125 results on '"Shuo-Ming Ou"'
Search Results
102. Adverse Effects of Oral Nonselective and cyclooxygenase-2-Selective NSAIDs on Hospitalization for Acute Kidney Injury
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Chia I. Chou, Shuo Ming Ou, Chih Yu Yang, Dachen Chu, Chia Jen Shih, Shu-Chen Kuo, and Yung Tai Chen
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medicine.medical_specialty ,business.industry ,Acute kidney injury ,Case-control study ,General Medicine ,Odds ratio ,030204 cardiovascular system & hematology ,urologic and male genital diseases ,medicine.disease ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Randomized controlled trial ,law ,Internal medicine ,Cohort ,Nested case-control study ,medicine ,030212 general & internal medicine ,Intensive care medicine ,business ,Adverse effect ,Cohort study - Abstract
To investigate the association between the use of nonselective or cyclooxygenase (COX)-2-selective nonsteroidal antiinflammatory drugs (NSAIDs) and risk of acute kidney injury (AKI) in a general Asian population. We conducted an observational, nationwide, nested case-control cohort study using Taiwan's National Health Insurance Research Database between 2010 and 2012. AKI cases were defined as hospitalization with a principle diagnosis of AKI. Each case was matched to 4 randomly selected controls based on age, sex, and the month and year of cohort entry. Odds ratios (ORs) were used to demonstrate the association between hospitalization for AKI and current, recent, or past use of an oral NSAID. During the study period, we identified 6199 patients with AKI and 24,796 matched controls. Overall, current users (adjusted OR 2.73, 95% confidence interval [CI] 2.28-3.28) and recent users (adjusted OR 1.17, 95% CI 1.01-1.35) were associated with increased risk of hospitalization for AKI. The risk was also similar for nonselective NSAIDs. However, neither current nor recent use of COX-2 inhibitors was significantly associated with AKI events. Our study supported that the initiation of nonselective NSAIDs rather than COX-2 inhibitors is associated with an increased risk of AKI requiring hospitalization. Future randomized trials are needed to elucidate these findings.
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- 2016
103. Carvedilol, Bisoprolol, and Metoprolol Use in Patients With Coexistent Heart Failure and Chronic Obstructive Pulmonary Disease
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Shuo Ming Ou, Diahn-Warng Perng, Yu Wen Hu, Tzeng Ji Chen, Chia Jen Liu, Vincent Yi Fong Su, Kuang Yao Yang, Yu Sheng Chang, Fa-Yauh Lee, Man Hsin Hung, and Kun Ta Chou
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Adult ,Male ,medicine.medical_specialty ,Adrenergic beta-Antagonists ,Population ,Carbazoles ,Taiwan ,Observational Study ,030204 cardiovascular system & hematology ,Propanolamines ,Pulmonary Disease, Chronic Obstructive ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Clinical endpoint ,Bisoprolol ,Humans ,Medicine ,030212 general & internal medicine ,education ,Carvedilol ,Aged ,Retrospective Studies ,Metoprolol ,Aged, 80 and over ,Heart Failure ,COPD ,education.field_of_study ,business.industry ,Contraindications ,Hazard ratio ,General Medicine ,Middle Aged ,medicine.disease ,Heart failure ,Cardiology ,Female ,business ,Research Article ,medicine.drug - Abstract
Beta (β)-blockers are under-prescribed in patients with heart failure (HF) and concurrent chronic obstructive pulmonary disease (COPD) due to concerns about adverse pulmonary effects and a poor understanding of the effects of these drugs. We aimed to evaluate the survival effects of β-blockers in patients with coexistent HF and COPD. Using the Taiwan National Health Insurance Research Database, we conducted a nationwide population-based study. Patients with coexistent HF and COPD diagnosed between 2000 and 2009 were enrolled. Doses of the 3 β-blockers proven to be beneficial to HF (carvedilol, bisoprolol, and metoprolol) during the study period were extracted. The primary endpoint was cumulative survival. Patients were followed until December 31, 2009. The study included 11,558 subjects, with a mean follow-up period of 4.07 years. After adjustment for age, sex, comorbidities, and severity of HF and COPD, bisoprolol use showed a dose–response survival benefit [low dose: adjusted hazard ratio (HR) = 0.76, 95% confidence interval (CI) = 0.59–0.97, P = 0.030; high dose: adjusted HR = 0.40, 95% CI = 0.26–0.63, P
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- 2016
104. Does Alzheimer's disease protect against cancers? A nationwide population-based study
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Tzeng Ji Chen, Shuo Ming Ou, Yu Wen Hu, Chia Jen Liu, Jong Ling Fuh, Shuu Jiun Wang, and Yi Jung Lee
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Oncology ,Adult ,Male ,medicine.medical_specialty ,Pathology ,Databases, Factual ,Epidemiology ,Taiwan ,Disease ,Cohort Studies ,Alzheimer Disease ,Internal medicine ,Neoplasms ,Medicine ,Humans ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Follow up studies ,Cancer ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Population based study ,Neoplasms diagnosis ,Population Surveillance ,Female ,Neurology (clinical) ,business ,Cohort study ,Follow-Up Studies - Abstract
Background: Previous studies suggested a decreased risk of cancer among patients with Alzheimer’s disease (AD). There is still a lack of data on the specific types of cancer, the risk factors, and the impact of cholinesterase inhibitors on developing cancer in AD. Methods: We performed a nationwide population-based study of 6,960 patients with AD between 1997 and 2006 using Taiwan’s National Health Insurance database. Patterns of cancer incidence in AD patients were compared with those of the general population using standardized incidence ratios (SIRs). Results: Patients with AD had a reduced risk of developing overall cancer [SIR = 0.88, 95% confidence interval (CI) = 0.80–0.97]. Specifically, patients with AD were protected from lung cancers (SIR = 0.75, 95% CI = 0.57–0.98), especially men (SIR = 0.61, 95% CI = 0.40–0.88). In subgroup analyses, women, patients aged 60–79 years, and those diagnosed as having AD for more than 1 year were more likely to be protected from cancers. Conclusions: Our study demonstrates a decreased incidence of overall cancers in patients with AD, a finding lower than but consistent with Western countries. Patients with AD had a significantly decreased risk of lung cancer. Further investigation of genetic evidence linking AD to cancer is warranted.
