PubMed Health⌕ Search

Biomedical subjects

Jong-Ling Fuh

Publications and source records attributed to Jong-Ling Fuh.

At least 19 recordsLinked to original sources
PubMed2006

Outcomes and predictors of chronic daily headache in adolescents: a 2-year longitudinal study.

OBJECTIVES: To assess the outcomes and predictors of chronic daily headache (CDH) in a community-based cohort of adolescents. METHODS: We established a field sample of 122 adolescents (32 M/90 F, ages 12 to 14) with CDH in 2000. These adolescents received annual follow-up by neurologists for 2 years via a semistructured telephone interview. CDH was defined as > or =15 headache days/month, average > or =2 h/day for >3 months; subtypes were classified based on the original and appendix criteria of the International Classification of Headache Disorders (2nd ed.; ICHD-2). Poor outcome was defined as persistence of CDH at 2 years. RESULTS: Follow-up response rates were 92% in 2001 and 84% in 2002. Average monthly headache frequency was 11.0 +/- 9.7 days in 2001 and 7.7 +/- 6.5 days in 2002. CDH persistence rates were 40% in 2001 and 25% in 2002. Medication overuse declined from 20% (baseline) to 6% at 2 years. The prevalence of migraine did not change throughout the follow-up (67 to 60%), whereas that of tension-type headache deceased from 86 to 46% (p < 0.001). Chronic migraine prevalence increased markedly at baseline and became the most common CDH subtype at follow-up when using the ICHD-2 appendix criteria. During follow-up, seven subjects (6%) dropped out of school. Independent predictors for CDH persistence were medication overuse and major depression. CONCLUSIONS: Most adolescents with chronic daily headache (CDH) continued to have frequent headaches, although the incidence of CDH declined at follow-up. Migraine diagnosis gained prominence as headache frequency decreased. The percentages of chronic migraine in adolescents with CDH increased obviously if the appendix criteria were applied.

Adolescent↗
PubMed2006

Chronic daily headache in adolescents: prevalence, impact, and medication overuse.

OBJECTIVES: To examine the prevalence, impact, and related medication use or overuse of primary chronic daily headache (CDH) among adolescents in a field sample. METHODS: The authors conducted a two-phase CDH survey of all students from ages 12 to 14 years in five selected middle schools in Taiwan. Subjects with CDH in the past year were identified and interviewed by neurologists. CDH was defined as headache occurring at a frequency of 15 days/month or more, average of 2 hours/day or more, for more than 3 months, and its subtypes were classified on the basis of the International Classification of Headache Disorders, 2nd edition. RESULTS: Of the 7,900 participants, 122 (1.5%) fulfilled the criteria for primary CDH in the past year. Girls had a higher prevalence (2.4%) than boys (0.8%) (p < 0.001). Of the CDH subjects, 88 (72%) could be classified into either chronic tension-type headache (65.6%) or chronic migraine (6.6%). None of them fulfilled the criteria of new daily-persistent headache or hemicrania continua. Twenty-four subjects (20%) overused medications. Eighty-two (67%) of all CDH subjects had migraine or probable migraine. In the past semester, most CDH subjects (65%) did not take any sick leave for headaches. Only 6 subjects consulted neurologists in the past year, and only 1 subject took headache prophylactic agents. CONCLUSIONS: Chronic daily headache (CDH) was common in a large nonreferred adolescent sample. Based on the International Classification of Headache Disorders, 2nd edition, criteria, chronic tension-type headache was the most common subtype; however, a majority of adolescents with CDH had headaches with features of migraine.

Adolescent↗
PubMed2006

Assessing quality of life in Taiwanese patients with Alzheimer's disease.

