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Aim: This study aimed to evaluate the association between tamoxifen use and hip fractures in older women with breast cancer in Taiwan. Methods: We carried out a retrospective nationwide case–control study using the database of the Taiwan National Health Insurance Program. A total of 762 female patients with breast cancer aged ≥65 years newly diagnosed with hip fractures from 2000 to 2011 were identified for inclusion in the study. Additionally, 7620 female patients with breast cancer aged ≥65 years without hip fractures were randomly selected as controls. Patients were defined as having used tamoxifen if they had an existing prescription for tamoxifen before the index date. Patients were defined as having never used tamoxifen if they had never been given a prescription for tamoxifen before the index date. We used an unconditional logistic regression model to calculate the odds ratio and 95% confidence interval for the association between tamoxifen use and risk of hip fractures. Results: After adjustment for confounding variables, compared with patients who did not use tamoxifen, the adjusted odds ratio of hip fracture was 2.29 for those who had used tamoxifen (95% confidence interval 1.92, 2.72). Furthermore, adjusted odds ratios were 2.74 (95% confidence interval 2.19, 3.42) among patients with a cumulative duration of tamoxifen use of >3 years. Conclusion: Tamoxifen use is associated with increased risk of hip fractures among older women with breast cancer in Taiwan. Geriatr Gerontol Int 2019; 19: 56–60. [ABSTRACT FROM AUTHOR]

Objective Out-of-hospital cardiac arrest ( OHCA) studies are usually conducted at metropolitan medical centres. Because rural studies are rare, our study aimed to assess non-traumatic OHCA prevalence and resuscitation outcomes in rural Taiwan. Design A retrospective observational study. Setting All seven designated community hospital emergency departments ( ED) in Nantou County, Taiwan. Participants All OHCA patients from May 2011 to March 2013. Main outcome measures Any return of spontaneous circulation ( ROSC) and survival for ED discharge. Results In the 23-month period, 850 OHCA cases were reported; 741 (87.2%) were non-traumatic. The overall ROSC achievement rate was 19.7%, with 16.4% case survival for ED discharge. Logistic regression identified that arrest in public ( OR: 2.62, 95% CI: 1.19-5.78), witness when collapsed ( OR: 2.14, 95% CI: 1.28-3.60), and cardiopulmonary resuscitation ( CPR) by bystander ( OR: 2.09, 95% CI: 1.02-4.26) might increase the likelihood of any ROSC; arrest in public ( OR: 2.68, 95% CI: 1.10-6.50), witnessed collapse ( OR: 2.26, 95% CI: 1.24-4.09) and CPR by bystander ( OR: 2.79, 95% CI: 1.28-6.05) might also increase the likelihood of survival. For non-traumatic OHCA patients conveyed to EDs via emergency medical service system ( EMS), a shorter response time ( OR: 1.09, 95% CI: 1.01-1.18) and travelling time ( OR: 1.04, 95% CI: 1.00-1.09) might also increase the chance of survival. Conclusion Compared to previous data from metropolitan areas, ROSC achievement rate was lower in rural Taiwan. Witness presence, response and travelling times affect ROSC achievement in non-traumatic OHCA patients in rural Taiwan. [ABSTRACT FROM AUTHOR]

Pulmonary mucormycosis is commonly encountered in patients with diabetic ketoacidosis, hematologic malignancies, neutropenia, organ or hematopoietic stem cell transplantation, and malignancy, but it rarely occurs in high-risk patients with systemic lupus erythematosus (SLE). We present the case of a 40-year-old SLE female with fulminant pneumonia after remission of nephritis treated with rituximab, who developed severe pulmonary mucormycosis that led to her rapid death from acute respiratory failure and acute respiratory distress syndrome. Pulmonary mucormycosis has a high mortality rate. However, with early diagnosis and antifungal therapy with lipid formulation-liposomal amphotericin B and surgical removal of the infected area, the outcome can be improved. [ABSTRACT FROM AUTHOR]