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- 2012
105. Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Terms of Major Cardiovascular Disease Outcomes in Elderly Patients
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Yung Tai Chen, Pei Wen Chao, Tzeng Ji Chen, Szu Yuan Li, Shu Chen Kuo, Chia Jen Shih, Shuu Jiun Wang, Shu Chen Chien, Hsi Chu, Der Cherng Tarng, Yi Jung Lee, and Shuo Ming Ou
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medicine.medical_specialty ,biology ,business.industry ,Hazard ratio ,Retrospective cohort study ,Angiotensin-converting enzyme ,General Medicine ,medicine.disease ,Heart failure ,Internal medicine ,Cohort ,medicine ,biology.protein ,cardiovascular diseases ,Myocardial infarction ,Intensive care medicine ,Adverse effect ,business ,Mace - Abstract
Renin and aldosterone activity levels are low in elderly patients, raising concerns about the benefits and risks of angiotensin-converting-enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARB) use. However, data from direct comparisons of the effects of ACEIs on ARBs in the elderly population remain inconclusive. In this nationwide study, all patients aged ≥ 70 years were retrieved from the Taiwan National Health Insurance database for the period 2000 to 2009 and were followed up until the end of 2010. The ARB cohort (12,347 patients who continuously used ARBs for ≥ 90 days) was matched to ACEI cohort using high-dimensional propensity score (hdPS). Intention-to-treat (ITT) and as-treated (AT) analyses were conducted. In the ITT analysis, after considering death as a competing risk, the ACEI cohort had similar risks of myocardial infarction (hazard ratio [HR] 0.92, 95% confidence interval [CI] 0.79–1.06), ischemic stroke (HR 0.98, 95% CI 0.90–1.07), and heart failure (HR 0.93, 95% CI 0.83–1.04) compared with the ARB cohort. No difference in adverse effects, such as acute kidney injury (HR 0.99, 95% CI 0.89–1.09) and hyperkalemia (HR 1.02, 95% CI 0.87–1.20), was observed between cohorts. AT analysis produced similar results to those of ITT analysis. We were unable to demonstrate a survival difference between cohorts (HR 1.03, 95% CI 0.88–1.21) after considering drug discontinuation as a competing risk in AT analysis. Our study supports the notion that ACEI and ARB users have similar risks of major adverse cardiovascular events (MACE), even in elderly populations.
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- 2015
106. Diagnostic Accuracy of Urine Protein/Creatinine Ratio Is Influenced by Urine Concentration
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Chia Jen Shih, Chih Ching Lin, Wu Chang Yang, Wen Sheng Liu, An Hang Yang, Fu An Chen, Chih Yu Yang, Shuo Ming Ou, and Chun Fan Chen
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Adult ,Male ,medicine.medical_specialty ,Urinalysis ,Urology ,lcsh:Medicine ,Urine ,Kidney ,Excretion ,chemistry.chemical_compound ,Predictive Value of Tests ,Internal medicine ,medicine ,Humans ,Renal Insufficiency, Chronic ,lcsh:Science ,Specific Gravity ,Aged ,Creatinine ,Multidisciplinary ,Proteinuria ,medicine.diagnostic_test ,Receiver operating characteristic ,Urine specific gravity ,lcsh:R ,Kidney metabolism ,Middle Aged ,Endocrinology ,chemistry ,Linear Models ,lcsh:Q ,Female ,medicine.symptom ,Research Article - Abstract
Background The usage of urine protein/creatinine ratio to estimate daily urine protein excretion is prevalent, but relatively little attention has been paid to the influence of urine concentration and its impact on test accuracy. We took advantage of 24-hour urine collection to examine both urine protein/creatinine ratio (UPCR) and daily urine protein excretion, with the latter as the reference standard. Specific gravity from a concomitant urinalysis of the same urine sample was used to indicate the urine concentration. Methods During 2010 to 2014, there were 540 adequately collected 24h urine samples with protein concentration, creatinine concentration, total volume, and a concomitant urinalysis of the same sample. Variables associated with an accurate UPCR estimation were determined by multivariate linear regression analysis. Receiver operating characteristic (ROC) curves were generated to determine the discriminant cut-off values of urine creatinine concentration for predicting an accurate UPCR estimation in either dilute or concentrated urine samples. Results Our findings indicated that for dilute urine, as indicated by a low urine specific gravity, UPCR is more likely to overestimate the actual daily urine protein excretion. On the contrary, UPCR of concentrated urine is more likely to result in an underestimation. By ROC curve analysis, the best cut-off value of urine creatinine concentration for predicting overestimation by UPCR of dilute urine (specific gravity ≦ 1.005) was ≦ 38.8 mg/dL, whereas the best cut-off values of urine creatinine for predicting underestimation by UPCR of thick urine were ≧ 63.6 mg/dL (specific gravity ≧ 1.015), ≧ 62.1 mg/dL (specific gravity ≧ 1.020), ≧ 61.5 mg/dL (specific gravity ≧ 1.025), respectively. We also compared distribution patterns of urine creatinine concentration of 24h urine cohort with a concurrent spot urine cohort and found that the underestimation might be more profound in single voided samples. Conclusions The UPCR in samples with low or high specific gravity is more likely to overestimate or underestimate actual daily urine protein amount, respectively, especially in a dilute urine sample with its creatinine below 38.8 mg/dL or a concentrated sample with its creatinine above 61.5 mg/dL. In particular, UPCR results should be interpreted with caution in cases that involve dilute urine samples because its overestimation may lead to an erroneous diagnosis of proteinuric renal disease or an incorrect staging of chronic kidney disease.