OBJECTIVE: To measure differences in patients with Alzheimer's disease (AD) and caregiver assessments of the patients' quality of life (QOL) and to identify the patient characteristics, caregiver characteristics, or patient-caregiver interactions responsible for these differences. METHODS: We recruited consecutive patients with AD and their caregivers from an outpatient clinic of a teaching hospital in Taiwan. Each patient and caregiver rated the patient's quality of life (QOL) using the Quality of Life-Alzheimer's Disease (QOL-AD) questionnaire. Additional measures included the Mini-Mental State Examination (MMSE), Clinical Dementia Rating, Blessed Activities of Daily Living assessment, and the Neuropsychiatric Inventory. Only patients with MMSE score >or= 10 were enrolled. RESULTS: Of the 94 patients enrolled, 81 with reliable caregivers were included. The internal consistency was good within both patient and caregiver reports (alpha=0.83 and 0.79, respectively). The agreement between patient and caregiver QOL-AD reports was moderate (absolute intraclass correlation coefficient: 0.41). Regression analyses indicated that caregiver distress was the most consistent predictor of QOL rating discrepancy between the patient and caregiver, and patient depressive disorder was the most significant predictor of QOL. CONCLUSIONS: Similar to previous studies in different ethnic groups, the QOL perception differed between the Taiwanese patients with AD and their caregivers. Medical professionals should be cautious if they try to use a caregiver-reported QOL to replace the patient-reported QOL among AD patients of mild to moderate severity.

Activities of Daily Living↗
PubMed2006

Validity, reliability and application of the taiwan version of the migraine disability assessment questionnaire.

BACKGROUND/PURPOSE: The seven-item Migraine Disability Assessment (MIDAS) questionnaire is a simple and useful tool for evaluating migraine-related disability. The goals of this study were: (1) to test the reliability and validity of the Taiwan version of the MIDAS (MIDAS-T) questionnaire, and (2) to measure the impact of migraine among Taiwanese patients in a headache clinic. METHODS: Consecutive migraine patients, aged 20-50 years, visiting the headache clinic at the Taipei Veterans General Hospital were invited to participate in the study. They completed the MIDAS-T and a form, which collected headache-related information including characteristics and impact on their lives. Of them, about 30 patients were randomly invited to repeat the MIDAS-T 3 weeks later. RESULTS: A total of 281 migraine patients (M/F, 63/218; mean age, 35.27 +/- 8.21 years) participated in the study. Of them, 31 completed the MIDAS-T again 3 weeks later. MIDAS-T showed acceptable internal consistency (Cronbach alpha = 0.79), test-retest reliability (r = 0.67) and criterion validity (r = 0.37 for question A [headache frequency] and r = 0.34 for question B [headache intensity], p < 0.001). The mean score of migraine patients on MIDAS-T was 34.21 +/- 45.90, ranging from 0 to 265. MIDAS grade I (score 0-5) was found in 22% of patients, grade II (6-10) in 15%, grade III (11-20) in 17%, and grade IV (>or=21) in 46%. CONCLUSION: This study supports the reliability and validity of MIDAS-T for use in Taiwanese patients. Almost half of the migraine patients were classified as having severe disability (grade IV).

Adult↗
PubMed2006

Characteristics and treatment of headache after traumatic brain injury: a focused review.

Headache is one of the most common complaints in patients with traumatic brain injury. By definition, headache that develops within 1 wk after head trauma (or within 1 wk after regaining consciousness) is referred to as posttraumatic headache (PTH). Although most PTH resolves within 6-12 mos after injury, approximately 18-33% of PTH persists beyond 1 yr. We performed a systematic literature review on this topic and found that many patients with PTH had clinical presentations very similar to tension-type headache (37% of all PTH) and migraine (29% of all PTH). Although there is no universally accepted protocol for treating PTH, many clinicians treat PTH as if they were managing primary headache. As a result of the heterogeneity in the terminology and paucity in prospective, well-controlled studies in this field, there is a definite need for conducting double-blind, placebo-controlled treatment trials in patients with PTH.

Analgesics↗
PubMed2006

[The application of migraine disability assessment questionnaire (MIDAS)].

