Biomedical subjects

Tony Hsiu-Hsi Chen

Publications and source records attributed to Tony Hsiu-Hsi Chen.

At least 19 recordsLinked to original sources

PubMed2007

Simplified electrodiagnostic criteria of diabetic polyneuropathy in field study (KCIS No. 14).

This study sought to determine the sensitivity of sural sensory action amplitude (SAP) and peroneal motor conduction velocity (MCV) for differentiating the status of other nerve conduction velocities and identifying important correlates of diabetic polyneuropathy. Subjects (n = 708) with type 2 diabetes from one community completed a preliminary questionnaire. Among the 298 subjects with positive questionnaire results, 272 completed nerve conduction tests. The means of 6 nerve conduction velocities of subjects with both SAP and MCV abnormalities were compared to those of normal controls. The mean conduction velocities of all motor and sensory nerves were slower (p < 0.05) in subjects with polyneuropathy than without polyneuropathy. Important known correlates of diabetic polyneuropathy can also be identified by this electrophysiological definition. The sural SAP and peroneal MCV together serve as a good diagnostic for diabetic polyneuropathy and can be used as a simplified criterion in field studies.

Action Potentials↗

PubMed2006

Distortion product otoacoustic emissions as a prognostic factor for idiopathic sudden sensorineural hearing loss.

We investigated distortion product otoacoustic emissions (DPOAE) as a prognostic factor in idiopathic sudden sensorineural hearing loss (ISSHL) patients with the time-dependent Cox proportional-hazards model. We also compared the importance of the prognostic factors that are reported in the literature. 108 patients with ISSHL were included. Both DPOAE and pure tone audiometry were performed everyday for a maximum of 7 days during admission and followed every other week or monthly after discharge. All DPOAE amplitudes were analyzed at 2f1-f2--namely 1093, 1375, 1750, 2187, 2781, 3500, 4375, and 5500 Hz. The average of two series of DPOAE intensity corrected for the noise level in eight frequencies was coded as dichotomous at > or =6 or <6 dB. We selected the most updated DPOAE at 3 days or more before the assessment of recovery into the analysis. The potential confounders including age, sex, history of vertigo at onset, history of hypertension, diabetes, coronary arterial disease, and stroke, configuration and severity of initial pure tone audiometry, the duration from onset to treatment, auditory brainstem response (ABR), vestibular evoked myogenic potential (VEMP), and plasma triglyceride and cholesterol levels, hemoglobin level, and erythrocyte sedimentation rate were collected for evaluation. The results showed that a better DPOAE amplitude was a significantly good prognostic indicator both in univariate analysis (recovery rate ratio = 3.626, 95% CI = 2.119-6.205, p < 0.0001) and multivariate analysis (recovery rate ratio = 2.94, 95% CI = 1.537-5.624, p = 0.0011). The Kaplan-Meier estimates showed that the younger age group (< or =40 years) with better initial pure tone audiometry (<65 dB) represented a better prognosis that was compatible with previous literature (log-rank test, p = 0.0297 and p = 0.0019 respectively). In the univariate analysis, normal ABR and VEMP waveforms were associated with a better prognosis (ABR: recovery rate ratio = 2.984, 95% CI = 1.742-5.112, p < 0.0001; VEMP: recovery rate ratio = 1.978, 95% CI = 1.183-3.305, p = 0.0093). The configuration of initial audiometry was also a significant prognostic factor that patients with scale-out type (recovery rate ratio = 0.228, 95% CI = 0.089-0.584, p = 0.002) and tent type (recovery rate ratio = 0.081, 95% CI = 0.008-0.778, p = 0.0295) were associated with a poorer prognosis than those with the flat type in the multivariate analysis. In this study, the time-dependent Cox proportional-hazards model established the prognostic value of DPOAE for ISSHL patients. This model can also be used for comparison of different treatment protocols. In addition, the further development of a predictive model based on this method is worthy of being investigated.

Adolescent↗

PubMed2006

Population-based survey on prevalence of adult patients with epilepsy in Taiwan (Keelung community-based integrated screening no. 12).