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- 2015
107. Reply: Renal Replacement Therapy in Sepsis
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Shuo-Ming Ou, Chia-Jen Shih, and Yung Tai Chen
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Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Muscle Weakness ,business.industry ,medicine.medical_treatment ,Muscle weakness ,Critical Care and Intensive Care Medicine ,medicine.disease ,Surgery ,Sepsis ,medicine ,Humans ,Female ,Renal replacement therapy ,medicine.symptom ,business - Published
- 2015
108. Urinary Calculi and Risk of Cancer
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Shuo Ming Ou, Chia Jen Shih, Der Cherng Tarng, Yung Tai Chen, Tzeng Ji Chen, and Wu Chang Yang
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Gynecology ,education.field_of_study ,medicine.medical_specialty ,business.industry ,Urinary system ,Incidence (epidemiology) ,Population ,Cancer ,General Medicine ,medicine.disease ,Confidence interval ,Standardized mortality ratio ,Internal medicine ,medicine ,Young adult ,education ,business ,Cohort study - Abstract
Previous studies have shown that urinary calculi are associated with increased risks of urinary tract cancers. However, the association between urinary calculi and overall cancers is a largely undefined body of knowledge. We conducted a nationwide population-based cohort study using Taiwan's National Health Insurance Research Database from 2000 and 2009. Patients were excluded if they had antecedent cancers or urinary calculi before the enrollment. All study subjects were followed until the occurrence of cancer, dropout from the NHI program, death, or the end of 2010. Patterns of cancer incidence in patients with urinary calculi were compared with those of the general population using standardized incidence ratio (SIR). A total of 43,516 patients with urinary calculi were included. After a median follow-up of 5.3 years, 1891 patients developed cancer. The risk of overall cancers was significantly increased (SIR, 1.75; 95% confidence interval [CI], 1.68–1.83). We observed that urinary calculi was associated with higher risk of cancers of kidney (4.24; 95% CI, 3.47–5.13), bladder (3.30; 95% CI, 2.69–4.00), thyroid (2.50; 95% CI, 1.78–3.40), hematologic origin (2.41; 95% CI, 1.92–2.99), breast (1.84; 95% CI, 1.54–2.20), lung (1.82; 95% CI, 1.59–2.07), digestive tract (1.69; 95% CI, 1.57–1.82), and head and neck (1.54; 95% CI, 1.32–1.79), respectively. Our study shows that urinary calculi are associated with higher risk of systemic cancers in addition to urinary tract cancers. Further study is required to validate this association.