Migraine is a recurring and disabling pain disorder. The prevalence is estimated as 9.1% in Taiwan. Patients suffer from significant loss of work, time at school or ability to perform household chores, as well as other family or leisure activities. Treatment strategies during migraine attacks should be tailored based on the severity of disability. Stewart and Lipton (1999) developed the Migraine Disability Assessment Questionnaire (MIDAS) to assess the severity of disability related to migraine. This simple, self-administered, 7-item questionnaire focuses on disability in three domains (school or paid work, household chores, and family, social, or leisure activities) in the first 5 items of the questionnaire. The internal consistency, test-retest reliability, validity, ease of use, and clinical utility were all tested with good results. The questionnaire offers a simple tool to improve physician-patient communication. As for treatment strategies, a recent large-scale study done in the USA showed that it is more efficacious to treat migraine patients by adopting a strategy of stratified care based on different disability status than a stepped-care strategy. The simple questionnaire, MIDAS, has received world-wide popularity and has been translated into Japanese, Italian and Turkish. All of these versions showed good reliability and validity. Recently, one of our studies demonstrated that the Taiwan version also yielded comparable internal consistency, reliability, and validity. We hope that the MIDAS questionnaire can be widely adopted in Taiwan to help physicians assess their patients' disability related to migraine and provide clues for clinical management.

Disability Evaluation↗
PubMed2006

Study of behavioral and psychological symptoms of dementia in Taiwan.

The behavioral and psychological symptoms of dementia (BPSD) are common serious problems that affect the quality of life for both the patients with such symptoms as well as their caregivers. BPSD present a major challenge in the medical management of patients and are the major cause of institutionalization. Alzheimer's Disease (AD) is the most common type of dementia in Taiwan. I performed a systematic literature review on BPSD studies and found that Taiwanese patients with AD exhibit many of the BPSD. Studies showed that between 30% and 63% of Taiwan's AD patients experienced delusion. Hallucination occurred less frequently, which ranged from 21% to 26%. Anxiety occurred in 35-76% of patients and depression 22-50%, sleep abnormalities 26-61% and 39-46%. The differences in the prevalence of BPSD might result from the different clinical settings and evaluation instruments. The prevalence and clinical manifestations of BPSD in Taiwan are similar to Western reports and it suggests that most of BPSD are neurobiologically determined. Based on differing cultural backgrounds, the interpretation of agitation and apathy might differ, so, the development of cross-cultural applicable criteria and rating scales for the assessment and treatment of BPSD are important for future studies.

Alzheimer Disease↗
PubMed2005

Does medication overuse headache represent a behavior of dependence?

Medication overuse is relatively common in patients with frequent headache. To explore the prevalence of patients who meet the criteria for substance dependence in Diagnostic and Statistical Manual of Mental Disorders, Edition IV (DSM-IV), and to identify variables of substance dependence among patients with chronic daily headache, we recruited consecutive patients with chronic daily headache at a headache clinic from November 1999 to June 2004. Each patient completed a headache intake form, a dependence questionnaire modified from DSM-IV, and the Hospital Anxiety and Depression Scale (HADS). The presence of probable medication overuse headache (pMOH) was defined on the basis of the International Classification of Headache Disorders, 2nd edition, 2004. A total of 1,861 patients with chronic daily headache (1,369 women, 492 men; mean age, 49.6+/-15.4 years) were recruited. Almost half (895/1,861, 48%) met criteria of pMOH, and 606 of these patients (606/895, 68%) met three of five DSM-IV substance dependence criteria. In contrast, only 191 of 968 patients without pMOH (20%) met the DSM-IV criteria (OR=8.6, [7.0-10.6], chi-square test, P<0.001). Patients who fulfilled DSM-IV criteria of dependence had higher numbers of physician appointments in the past year. Multivariate logistic regression analyses revealed that migraine headache, frequent physician consultation, intensity of headache, and presence of a higher anxiety score were significant independent variables for substance dependence. Among patients with chronic daily headache, pMOH was associated with behaviors of substance dependence.

Analgesics↗
PubMed2005

Hot flashes are associated with psychological symptoms of anxiety and depression in peri- and post- but not premenopausal women.