PURPOSE: To determine the prevalence rate and patterns of adult patients with epilepsy in Taiwan, we conducted a community-based neuroepidemiological survey. METHODS: Epilepsy was detected by neurologists using one-stage method. It was integrated into a community health screening service and performed from 1 January 2001 to 31 December 2001 in Keelung, a northern city in Taiwan. A total of 13,663 subjects aged 30 years or older participated in this survey. RESULTS: There were 52 patients with epilepsy in this study. Among them, 37 were patients with active epilepsy. The age-adjusted prevalence rate of active epilepsy above 30 years old was 2.77/1000 (to the 1980 US population) with the highest rate in subjects aged 40-49 years (4.0/1000). There was a trend of higher prevalence rate in male than in female. The most common seizure type was complex partial seizure (46.0%). Using one-stage detection method, we found nine (24.3%) patients with active epilepsy who had never been diagnosed before. Among the patients with active epilepsy, 35.1% were symptomatic cases. Head injury (13.5%) is the leading cause, followed by CNS infection (8.1%), stroke (5.4%) and perinatal insult (5.4%). The lifetime prevalence rate of epilepsy (including active epilepsy and epilepsy in remission) was 3.14/1000 for age above 30 years. CONCLUSIONS: Comparing to previous epilepsy survey in 1993, our results showed that the prevalence rate of epilepsy was rather stable over the past decade in northern Taiwan. Head injury is the leading cause responsible for active epilepsy. Improving public safety is an important public health issue which may help to reduce occurrence of epilepsy.

Adult↗

PubMed2006

Location and size of infarct on functional outcome of noncardioembolic ischemic stroke.

PURPOSE: Studies regarding the effects of location and size of infarct on the functional outcome after stroke have yielded inconsistent results. This study aimed to investigate the relationships of neuroimage findings and longitudinal Barthel index (BI) scores in patients with first-ever ischemic stroke. METHOD: The neuroimage findings of enrolled subjects were grouped by anatomical location. The size of infarct was determined by the largest diameter of the lesion. Patients were followed up prospectively at onset, 2 weeks, 1, 2, 4, and 6 months after stroke. Linear mixed model was employed for the repeated measurement analysis of BI at these six time points in each patient. RESULTS: A total of 111 patients were enrolled. The BI increased rapidly during the first two months, and reached plateau after four months. The location and size of the lesion had significant effects on serial measurements of BI. After adjustment for age, sex, treatment mode, and baseline BI score, the posterior cerebral artery infarct group showed the largest improvement in BI. There was a trend that the smaller the lesion size, the more favourable the functional outcome. CONCLUSIONS: Both location and size of lesion in noncardioembolic stroke were significant prognostic factors for functional outcome.

Activities of Daily Living↗

PubMed2006

Population-based family case-control proband study on familial aggregation of metabolic syndrome: finding from Taiwanese people involved in Keelung community-based integrated screening (KCIS no. 5).

A population-based case-control proband study was undertaken to elucidate familial aggregation, independent environmental factors, and the interaction between them. A total of 7308 metabolic syndrome (MET-S) cases were identified from the Keelung community-based integrated screening programme between 1999 and 2002. The study has a case-control/family sampling design. A total of 1417 case probands were randomly selected from 3225 metabolic syndrome cases and the corresponding 2458 controls selected from 16,519 subjects without metabolic syndrome by matching on sex, age (+/-3 years) and place of residence. The generalized estimation equation model was used to estimate odds ratios and corresponding 95% confidence intervals. The risk for having metabolic syndrome among family members for cases versus control probands was 1.56-fold (1.29-1.89) after controlling for significant environmental factors. Higher risk of metabolic syndrome was found in parents than spouse. Low education against high education had 2.06-fold (1.36-3.13) risk for metabolic syndrome. Betel quid chewing was positively associated with the risk of MET-S, with 1.99-fold (1.13-3.53) risk for 1-9 pieces and 1.76-fold (0.96-3.23) risk for >or=10 pieces compared with non-chewer. Moderate and high intensity of non-occupational exercise led to 21.0% (OR=0.79 (0.63-0.98)) and 26.0% (OR=0.74 (0.59-0.94)) reduction in the risk for metabolic syndrome, respectively. The frequent consumption of vegetable reduced 24.0% (OR=0.76 (0.62-0.92)) risk for MET-S. The frequent consumption of coffee was associated the increased risk for metabolic syndrome (OR=1.32 (1.07-1.64)). The present study confirmed the risk of metabolic syndrome not only has the tendency towards familial aggregation but is affected by independent effect of environmental or individual correlates.