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- 2014
109. Dipeptidyl peptidase-4 inhibitors and cardiovascular risks in patients with pre-existing heart failure.
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Shuo-Ming Ou, Hung-Ta Chen, Shu-Chen Kuo, Tzeng-Ji Chen, Chia-Jen Shih, Yung-Tai Chen, Ou, Shuo-Ming, Chen, Hung-Ta, Kuo, Shu-Chen, Chen, Tzeng-Ji, Shih, Chia-Jen, and Chen, Yung-Tai
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CARDIOVASCULAR diseases risk factors ,CD26 antigen ,HEART failure patients ,PUBLIC health ,CARDIAC research ,THERAPEUTICS ,TYPE 2 diabetes diagnosis ,THERAPEUTIC use of protease inhibitors ,STROKE prevention ,CEREBRAL ischemia ,DATABASES ,CAUSES of death ,HEART failure ,HOSPITAL care ,MYOCARDIAL infarction ,TYPE 2 diabetes ,PROBABILITY theory ,PROTEOLYTIC enzymes ,RISK assessment ,STROKE ,TIME ,TREATMENT effectiveness ,DISEASE incidence ,PROPORTIONAL hazards models ,DIAGNOSIS ,PREVENTION - Abstract
Background: Although recent clinical trials raised concerns about the risk for heart failure (HF) in dipeptidyl peptidase-4 (DPP-4) inhibitor use, data on the cardiovascular risks in the patients with pre-existing HF are still lacking.Methods: We used Taiwan's National Health Insurance Research Database to identify 196 986 patients diagnosed with type 2 diabetes mellitus (T2DM) who had previous history of HF between 2009 and 2013. This population included 30 204 DPP-4 inhibitor users and 166 782 propensity score-matched DPP-4 inhibitor non-users. The outcomes of interest were all-cause mortality, combination of myocardial infarction (MI) and ischaemic stroke, and hospitalisation for HF.Results: The incidence in DPP-4 users compared with non-users was 67.02 vs 102.85 per 1000 person-years for all-cause mortality, 37.89 vs 47.54 per 1000 person-years for the combination of MI and ischaemic stroke, 12.70 vs 16.18 per 1000 person-years for MI and 26.37 vs 32.46 per 1000 person-years for ischaemic stroke. The risk of all-cause mortality was lower in DPP-4 inhibitor users (HR 0.67, 95% CI 0.64 to 0.70), combination of MI and stroke (HR 0.81, 95% CI 0.76 to 0.87), MI (HR 0.80, 95% CI 0.71 to 0.89) and ischaemic stroke (HR 0.83, 95% CI 0.76 to 0.89) than in non-users. Notably, the risk of hospitalisation for HF did not differ significantly between groups. The results were similar after accounting for death as a competing risk.Conclusions: In this nationwide T2DM cohort, the risks of mortality and the combination of MI and ischaemic stroke were lower for patients receiving DPP-4 inhibitors than for those who did not receive such treatment. DPP-4 inhibitor use was not associated with a higher risk of hospitalisation for HF even in patients with pre-existing HF. [ABSTRACT FROM AUTHOR]- Published
- 2017
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110. Long-Term Mortality and Major Adverse Cardiovascular Events in Sepsis Survivors. A Nationwide Population-based Study.
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Shuo-Ming Ou, Hsi Chu, Pei-Wen Chao, Yi-Jung Lee, Shu-Chen Kuo, Tzeng-Ji Chen, Ching-Min Tseng, Chia-Jen Shih, Yung-Tai Chen, Ou, Shuo-Ming, Chu, Hsi, Chao, Pei-Wen, Lee, Yi-Jung, Kuo, Shu-Chen, Chen, Tzeng-Ji, Tseng, Ching-Min, Shih, Chia-Jen, and Chen, Yung-Tai
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CARDIOVASCULAR diseases ,SEPSIS ,PROPORTIONAL hazards models - Abstract
Rationale: Patients with sepsis who survive to hospital discharge may present with ongoing high morbidity and mortality. However, little is known about the risk of long-term, all-cause mortality and cardiovascular outcomes after sepsis.Objectives: Our study aimed to investigate the long-term clinical outcomes in sepsis survivors.Methods: In this nationwide population-based study, data from patients with sepsis were retrieved from Taiwan's National Health Insurance Research Database between 2000 and 2002. Each sepsis survivor was 1:1 propensity-matched to control subjects from two different control populations: subjects who were in the general population and subjects who were hospitalized for a nonsepsis diagnosis. The primary outcomes were all-cause mortality, major adverse cardiovascular events, myocardial infarction, heart failure, stroke, and sudden cardiac death or ventricular arrhythmia.Measurements and Main Results: Compared with matched population control subjects, sepsis survivors had higher risks of all-cause mortality (hazard ratio [HR], 2.18; 95% confidence interval [CI], 2.14-2.22), major adverse cardiovascular events (HR, 1.37; 95% CI, 1.34-1.41), ischemic stroke (HR, 1.27; 95% CI, 1.23-1.32), hemorrhagic stroke (HR, 1.36; 95% CI, 1.26-1.46), myocardial infarction (HR, 1.22; 95% CI, 1.14-1.30), heart failure (HR, 1.48; 95% CI, 1.43-1.53), and sudden cardiac death or ventricular arrhythmia (HR, 1.65; 95% CI, 1.57-1.74). Similar results, although slightly attenuated risks, were found when comparisons were made with hospitalized control subjects without sepsis.Conclusions: These data indicate that sepsis survivors had substantially increased risks of subsequent all-cause mortality and major adverse cardiovascular events at 1 year after discharge, which persisted for up to 5 years after discharge. [ABSTRACT FROM AUTHOR]- Published
- 2016
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111. Long-Term Outcomes in Critically Ill Septic Patients Who Survived Cardiopulmonary Resuscitation.
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Pei-Wen Chao, Hsi Chu, Yung-Tai Chen, Yu-Ning Shih, Shu-Chen Kuo, Szu-Yuan Li, Shuo-Ming Ou, Chia-Jen Shih, Chao, Pei-Wen, Chu, Hsi, Chen, Yung-Tai, Shih, Yu-Ning, Kuo, Shu-Chen, Li, Szu-Yuan, Ou, Shuo-Ming, and Shih, Chia-Jen
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- 2016
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112. Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and the risk of major adverse cardiac events in patients with diabetes and prior stroke: a nationwide study.