OBJECTIVE: To explore the relationship between anxiety, depression, vasomotor symptoms, and menopausal status among middle-aged women. DESIGN: A population-based study involving a rural Taiwanese population. Participants received a structured questionnaire, which included the hospital anxiety and depression scale (HADS), gynecological history and a checklist of menopausal symptoms in the most recent 2 weeks. RESULTS: A total of 1273 women with no history of surgical menopause and hormonal therapy history participated. The mean anxiety, depression, and total HADS scores were 4.3 +/- 3.3, 3.3 +/- 2.8 and 7.6 +/- 5.3, respectively, and did not differ according to menopausal status. A total of 10.5% participants reported hot flashes within the previous 2 weeks. After controlling for educational status and insomnia, anxiety (6.0 +/- 3.8 versus 4.1 +/- 3.1) and depression scores (4.0 +/- 3.3 versus 3.2 +/- 2.7) were significantly higher (p < 0.001) compared with those without hot flashes. These differences were attributed to peri- and postmenopausal subjects. CONCLUSIONS: Hot flashes in peri- and postmenopausal women were associated with anxious and depressive symptoms in East Asian population with low prevalence of vasomotor symptoms.

Adult↗
PubMed2005

A longitudinal study of cognition change during early menopausal transition in a rural community.

OBJECTIVE: To characterize changes in cognition that occur during the hormonal transitions of menopause. METHOD: We conducted a longitudinal population-based study in Kinmen, Taiwan, recruiting all women age 40-54 years who were premenopausal and without a history of hormone replacement therapy (HRT) or hysterectomy. The cognitive measures used to assess function included the Auditory-Verbal Learning Test, visual memory, verbal fluency, Trail Making Test and digit span. RESULTS: A total of 694 eligible women participated in the baseline study, and 573 women (83%) completed follow-up 18 months later. After excluding 78 women who received hysterectomy or HRT, the final sample was composed of 495 subjects, of whom 114 (23%) progressed to perimenopause during follow-up. Women who remained premenopausal were younger than those who became perimenopausal (44.7 +/- 2.3 years versus 47.1 +/- 3.0 years, p < 0.01). All follow-up cognitive scores in women who entered perimenopause were slightly better than baseline measures except for Rey Auditory-Verbal Learning Test, which decreased by 0.23 (S.D. = 2.9, p = 0.3). At follow-up, cognitive function except for verbal fluency did not differ significantly between women who stayed premenopausal and those became perimenopausal after controlling for age, education, and baseline cognitive scores. Women who entered perimenopause have an average of 1.3 items (S.D. = 0.4) less in verbal fluency measures as compared with their premenopausal peers at the follow-up period. CONCLUSIONS: The menopausal transition might not accompany significant cognitive decline except for verbal fluency.

Adult↗
PubMed2005

Attitudes toward menopause among middle-aged women: a community survey in an island of Taiwan.

OBJECTIVES: The purpose of this report is to explore the attitudes toward menopause of middle-aged women in Taiwan as well as to examine related factors. METHODS: A large community-based sample of Taiwanese women aged 40-54 years who are living on the islet of Kinmen were recruited for this study. Attitudes toward menopause were collected with a self-administered questionnaire. RESULTS: Of a targeted population of 1429 individuals, 1113 (78%) participated in the study. The mean age was 48.5+/-4.0 years (range, 43-57 years) and 434 women (39%) were premenopausal. The rate of current hormone use was 13.5%. Compared to premenopausal women, fewer postmenopausal women agreed that menopause depressed them, and that interests distracted their attention from menopause (p<0.01, Mann-Whitney test). Postmenopausal women did not believe that menopause would change their lives, and not having periods made women feel regretful. Compared with the illiterate women, higher educated women were more regretful about menopause (p<0.05, Mann-Whitney test). Women who experienced vasomotor symptoms within 2 weeks of the study expressed a more negative attitude regarding menopause. CONCLUSIONS: Women in Taiwan held a more positive attitude toward menopause as compared to prior studies in other countries. They had a more positive attitude when they actually faced menopause. Education and vasomotor symptoms had a significantly negative impact on menopausal perceptions. This report provides more insight on the perception of menopause in Taiwanese women that will guide future public health initiatives.

