Search

Objective: Immune checkpoint inhibitors (ICI) are recommended as the first‐line therapy for platinum‐refractory head and neck squamous cell carcinoma (HNSCC), a disease with a poor prognosis. However, biomarkers in this situation are rare. The objective was to identify radiomic features‐associated biomarkers to guide the prognosis and treatment opinions in the era of ICI. Methods: A total of 31 platinum‐refractory HNSCC patients were retrospectively enrolled. Of these, 65.5% (20/31) received ICI‐based therapy and 35.5% (11/31) did not. Radiomic features of the primary site at the onset of recurrent metastatic (R/M) status were extracted. Prognostic and predictive radiomic biomarkers were analysed. Results: The median overall survival from R/M status (R/M OS) was 9.6 months. Grey‐level co‐occurrence matrix‐associated texture features were the most important in identifying the patients with or without 9‐month R/M death. A radiomic risk‐stratification model was established and equally separated the patients into high‐, intermittent‐ and lower‐risk groups (1‐year R/M death rate, 100.0% vs. 70.8% vs. 27.1%, p = 0.001). Short‐run high grey‐level emphasis (SRHGE) was more suitable than programmed death ligand 1 (PD‐L1) expression in selecting whether patients received ICI‐based therapy. Conclusions: Radiomic features were effective prognostic and predictive biomarkers. Future studies are warranted. [ABSTRACT FROM AUTHOR]

Psoriatic disease is a chronic inflammatory disorder with skin and joint manifestations. Due to the persistent inflammatory state exhibited by patients with psoriasis, multiple systemic comorbidities occur more frequently in patients with psoriasis than in the general population, and the risk of cardiovascular (CV) diseases is significantly increased. As the pathophysiology of psoriatic disease is becoming better understood, the sharing of underlying pathogenic mechanisms between psoriatic and CV diseases is becoming increasingly apparent. Consequently, careful attention to CV comorbidities that already exist or may potentially develop is needed in the management of patients with psoriasis, particularly in the screening and primary prevention of CV disease and in treatment selection due to potential drug-drug and drug-disease interactions. Furthermore, as the use of effective biologic therapy and more aggressive oral systemic treatment for psoriatic disease is increasing, consideration of the potential positive and negative effects of oral and biologic treatment on CV disease is warranted. To improve outcomes and quality of care for patients with psoriasis, the Taiwanese Dermatological Association, the Taiwanese Association for Psoriasis and Skin Immunology, and the Taiwan Society of Cardiology established a Task Force of 20 clinicians from the fields of dermatology, cardiology, and rheumatology to jointly develop consensus expert recommendations for the management of patients with psoriatic disease with attention to CV comorbidities. [ABSTRACT FROM AUTHOR]

Inadequate diagnosis, treatment, and palliative care provided in the emergency department could let the patients revisit shortly after being seen. The aim of this study was to evaluate the emergency dental revisits by using Taiwanese National Health Insurance Research Database (NHIRD). The Dental dataset from NHIRD was used to analyze the demographic characteristics of emergency dental revisits in Taiwanese population from 1999 to 2012. In addition, the conditions of emergency dental revisits were also identified based on the International Classification of Diseases, Ninth Revision (ICD-9). Total 169,437 individuals had sought for emergency dental treatment from 1999 to 2012. In addition, 9624 individuals (5.68%) had repeated emergency dental visits within 1 year. The top 3 dental conditions were diseases of pulp and periapical tissues (ICD-9: 522), gingival and periodontal diseases (ICD-9: 523), and diseases of the oral soft tissues, excluding lesions specific for gingiva and tongue (ICD-9: 528). Males paid emergency dental revisits more than twice a year outnumber female counterparts (aOR = 1.252, 95% CI: 1.116–1.404). The higher odds ratio for emergency dental revisits over twice a year were found in 0–6 years, 35–49 years, 50–69 years, and ≧ 70 years subgroup as compared the reference of 20–34 years group. However, there were no significant differences for the stratification by year, day, region, and payroll bracket. Taken together, this data demonstrated the current situation of emergency dental revisits in Taiwan. It would raise the important issue about how to reduce the unnecessary repeated emergency visits. [ABSTRACT FROM AUTHOR]

Sialolithiasis, the so-called salivary gland stone, is a condition forming salivary calculi within a salivary gland or ducts. Little is known about the epidemiological survey of sialolithiasis in Taiwanese population. In this study, we conducted an age-period-cohort (APC) analysis evaluating the prevalence of sialolithiasis. A retrospective study was conducted to analyze the registered database compiled by the Taiwanese National Health Insurance Research Database from 1996 to 2013. The APC analysis was performed to investigate the effects of age, diagnosis period, and birth cohort with sialolithiasis. We found that the prevalence of sialolithiasis varied from 1.4 (105) to 2.3 (105). The mean age ±standard deviation with sialolithiasis from 1996 to 2013 was 37.7 ± 18.5 and 46.2 ± 18.6 years old, respectively. The prevalence was higher among male than female (RR: 1.10; 95% CI: 1.05–1.15, p < 0.001). The age >65 group had higher risk compared to age <40 group (RR: 2.27; 95% CI: 2.13–2.43, p < 0.001). The relative risk for sialolithiasis demonstrated significant age effect (p < 0.001). The relative risk for sialolithiasis did not show the significant period effect (p = 0.742). The relative risk for sialolithiasis demonstrated significant cohort effect (p = 0.01). The relative risk for sialolithiasis demonstrated significant APC effect (p = 0.002). Form this nationwide population-based database, the prevalence of sialolithiasis occurs more frequently in male than in female. In addition, the relative risk for sialolithiasis demonstrated the significant APC effects. [ABSTRACT FROM AUTHOR]