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Chia-Jen Shih, Hung-Ta Chen, Pei-Wen Chao, Shu-Chen Kuo, Szu-Yuan Li, Chih-Yu Yang, Der-Cherng Tarng, Shuo-Ming Ou, Yung-Tai Chen, Shih, Chia-Jen, Chen, Hung-Ta, Chao, Pei-Wen, Kuo, Shu-Chen, Li, Szu-Yuan, Yang, Chih-Yu, Tarng, Der-Cherng, Ou, Shuo-Ming, and Chen, Yung-Tai
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- 2016
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113. Carvedilol, Bisoprolol, and Metoprolol Use in Patients With Coexistent Heart Failure and Chronic Obstructive Pulmonary Disease.
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Vincent Yi-Fong Su, Yu-Sheng Chang, Yu-Wen Hu, Man-Hsin Hung, Shuo-Ming Ou, Fa-Yauh Lee, Kun-Ta Chou, Kuang-Yao Yang, Diahn-Warng Perng, Tzeng-Ji Chen, Chia-Jen Liu, Su, Vincent Yi-Fong, Chang, Yu-Sheng, Hu, Yu-Wen, Hung, Man-Hsin, Ou, Shuo-Ming, Lee, Fa-Yauh, Chou, Kun-Ta, Yang, Kuang-Yao, and Perng, Diahn-Warng
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- 2016
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114. Risks of Death and Stroke in Patients Undergoing Hemodialysis With New-Onset Atrial Fibrillation: A Competing-Risk Analysis of a Nationwide Cohort.
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Chia-Jen Shih, Shuo-Ming Ou, Pei-Wen Chao, Shu-Chen Kuo, Yi-Jung Lee, Chih-Yu Yang, Der-Cherng Tarng, Chih-Ching Lin, Po-Hsun Huang, Szu-Yuan Li, Yung-Tai Chen, Shih, Chia-Jen, Ou, Shuo-Ming, Chao, Pei-Wen, Kuo, Shu-Chen, Lee, Yi-Jung, Yang, Chih-Yu, Tarng, Der-Cherng, Lin, Chih-Ching, and Huang, Po-Hsun
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SUDDEN death , *ATRIAL fibrillation , *ANTICOAGULANTS , *WARFARIN , *HEMODIALYSIS complications , *PATIENTS , *ATRIAL fibrillation diagnosis , *STROKE diagnosis , *STROKE-related mortality , *HEMODIALYSIS , *LONGITUDINAL method , *PUBLIC health surveillance , *STATISTICS , *STROKE , *RETROSPECTIVE studies , *HOSPITAL mortality ,STROKE risk factors - Abstract
Background: Whether oral anticoagulant use should be considered in patients undergoing hemodialysis with atrial fibrillation (AF) remains controversial because of the uncertainty regarding risk-benefit assessments. The purpose of this study was to investigate the risk of ischemic stroke in patients undergoing hemodialysis with new-onset AF, in comparison with those without arrhythmia.Methods and Results: This nationwide, population-based, propensity score-matched cohort study used data from Taiwan's National Health Insurance Research Database during 1998 to 2011 for patients on hemodialysis with new-onset nonvalvular AF and matched subjects without arrhythmia. The clinical end points were ischemic stroke (fatal or nonfatal), all-cause death, and other serious adverse cardiovascular events. In comparison with the matched cohort, patients with AF (n=6772) had higher risks of ischemic stroke (adjusted hazard ratio [aHR], 1.27; 95% confidence interval [CI], 1.13-1.43), all-cause death (aHR, 1.59; 95% CI, 1.52-1.67), in-hospital cardiovascular death (aHR, 1.83; 95% CI, 1.71-1.94), myocardial infarction (aHR, 1.33; 95% CI, 1.17-1.51), and hospitalization for heart failure (aHR, 1.90; 95% CI, 1.76-2.05). After considering in-hospital death as a competing risk, AF significantly increased the risk of heart failure (HR, 1.56; 95% CI, 1.45-1.68), but not those of ischemic stroke and myocardial infarction. Additionally, the predictive value of the CHA2DS2-VASc score for ischemic stroke was diminished in the competing-risk model.Conclusions: The risk of stroke was only modestly higher in patients undergoing hemodialysis with new-onset AF than in those without AF, and it became insignificant when accounting for the competing risk of in-hospital death. [ABSTRACT FROM AUTHOR]- Published
- 2016
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115. Effects on Clinical Outcomes of Adding Dipeptidyl Peptidase-4 Inhibitors Versus Sulfonylureas to Metformin Therapy in Patients With Type 2 Diabetes Mellitus.