Adult↗

PubMed2006

Perception of nocturia and medical consulting behavior among community-dwelling women.

We investigated the perception of nocturia and possible explanatory factors for medical consultation among community-dwelling women. Between October 2004 and February 2005, women aged > or =40 years living in Matsu, Taiwan, who were identified as having nocturia in a previous epidemiological survey, were interviewed with a questionnaire eliciting information about nocturia-specific quality of life impact (N-QOL), perceptions of nocturia, and medical-consultation behavior. A total of 328 women completed this study. Of these, 187 (57%), 99 (30.2%), 30 (9.1%), and 12 (3.7%) reported one, two, three, and four or more nocturia episodes, respectively, per night during the past 4 weeks. Most women attributed nocturia to aging or excessive fluid intake and had a lack of medical information. Overall, only 13.1% had visited a doctor for this condition. Nocturia episodes [> or = three vs <three, odds ratio (OR) 3.8], N-QOL score (OR 2.0, per 10-point decrement), linking nocturia to a disease (OR 2.9), and medical information (OR 2.2) were independent factors associated with medical-consultation, whereas the lack of knowledge that nocturia was treatable appeared to be an important barrier to medical-consultation. Only 62.8% of the women were offered treatment upon consultation, even though nearly half of those treated reported significant improvement. A few women with nocturia have sought medical help, which appears to be affected by a compendium of factors. This study suggests that more information about nocturia should be provided to health providers and patients to identify and meet their most essential needs.

Adult↗

PubMed2006

Cost-effectiveness analysis of colorectal cancer screening with stool DNA testing in intermediate-incidence countries.

BACKGROUND: The aim of this study is to compare the cost-effectiveness of screening with stool DNA testing with that of screening with other tools (annual fecal occult blood testing, flexible sigmoidoscopy every 5 years, and colonoscopy every 10 years) or not screening at all. METHODS: We developed a Markov model to evaluate the above screening strategies in the general population 50 to 75 years of age in Taiwan. Sensitivity analyses were performed to assess the influence of various parameters on the cost-effectiveness of screening. A third-party payer perspective was adopted and the cost of dollar 13,000 per life-year saved (which is roughly the per capita GNP of Taiwan in 2003) was chosen as the ceiling ratio for assessing whether the program is cost-effective. RESULTS: Stool DNA testing every three, five, and ten years can reduce colorectal cancer mortality by 22%, 15%, and 9%, respectively. The associated incremental costs were dollar 9,794, dollar 9,335, and dollar 7,717, per life-year saved when compared with no screening. Stool DNA testing strategies were the least cost-effective with the cost per stool DNA test, referral rate with diagnostic colonoscopy, prevalence of large adenoma, and discount rate being the most influential parameters. CONCLUSION: In countries with a low or intermediate incidence of colorectal cancer, stool DNA testing is less cost-effective than the other currently recommended strategies for population-based screening, particularly targeting at asymptomatic subjects.

Colonoscopy↗

PubMed2006

Impact of nocturia on symptom-specific quality of life among community-dwelling adults aged 40 years and older.

