7 results on '"Kuo, Chen-Chun"'
Search Results
2. Evaluating the Primary Prevention of Ischemic Stroke of Oral Antithrombotic Therapy in Head and Neck Cancer Patients with Radiation Therapy.
- Author
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Hsu, Chin-Wei, Huang, Yaw-Bin, Kuo, Chen-Chun, and Chen, Chung-Yu
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STROKE prevention , *FIBRINOLYTIC agents , *CHI-squared test , *CONFIDENCE intervals , *HEAD tumors , *HEMORRHAGE , *MORTALITY , *NECK tumors , *PROBABILITY theory , *RESEARCH funding , *STROKE , *T-test (Statistics) , *TREATMENT effectiveness , *DISEASE incidence , *PROPORTIONAL hazards models , *RETROSPECTIVE studies , *DATA analysis software , *DESCRIPTIVE statistics , *DISEASE complications ,STROKE risk factors - Abstract
Although previous studies demonstrated the risk of ischemic stroke (IS) in patients with head and neck cancer (HNC), the impact of oral antithrombotic therapy (OAT) on this risk has not yet been assessed. We aimed to evaluate the effectiveness and safety of OAT in patients with HNC treated with RT. This retrospective cohort study was performed using the National Health Insurance Research Database of Taiwan. A total of 37,638 patients diagnosed with HNC included in the study were classified as users and nonusers of OAT. Primary outcome was IS or transient ischemic attack (TIA), and secondary outcomes were death and major bleeding. The Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). There was no significant difference in the risk of IS or TIA between patients on continuous OAT and nonusers (adjusted HR, 0.812; 95% CI, 0.199–3.309). The risk of major bleeding was not significantly different between the groups. From a national population database, we did not find an association between OAT and decreasing risk of ischemic stroke/TIA or increasing hazard of major bleeding. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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3. Risk of ischemic stroke in patients with prostate cancer receiving androgen deprivation therapy in Taiwan.
- Author
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Liao, Kuang-Ming, Huang, Yaw-Bin, Chen, Chung-Yu, and Kuo, Chen-Chun
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PROSTATE cancer patients , *STROKE patients , *ANDROGENS , *PROSTATE cancer , *CARDIOVASCULAR diseases - Abstract
Background: Androgen deprivation therapy (ADT) in the treatment of prostate cancer may be associated with an increased risk of thromboembolic disease. The aim of our study was to investigate the association of ADT in the treatment of prostate cancer with ischemic stroke risk.Methods: We identified individuals older than 20 years of age who were newly diagnosed with prostate cancer between January 1, 2005, and December 31, 2012. Patients who experienced ischemic stroke or transient ischemic stroke before the index date were excluded. Patients who received at least one prescription for ADT within 6 months were defined as the ADT user group. Patients who did not receive at least one prescription for ADT within 6 months were defined as the ADT nonuser group. The patients were followed until the first occurrence of one of the primary outcome measures (ischemic stroke or death) or until December 31, 2013. The primary composite outcome was the time to any cause of death or ischemic stroke.Results: There was no significant difference in the primary composite outcomes in the prostate cancer patients between the ADT user and nonuser groups. Prostate cancer patients who received ADT had a higher mortality rate than those who were not treated with ADT, and the adjusted hazard ratio was 1.907 (95% confidence interval: 1.278-2.844; P = 0.0016) after adjusting for age, comorbidities and comedication use.Conclusion: ADT in the treatment of prostate cancer may not be associated with an increased risk of ischemic stroke. The differences in thromboembolic effects in cardiovascular disease and ischemic stroke secondary to ADT should be further discussed and evaluated prospectively. [ABSTRACT FROM AUTHOR]- Published
- 2019
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4. Developing an App by Exploiting Web-Based Mobile Technology to Inspect Controlled Substances in Patient Care Units.
- Author
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Lu, Ying-Hao, Lee, Li-Yao, Chen, Ying-Lan, Cheng, Hsing-I, Tsai, Wen-Tsung, Kuo, Chen-Chun, Chen, Chung-Yu, and Huang, Yaw-Bin
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HUMAN error , *ACADEMIC medical centers , *DRUG monitoring , *ELECTRONIC security systems , *INTERNET , *MEDICAL care , *PATIENTS , *PROGRAMMING languages , *RESEARCH funding , *TECHNOLOGY , *DATA security , *CONTROLLED substances , *SMARTPHONES , *MOBILE apps , *PREVENTION ,RESEARCH evaluation - Abstract
We selected iOS in this study as the App operation system, Objective-C as the programming language, and Oracle as the database to develop an App to inspect controlled substances in patient care units. Using a web-enabled smartphone, pharmacist inspection can be performed on site and the inspection result can be directly recorded into HIS through the Internet, so human error of data translation can be minimized and the work efficiency and data processing can be improved. This system not only is fast and convenient compared to the conventional paperwork, but also provides data security and accuracy. In addition, there are several features to increase inspecting quality: (1) accuracy of drug appearance, (2) foolproof mechanism to avoid input errors or miss, (3) automatic data conversion without human judgments, (4) online alarm of expiry date, and (5) instant inspection result to show not meted items. This study has successfully turned paper-based medication inspection into inspection using a web-based mobile device. [ABSTRACT FROM AUTHOR]
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- 2017
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5. A Retrospective Observational Study to Assess Prescription Pattern in Patients with Type B Aortic Dissection and Treatment Outcome.