Objective: To analyse the epidemiology of mandibular fractures and the correlation between combined fractures during a 10-year period in central Taiwan., Methods: This retrospective study analysed data collected from the medical records of patients that had mandibular fractures between January 2007 and October 2017. Data on age, sex, cause of injury, anatomical site of fracture, treatment and complications were obtained and analysed., Results: A total of 265 patients who received treatment were included in the study. The mean ± SD age was 30.08 ± 13.47 years (range, 6-70 years) and the 21-30 years age group showed the highest incidence of mandibular fractures. The male-to-female ratio was 1.25:1. Road traffic accidents were the most common cause of fracture (206 of 265; 77.74%). The symphysis and parasymphysis area was the most common fracture site (169 of 420; 39.29%). Single-site fracture represented slightly more than 50% of the total 420 fractures. The most frequent combination of two fractures was an angle fracture combined with a symphysis and parasymphysis fracture (29 of 106 double fracture patients [27.36%]). There was a weak positive association between several combinations of fractures., Conclusions: A better understanding of the influence of age and sex on the mechanism of injury is of great clinical importance in the assessment and diagnosis of fractures.

Pulmonary arterial hypertension (PAH) is characterized as a progressive and sustained increase in pulmonary vascular resistance, which may induce right ventricular failure. In 2014, the Working Group on Pulmonary Hypertension of the Taiwan Society of Cardiology (TSOC) conducted a review of data and developed a guideline for the management of PAH. 4 In recent years, several advancements in diagnosis and treatment of PAH has occurred. Therefore, the Working Group on Pulmonary Hypertension of TSOC decided to come up with a focused update that addresses clinically important advances in PAH diagnosis and treatment. This 2018 focused update deals with: (1) the role of echocardiography in PAH; (2) new diagnostic algorithm for the evaluation of PAH; (3) comprehensive prognostic evaluation and risk assessment; (4) treatment goals and follow-up strategy; (5) updated PAH targeted therapy; (6) combination therapy and goal-orientated therapy; (7) updated treatment for PAH associated with congenital heart disease; (8) updated treatment for PAH associated with connective tissue disease; and (9) updated treatment for chronic thromboembolic pulmonary hypertension., (Copyright © 2019. Published by Elsevier B.V.)

Background: Little information is available in Asia about the real-world practice of dual antiplatelet therapy (DAPT) duration for acute coronary syndrome (ACS) and its influence on clinical outcomes.Methods and Results:The Taiwan ACS STENT Registry was a prospective, multicenter study to observe ACS patients using clopidogrel-based DAPT after percutaneous coronary intervention (PCI). The primary outcome was a composite of cardiovascular death, myocardial infarction, and stroke. Overall, 2,221 ACS patients (62 years, 83% men) were included. DAPT duration was ≤9 months in 935 (42.1%). The incidence of primary outcome was higher in patients receiving DAPT ≤9 months compared with those receiving DAPT >9 months at 1 year (3.5% vs. 1.6%, P=0.0026). The incidence of stent thrombosis (overall 0.5%) was similar between groups. Multivariable analysis showed that DAPT >9 months was associated with a significantly lower risk of primary outcome (odds ratio 0.725, 95% confidence interval 0.545-0.965)., Conclusions: Our data showed that short duration of DAPT (≤9 months) was common (42.1%) in Taiwan for ACS patients undergoing PCI. DAPT ≤9 months increased the risk of the primary outcome.

Osteopontin (OPN) is an extracellular matrix protein in hard tissues. The polymorphism in promoter region of OPN gene correlates to different gene expression and might implicate potential roles in tumor progression and metastasis. Immunohistochemistry (IHC) was utilized to detect the OPN expression in 58 oral squamous cell carcinoma (OSCC) tissues and adjacent normal oral mucosa. The differential OPN expression was further analyzed in relation to clinico-pathological features. Genomic DNA was obtained from isolated leukocytes of blood samples of OSCC patients (n=100), and healthy individuals (n=97) from Taiwan. The OPN gene polymorphism was analyzed by direct sequencing. Our result showed OPN expression was significantly higher in OSCC tissues than in the paired adjacent normal tissues (p<0.01). The expression of OPN was significantly associated with nodal metastasis and the more advanced clinical stage (p<0.05). More prevalent -156 insGG/insGG genotype and -443 T/T genotype was found in OSCC patients (p<0.05). A significant difference in -443T/-156GG/-66T and -443C/-156G/-66T haplotypes between OSCC and controls (p<0.05) was also noted. The OPN expression in tumor tissues significantly correlated with -156 insGG/insGG and -156 G/G+insGG/G genotypes (p<0.05). The conclusion is tissue OPN expression correlates to OSCC progression. -156 insGG/insGG genotype is associated with OSCC susceptibility and higher OPN expression., (Copyright 2010 Elsevier Ltd. All rights reserved.)