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Shuo-Ming Ou, Chia-Jen Shih, Pei-Wen Chao, Hsi Chu, Shu-Chen Kuo, Yi-Jung Lee, Shuu-Jiun Wang, Chih-Yu Yang, Chih-Ching Lin, Tzeng-Ji Chen, Der-Cherng Tarng, Szu-Yuan Li, Yung-Tai Chen, Ou, Shuo-Ming, Shih, Chia-Jen, Chao, Pei-Wen, Chu, Hsi, Kuo, Shu-Chen, Lee, Yi-Jung, and Wang, Shuu-Jiun
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TYPE 2 diabetes treatment , *CD26 antigen , *GLYCEMIC control , *SULFONYLUREAS , *METFORMIN , *HEALTH outcome assessment , *THERAPEUTIC use of protease inhibitors , *TYPE 2 diabetes complications , *CARDIOVASCULAR diseases , *COMBINATION drug therapy , *CAUSES of death , *HEART failure , *HYPOGLYCEMIA , *HYPOGLYCEMIC agents , *MYOCARDIAL infarction , *TYPE 2 diabetes , *PROBABILITY theory , *STROKE , *PROTEASE inhibitors , *TREATMENT effectiveness , *THERAPEUTICS - Abstract
Background: Recent studies concluded that dipeptidyl peptidase-4 (DPP-4) inhibitors provide glycemic control but also raised concerns about the risk for heart failure in patients with type 2 diabetes mellitus (T2DM). However, large-scale studies of the effects on cardiovascular outcomes of adding DPP-4 inhibitors versus sulfonylureas to metformin therapy remain scarce.Objective: To compare clinical outcomes of adding DPP-4 inhibitors versus sulfonylureas to metformin therapy in patients with T2DM.Design: Nationwide study using Taiwan's National Health Insurance Research Database.Setting: Taiwan.Patients: All patients with T2DM aged 20 years or older between 2009 and 2012. A total of 10,089 propensity score-matched pairs of DPP-4 inhibitor users and sulfonylurea users were examined.Measurements: Cox models with exposure to sulfonylureas and DPP-4 inhibitors included as time-varying covariates were used to compare outcomes. The following outcomes were considered: all-cause mortality, major adverse cardiovascular events (MACEs) (including ischemic stroke and myocardial infarction), hospitalization for heart failure, and hypoglycemia. Patients were followed until death or 31 December 2013.Results: DPP-4 inhibitors were associated with lower risks for all-cause death (hazard ratio [HR], 0.63 [95% CI, 0.55 to 0.72]), MACEs (HR, 0.68 [CI, 0.55 to 0.83]), ischemic stroke (HR, 0.64 [CI, 0.51 to 0.81]), and hypoglycemia (HR, 0.43 [CI, 0.33 to 0.56]) compared with sulfonylureas as add-on therapy to metformin but had no effect on risks for myocardial infarction and hospitalization for heart failure.Limitation: Observational study design.Conclusion: Compared with sulfonylureas, DPP-4 inhibitors were associated with lower risks for all-cause death, MACEs, ischemic stroke, and hypoglycemia when used as add-ons to metformin therapy.Primary Funding Source: None. [ABSTRACT FROM AUTHOR]- Published
- 2015
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116. Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Terms of Major Cardiovascular Disease Outcomes in Elderly Patients: A Nationwide Population-Based Cohort Study.
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Shu-Chen Chien, Shuo-Ming Ou, Chia-Jen Shih, Pei-Wen Chao, Szu-Yuan Li, Yi-Jung Lee, Shu-Chen Kuo, Shuu-Jiun Wang, Tzeng-Ji Chen, Der-Cherng Tarng, Hsi Chu, Yung-Tai Chen, Chien, Shu-Chen, Ou, Shuo-Ming, Shih, Chia-Jen, Chao, Pei-Wen, Li, Szu-Yuan, Lee, Yi-Jung, Kuo, Shu-Chen, and Wang, Shuu-Jiun
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- 2015
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117. The Effect of Cold Temperature on Increased Exacerbation of Chronic Obstructive Pulmonary Disease: A Nationwide Study
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Shuo Ming Ou, Ching Min Tseng, Diahn-Warng Perng, Tzeng Ji Chen, Yi Han Hsiao, Yung Tai Chen, Shuu Jiun Wang, Szu Yuan Li, and Albert C. Yang
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Male ,Environmental Impacts ,Atmospheric Science ,Acute exacerbation of chronic obstructive pulmonary disease ,Pulmonology ,Chronic Obstructive Pulmonary Diseases ,Exacerbation ,Epidemiology ,Cross-sectional study ,lcsh:Medicine ,Pulmonary Disease, Chronic Obstructive ,Registries ,lcsh:Science ,Aged, 80 and over ,Climatology ,COPD ,Multidisciplinary ,Ecology ,Agriculture ,Middle Aged ,Cold Temperature ,Air temperature ,Medicine ,Female ,Information Technology ,Research Article ,medicine.medical_specialty ,Ecological Metrics ,Climate Change ,Taiwan ,Pulmonary disease ,Environmental and Occupational Lung Diseases ,Environmental Epidemiology ,Databases ,Agricultural Production ,Internal medicine ,medicine ,Humans ,Biology ,Aged ,Retrospective Studies ,business.industry ,lcsh:R ,Retrospective cohort study ,medicine.disease ,respiratory tract diseases ,Cross-Sectional Studies ,Copd exacerbation ,Computer Science ,Earth Sciences ,Physical therapy ,lcsh:Q ,business - Abstract
BACKGROUND: Seasonal variations in the acute exacerbation of chronic obstructive pulmonary disease (COPD) have been reported. However, the influence of air temperature and other meteorological factors on COPD exacerbation remains unclear. METHODS: National Health Insurance registry data from January 1, 1999 to December 1, 2009 and meteorological variables from the Taiwan Central Weather Bureau for the same period were analyzed. A case-crossover study design was used to investigate the association between COPD exacerbation and meteorological variables. RESULTS: A total of 16,254 cases who suffered from COPD exacerbation were enrolled. We found that a 1°C decrease in air temperature was associated with a 0.8% increase in the exacerbation rate on event-days (95% confidence interval (CI), 1.015-1.138, p = 0.015). With a 5°C decrease in mean temperature, the cold temperature (28-day average temperature) had a long-term effect on the exacerbation of COPD (odds ratio (OR), 1.106, 95% CI 1.063-1.152, p
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- 2013
118. Association of Hypoglycemia With Incident Chronic Kidney Disease in Patients With Type 2 Diabetes.
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Chia-Jen Shih, Yueh-Lin Wu, Yuan-Hao Lo, Shu-Chen Kuo, Der-Cherng Tarng, Chih-Ching Lin, Shuo-Ming Ou, and Yung-Tai Chen
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- 2015
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119. Long-Term Clinical Outcome of Major Adverse Cardiac Events in Survivors of Infective Endocarditis.