Adult↗
PubMed2005

Correlation of magnetic resonance images with neuropathology in acute Wernicke's encephalopathy.

We correlated serial brain MRIs with neuropathological findings in a 16-year-old female whose autopsy was consistent with Wernicke's encephalopathy (WE). Diffusion-weighted imaging, diffusion coefficients mapping and neuropathology findings were suggested vasogenic edema in the periaqueductal and peri-the-fourth ventricular areas. This is the first documented case report to make this direct comparison. The characteristic WE changes in the mammillary body was also correlated with the findings of MRI with contrast enhancement. Bilateral cortical lesions revealed by MRI were atypical and rare in WE and were not evidenced by pathological changes.

Adolescent↗
PubMed2005

Assessing quality of life for adolescents in Taiwan.

This study was to evaluate the psychometric properties of the Taiwanese quality of life questionnaire for adolescents and the factors affecting the quality of life of Taiwanese adolescents. The survey involved 5538 junior high school students, aged 13-15 years. An initial 90-item questionnaire was shortened to 38 items by means of principal component analyses. Quality of life assessment involved seven factors: family, residential environment, personal competence, social relationships, physical appearance, psychological well-being, and pain. The rate of missing data was low. The Cronbach alpha coefficient remained above the 0.75 threshold criterion for the global scale and seven subdomain scales. A lower quality of life score was evident for female adolescents in higher grades in school, those living with a single parent or other relatives, and those living in rural areas. This 38-item questionnaire should serve as a reliable tool for future studies.

Adolescent↗
PubMed2005

Spontaneous intracranial hypotension presenting as mental deterioration.

A 55-year-old woman had new onset of postural headache followed by change of mental status 3 weeks later. Magnetic resonance imaging (MRI) of the brain and whole spine showed typical spontaneous intracranial hypotension (SIH) findings, bilateral subdural hematoma, and cerebrospinal fluid leakage over the T7-T9. Her headache and mentality improved after epidural blood patches. Early recognition and correct diagnosis are crucial for successful treatment in patients with SIH presenting with mental confusion.

Blood Patch, Epidural↗
PubMed2005

Understanding of senile dementia by children and adolescents: why grandma can't remember me?

BACKGROUND: The present study sought to determine the knowledge and attitudes concerning senile dementia among children and adolescents in Taiwan with the intent of using the results in the design of an educational program about senile dementia for this population. METHODS: A 10-item questionnaire was distributed to all students aged 10 to 15 at 7 geographically selected public schools in Taiwan. The teachers in these schools and a group of 20 health professionals who were specialists in dementia were also invited to complete questionnaire for comparison. RESULTS: The majority of children, adolescents and teachers worried that their parents and grandparents might develop dementia in the future. Seven percent of all the student respondents felt that they would be embarrassed to invite classmates to their homes either because of actual demented family members living at home or if the hypothetical situation arose in which they actually had demented family members living at home. The younger students were more likely to have this feeling (chi square for linear trend = 73.636, df = 1, p = 0.000). CONCLUSION: Younger children were more likely to feel stigmatized by dementia in a family member which suggests that they may need more psychological support in order to effectively deal with dementia related issues. These results have important implications for the development of suitable educational programs about dementia in the curricula of primary and junior high schools.

Adolescent↗
PubMed2005

Intractable hiccups as an unusual presentation of a uterine leiomyoma: a case report.

BACKGROUND: Hiccups, or singultus, are an abrupt, intense contraction of the inspiratory muscles accompanied by closure of the glottis and are experienced by most people. people. CASE: A 41-year-old woman with a large uterine myoma presented with recurrent and intractable hiccup boutsfor 1 year. The hiccups resolved spontaneously after hysterectomy. CONCLUSION: A uterine leiomyoma, especially the subserosal type, might become a possible etiology of hiccups when large enough to cause irritation of the vagus or phrenic nerve.

Adult↗