- Author
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Liao, Kuang-Ming, Chen, Chung-Yu, Wang, Shih-Han, Huang, Jiann-Woei, Kuo, Chen-Chun, and Huang, Yaw-Bin
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DRUG therapy for hyperlipidemia , *STATINS (Cardiovascular agents) , *AORTIC dissection , *DRUG prescribing , *HYPERTENSION , *ANTIHYPERTENSIVE agents , *SCIENTIFIC observation , *RESEARCH funding , *COMORBIDITY , *PHYSICIAN practice patterns , *BODY mass index , *TREATMENT effectiveness , *RETROSPECTIVE studies , *DATA analysis software - Abstract
Aortic dissection is a life-threatening condition. However, the use of medication to treat it remains unclear in our population, particularly in patients with a type B aortic dissection (TBAD) who do not receive surgery. This retrospective cohort study evaluated antihypertensive prescription patterns and outcomes in patients with nonsurgical TBAD. We reviewed the hospital records of patients with TBAD at a medical center in Taiwan from January 2008 to June 2013 to assess the baseline information, prescribing pattern, event rate, and clinical effectiveness of different antihypertensive treatment strategies. A Cox proportional hazards model was used to estimate outcomes in different antihypertensive strategies. The primary endpoints were all-cause mortality and hospital admission for an aortic dissection. We included 106 patients with a mean follow-up period of 2.75 years. The most common comorbidity was hypertension followed by dyslipidemia and diabetes mellitus. Study endpoints mostly occurred within 6 months after the index date. Over 80% of patients received dual or triple antihypertensive strategies. Patients treated with different treatment strategies did not have a significantly increased risk of a primary outcome compared with those treated with a monotherapy. We found no significant difference in the primary outcome following the use of different antihypertensive medication regimes. [ABSTRACT FROM AUTHOR]
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- 2016
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6. Increasing risks of ischemic stroke in oral cancer patients treated with radiotherapy or chemotherapy: a nationwide cohort study.
- Author
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Wu, Yu-Ting, Chen, Chung-Yu, Lai, Wen-Ter, Kuo, Chen-Chun, and Huang, Yaw-Bin
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TRANSIENT ischemic attack , *ORAL cancer patients , *RADIOTHERAPY , *CANCER chemotherapy , *COHORT analysis , *HAZARD function (Statistics) , *DISEASE risk factors - Abstract
Background: Several studies have identified correlations between cancer and increased risks of ischemic stroke (IS), particularly following radiotherapy (RT) or chemotherapy (CT). However, data regarding relative risks of IS in oral cancer are limited. The aim of this study was to compare hazard ratios (HR) of IS among oral cancer patients treated with and without RT, CT, or both (CCRT).Methods: We analyzed data collected by the Taiwan National Health Insurance Research Database (NHIRD) from 1996 to 2009, which covered approximately 99.5% of the medical claims submitted nationally. A total of 21,853 patients diagnosed with oral cancer from 2000 to 2008 were included. The Cox proportional hazard model was used to estimate the HRs of IS among different treatment modalities and a matched cohort.Results: The overall risk of IS was1.24-fold greater in patients treated with RT/CT/CCRT than those treated with surgery alone and 1.08-fold greater for surgery with adjuvant therapy (radiotherapy or chemotherapy after surgery) after adjusting for confounding factors. The incidence of IS was 0.23-fold lower in matched control group than in the oral cancer cohort. In subgroup analysis, patients who received RT/CT/CCRT and aged <40 years old were at a 2.77-fold greater risk for IS than age-matched patients who underwent surgery alone, although this difference decreased with patient age.Conclusions: Oral cancer patients, particularly those aged <40 years, who underwent RT or CT are at increased risks for IS. Other significant risk factors for IS included Charlson comorbidity index (CCI) >1, hypertension, coronary artery disease, and atrial fibrillation. [ABSTRACT FROM PUBLISHER]
- Published
- 2015
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7. Quantification of meropenem in plasma and cerebrospinal fluid by micellar electrokinetic capillary chromatography and application in bacterial meningitis patients
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Chou, Yu-Wei, Yang, Yuan-Han, Chen, Jin-Hon, Kuo, Chen-Chun, and Chen, Su-Hwei
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HYDROGEN-ion concentration , *CEREBROSPINAL fluid , *CHROMATOGRAPHIC analysis , *NEISSERIA meningitidis , *CENTRAL nervous system diseases , *SILICON compounds , *SURFACE active agents - Abstract
Abstract: A high-performance micellar electrokinetic capillary chromatography (MEKC) has been demonstrated for the determination of meropenem in human plasma and in cerebrospinal fluid (CSF) and application in meningitis patients after intravenous (IV) administration. Plasma sample was pretreated by means of solid-phase extraction (SPE) on C18 cartridge and CSF sample was by direct injection without sample pretreatment, with subsequent quantitation by MEKC. The separation of meropenem was carried out in an untreated fused-silica capillary (40.2cm×50μm I.D., effective length 30cm) and was performed at 25°C using a background electrolyte consisting of Tris buffer (40mM, pH 8.0) solution with sodium dodecyl sulfate (SDS) as the running buffer and on-column detection at 300nm. Several parameters affecting the separation and sensitivity of the drug were studied, including pH, the concentrations of Tris buffer and surfactant. Using cefotaxime as an internal standard (IS), the linear ranges of the method for the determination of meropenem in plasma and in CSF were all over 0.5–50μg/mL; the detection limits (signal-to-noise ratio=3) of meropenem in plasma and in CSF were 0.2μg/mL and 0.3μg/mL, respectively. [Copyright &y& Elsevier]
- Published
- 2007
- Full Text
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