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Chia-Jen Shih, Hsi Chu, Pei-Wen Chao, Yi-Jung Lee, Shu-Chen Kuo, Szu-Yuan Li, Der-Cherng Tarng, Chih-Yu Yang, Wu-Chang Yang, Shuo-Ming Ou, and Yung-Tai Chen
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- 2014
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120. Association of Postdischarge Rehabilitation with Mortality in Intensive Care Unit Survivors of Sepsis.
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Pei-wen Chao, Chia-Jen Shih, Yi-Jung Lee, Ching-Min Tseng, Shu-Chen Kuo, Yu-Ning Shih, Kun-Ta Chou, Der-Cherng Tarng, Szu-Yuan Li, Shuo-Ming Ou, and Yung-Tai Chen
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- 2014
- Full Text
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121. The impact of dialysis therapy on older patients with advanced chronic kidney disease: a nationwide population-based study.
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Chia-Jen Shih, Yung-Tai Chen, Shuo-Ming Ou, Wu-Chang Yang, Shu-Chen Kuo, Der-Cherng Tarng, and for the Taiwan Geriatric Kidney Disease Research (TGKD) Group
- Abstract
Background: Older patients with advanced chronic kidney disease (CKD) face the decision of whether to undergo dialysis. Currently available data on this issue are limited because they were generated by small, short-term studies with statistical drawbacks. Further research is urgently needed to provide objective information for dialysis decision making in older patients with advanced CKD. Methods: This nationwide population-based cohort study was conducted using Taiwanfs National Health Insurance Research Database. Data from 2000 to 2010 were extracted. A total of 8,341 patients ≥70 years old with advanced CKD and serum creatinine levels >6 mg/dl, who had been treated with erythropoiesis-stimulating agents were included. Cox proportional hazard models in which initiation of chronic dialysis was defined as the time-dependent covariate were used to calculate adjusted hazard ratios for mortality. The endpoint was all-cause mortality. Results: During a median follow-up period of 2.7 years, 6,292 (75.4%) older patients chose dialysis therapy and 2,049 (24.6%) received conservative care. Dialysis was initiated to treat kidney failure a median of 6.4 months after enrollment. Dialysis was associated with a 1.4-fold increased risk of mortality compared with conservative care (adjusted hazard ratio 1.39, 95% confidence interval 1.30 to 1.49). In subgroup analyses, the risk of mortality remained consistently increased, independent of age, sex and comorbidities. Conclusions: In older patients, dialysis may be associated with increased mortality risk and healthcare cost compared with conservative care. For patients who are ≥70 years old with advanced CKD, decision making about whether to undergo dialysis should be weighted by consideration of risks and benefits. [ABSTRACT FROM AUTHOR]
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- 2014
- Full Text
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122. Does Alzheimer's Disease Protect against Cancers? A Nationwide Population-Based Study.
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Shuo-Ming Ou, Yi-Jung Lee, Yu-Wen Hu, Chia-Jen Liu, Tzeng-Ji Chen, Jong-Ling Fuh, and Shuu-Jiun Wang
- Abstract
Background: Previous studies suggested a decreased risk of cancer among patients with Alzheimer's disease (AD). There is still a lack of data on the specific types of cancer, the risk factors, and the impact of cholinesterase inhibitors on developing cancer in AD. Methods: We performed a nationwide population-based study of 6,960 patients with AD between 1997 and 2006 using Taiwan's National Health Insurance d tabase. Patterns of cancer incidence in AD patients were compared with those of the general population using standardized incidence ratios (SIRs). Results: Patients with AD had a reduced risk of developing overall cancer [SIR = 0.88 95% confidence interval (CI) = 0.80-0.97]. Specifically, patients with AD were protected from lung cancers (SIR = 0.75, 95% CI = 0.57-0.98), especially men (SIR = 0.61, 95% CI = 0.40-0.88). In subgroup analyses, women, patients aged 60-79 years, and those diagnosed as having AD for more than 1 year were more likely to be protected from cancers. Conclusions: Our study demonstrates a decreased incidence of overall cancers in patients with AD, a finding lower than but consistent with Western countries. Patients with AD had a significantly decreased risk of lung cancer. Further investigation of genetic evidence linking AD to cancer is warranted. [ABSTRACT FROM AUTHOR]
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- 2013
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123. Plasma Galectin-9 Is a Useful Biomarker for Predicting Renal Function in Patients Undergoing Native Kidney Biopsy.
