was found in a univariate cox regression analysis. After multivariate adjustment, age, comorbidities (hypertension, diabetes, stroke), and lower insurance premiums were associated with IHD events in patients who had a heat stroke. IHD was independently associated with heat stroke following cox multivariate regression analysis and patients with a heat stroke episode had a higher incidence of IHD events compared to those without any heat stroke episode (2598.41/105 person-years vs. 1286.14/105 person-years, adjusted hazard ratio 3.527, 95% CI: 2.078-4.032, p < .001). The onset of IHD in patients who suffered a heat stroke was earlier than in those without a heat stroke episode (2.08 ±â€¯3.45 vs. 3.61 ±â€¯3.25 years, p < .001). In conclusion, clinicians should be aware about evaluating the IHD risk following a heat stroke episode in a patient.


Assuntos
Golpe de Calor/epidemiologia , Isquemia Miocárdica/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Feminino , Humanos , Incidência , Estimativa de Kaplan-Meier , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Pontuação de Propensão , Estudos Retrospectivos , Distribuição por Sexo , Taiwan/epidemiologia , Adulto Jovem
6.
PLoS One ; 13(9): e0203088, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30235226

RESUMO

OBJECT: Traumatic intracranial hemorrhage (TICH) patients with acute kidney injury (AKI) were reported to have a high mortality rate. Renal replacement therapy (RRT) is indicated for patients with a severe kidney injury. This study aimed to compare the effects of different RRT modalities regarding chronic dialysis rate among adult TICH patients with AKI. METHODS: A retrospective search of computerized hospital records from 2000 to 2010 for patients with a discharge diagnosis of TICH was conducted to identify the index cases. We collected the data of TICH patients with increased intracranial pressure combined with severe AKI who received intermittent hemodialysis (IHD) or continuous veno-venous hemofiltration (CVVH) as RRT. The outcome was dialysis dependence between 2000 and 2010. RESULTS: From a total of 310 patients who were enrolled in the study, 134 (43%) received CVVH and 176 (57%) received IHD. The risk of dialysis dependency was significantly lower in the CVVH group than in the IHD group (adjusted hazard ratio: 0.368, 95% CI, 0.158-0.858, P = 0.034). Diabetes mellitus and coronary artery disease were risk factors for dialysis dependency. CVVH compared with IHD modality was associated with lower dialysis dependency rate in TICH patients combined with AKI and diabetes mellitus and those with an injury severity score (ISS) ≥16. CONCLUSION: CVVH may yield better renal outcomes than IHD among TICH patients with AKI, especially those with diabetes mellitus and an ISS ≥16. The beneficial impact of CVVH on TICH patients needs to be clarified in a large cohort study in future.


Assuntos
Injúria Renal Aguda/complicações , Injúria Renal Aguda/terapia , Hemofiltração , Hemorragia Intracraniana Traumática/complicações , Hemorragia Intracraniana Traumática/terapia , Diálise Renal , Injúria Renal Aguda/epidemiologia , Adulto , Complicações do Diabetes/epidemiologia , Feminino , Seguimentos , Humanos , Hemorragia Intracraniana Traumática/epidemiologia , Masculino , Estudos Retrospectivos , Fatores de Risco , Taiwan
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