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Ming-Tsun Tsai, Ruey-Bing Yang, Shuo-Ming Ou, Wei-Cheng Tseng, Kuo-Hua Lee, Chih-Yu Yang, Fu-Pang Chang, and Der-Cherng Tarng
- Subjects
- *
KIDNEY physiology , *PROTEINS , *BIOMARKERS , *CHRONIC kidney failure , *IN vitro studies , *BIOPSY , *STAINS & staining (Microscopy) , *ANIMAL experimentation , *IMMUNOHISTOCHEMISTRY , *FLUOROIMMUNOASSAY , *KIDNEY tubules , *PROTEINURIA , *MESSENGER RNA , *SYMPTOMS , *POLYMERASE chain reaction , *LOGISTIC regression analysis , *MICE - Abstract
* Context.--Galectin-9 reduces tissue damage in certain immune-mediated glomerular diseases. However, its role in structural and functional renal changes in patients with varying types of chronic kidney disease (CKD) is less clear. Objective.--To investigate the association between plasma galectin-9 levels, proteinuria, tubulointerstitial lesions, and renal function in different CKD stages. Design.--We measured plasma galectin-9 levels in 243 patients undergoing renal biopsy for determining the CKD etiology. mRNA and protein expression levels of intrarenal galectin-9 were assessed by quantitative real-time polymerase chain reaction and immunostaining. Relationships between plasma galectin-9, clinical characteristics, and tubulointerstitial damage were analyzed with logistic regression. We investigated galectin-9 expression patterns in vitro in murine J774 macrophages treated with differing stimuli. Results.--To analyze the relationship between galectin-9 and clinical features, we divided the patients into 2 groups according to median plasma galectin-9 levels. The high galectin-9 group tended to be older and to have decreased renal function, higher proteinuria, and greater interstitial fibrosis. After multivariable adjustment, elevated plasma galectin-9 levels were independently associated with stage 3b or higher CKD. An analysis of gene expression in the tubulointerstitial compartment in the biopsy samples showed a significant positive correlation between intrarenal galectin-9 mRNA expression and plasma galectin-9 levels. Immunohistochemistry confirmed increased galectin-9 expression in the renal interstitium of patients with advanced CKD, and most galectin-9--positive cells were macrophages, as determined by double-immunofluorescence staining. In vitro experiments showed that galectin-9 expression in macrophages was significantly increased after interferon-c stimulation. Conclusions.--Our findings suggest that plasma galectin- 9 is a good biomarker for diagnosing advanced CKD. [ABSTRACT FROM AUTHOR]
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- 2023
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124. The Methodology of Assessing Long-Term Mortality and Cardiovascular Risks in Survivors of Sepsis.
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Henriksen, Daniel Pilsgaard, Damkier, Per, Davidsen, Jesper Rømhild, Laursen, Christian B., Shuo-Ming Ou, Chia-Jen Shi, and Yung-Tai Chen
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- 2016
- Full Text
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125. Angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers and the risk of major adverse cardiac events in patients with diabetes and prior stroke: a nationwide study.
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Shih CJ, Chen HT, Chao PW, Kuo SC, Li SY, Yang CY, Tarng DC, Ou SM, and Chen YT
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- Acute Kidney Injury epidemiology, Aged, Cohort Studies, Comorbidity, Databases, Factual, Female, Hospitalization, Humans, Hyperkalemia epidemiology, Hypertension epidemiology, Intention to Treat Analysis, Male, Middle Aged, Proportional Hazards Models, Risk, Taiwan epidemiology, Angiotensin Receptor Antagonists therapeutic use, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Cardiovascular Diseases mortality, Diabetes Mellitus, Type 2 epidemiology, Hypertension drug therapy, Myocardial Infarction epidemiology, Stroke epidemiology
- Abstract
Objective: Renin-angiotensin-aldosterone system blockers are the preferred antihypertensive medications in patients with diabetes and prior stroke. This study aimed to compare the effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) in terms of major adverse cardiac events (MACEs) in patients with diabetes who survived ischemic stroke., Methods: We conducted an observational, nationwide, propensity score-matched cohort study using Taiwan's National Health Insurance Research Database. Patients aged at least 20 years with type 2 diabetes who initiated ACEI (n = 15,959) or ARB (n = 23,929) use within 90 days after discharge for first ischemic stroke between January 2000 and December 2011 were allocated to ACEI and ARB groups, respectively. The primary outcomes were MACEs (myocardial infarction, ischemic stroke, and cardiovascular mortality). The secondary outcomes were hospitalization for acute kidney injury and hyperkalemia. Intention-to-treat and as-treated models were used., Results: Intention-to-treat analysis showed no significant difference between the ACEI and ARB groups in the outcomes of MACEs [hazard ratio (HR), 0.99; 95% confidence interval (CI), 0.95-1.04], including ischemic stroke (HR, 1.01; 95% CI, 0.97-1.06), myocardial infarction (HR, 1.06; 95% CI, 0.95-1.18), and cardiovascular mortality (HR, 0.98; 95% CI, 0.91-1.06). As-treated analysis produced similar results. Additionally, the groups showed no difference in the risk of hospitalization for acute kidney injury or hyperkalemia., Conclusion: Our study supports the hypothesis that the risks of MACEs and two additional secondary outcomes in patients with diabetes who survived ischemic stroke did not differ according to ACEI versus ARB use.
- Published
- 2016
- Full Text
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