OBJECTIVES: To evaluate factors predicting the effect of nocturia in a community-based cohort of adults using a nocturia-specific quality-of-life (N-QOL) questionnaire. METHODS: From October 2004 to February 2005, adults aged 40 years old or older living in Matsu, Taiwan and reporting nocturia of one episode or more per night were interviewed with a 12-item N-QOL questionnaire consisting of Sleep/Energy and Bother/Concern subscales. Univariate analyses were used to analyze the effects of demographic characteristics, frequency and duration of nocturia, and sleeping characteristics on the N-QOL score. Multiple linear regression analysis was used to identify factors predicting the N-QOL score. RESULTS: A total of 663 adults completed this study (mean age 59.4 years). The average N-QOL scores (a lower score indicates worse QOL) were 91.4 +/- 11.2, 83.7 +/- 13.2, 77.6 +/- 16.8, and 67.6 +/- 21.2 for nocturia episodes of 1, 2, 3, and 4 or more per night, respectively (P < 0.001). Men reported significantly lower N-QOL (85.6 +/- 15.1 versus 88.9 +/- 13.1, P = 0.003) and Bother/Concern subscale scores (42.0 +/- 8.4 versus 44.0 +/- 7.4, P < 0.001), but not Energy/Sleep subscale scores (43.6 +/- 7.8 versus 44.4 +/- 7.3, P = 0.158) than women. On multiple linear regression analysis, increasing nocturia episodes (regression coefficient -6.2, 95% confidence interval -7.4 to -5.0), male sex (regression coefficient -3.5, 95% confidence interval -5.4 to -1.5), and degree of sleeping disturbance after nocturia (regression coefficient -4.5, 95% confidence interval -5.6 to -3.4) independently predicted a significantly lower N-QOL score. CONCLUSIONS: The results of our study have confirmed that nocturia has a more significant QOL impact when the patient has two or more episodes per night. Moreover, men experienced a greater impact from nocturia than women, particularly in the Bother/Concern domain.

Adult↗

PubMed2006

Incidence and risk factors associated with bilateral breast cancer in area with early age diagnosis but low incidence of primary breast cancer: analysis of 10-year longitudinal cohort in Taiwan.

This study aims to examine the incidence and risk factors of bilateral breast cancer in area with low incidence rate. A total of 120 and 1902 women with bilateral and unilateral breast cancers were enrolled; various factors, including those concerning their medical history and life style, were extracted. Using Kaplan-Meier method, we calculate the cumulative incidence of contralateral breast cancer. The results show as follows. The cumulative incidences of contralateral breast cancer at 1, 3, 5 years after diagnosis of first breast cancer were 1.15, 1.94, and 2.97%, respectively. The statistically significant risk factors included menopause (Hazard Ratio (HR) =1.56, (1.00-2.42)), invasive lobular carcinoma (HR=2.98, (1.35-6.56)), receiving chemotherapy (HR=2.21, (1.43-3.42)) and/or radiotherapy (HR=3.32, (2.19-5.05) and a protective factor was tamoxifen therapy (HR=0.5 (0.34-0.74). Size of the second occurred tumour (2.97 cm) tended to be smaller than the first one (3.58 cm) with borderline statistical significance (p=0.0731). Comparing to the existing data on Western countries, we find a higher risk for developing contralateral breast cancer in Taiwan where a low incidence of first breast cancer rate with early age diagnosis is noted. It suggests that first primary breast tumour with early age of onset and lobular carcinoma are found more likely to develop bilateral breast cancers.

Adult↗

PubMed2006

Treatment of low back pain by acupressure and physical therapy: randomised controlled trial.

OBJECTIVE: To evaluate the effectiveness of acupressure in terms of disability, pain scores, and functional status. DESIGN: Randomised controlled trial. SETTING: Orthopaedic clinic in Kaohsiung, Taiwan. PARTICIPANTS: 129 patients with chronic low back pain. INTERVENTION: Acupressure or physical therapy for one month. MAIN OUTCOME MEASURES: Self administered Chinese versions of standard outcome measures for low back pain (primary outcome: Roland and Morris disability questionnaire) at baseline, after treatment, and at six month follow-up. RESULTS: The mean total Roland and Morris disability questionnaire score after treatment was significantly lower in the acupressure group than in the physical therapy group regardless of the difference in absolute score (- 3.8, 95% confidence interval - 5.7 to - 1.9) or mean change from the baseline (- 4.64, - 6.39 to - 2.89). Acupressure conferred an 89% (95% confidence interval 61% to 97%) reduction in significant disability compared with physical therapy. The improvement in disability score in the acupressure group compared with the physical group remained at six month follow-up. Statistically significant differences also occurred between the two groups for all six domains of the core outcome, pain visual scale, and modified Oswestry disability questionnaire after treatment and at six month follow-up. CONCLUSIONS: Acupressure was effective in reducing low back pain in terms of disability, pain scores, and functional status. The benefit was sustained for six months.

Acupressure↗

PubMed2006

Type 2 diabetes and hepatocellular carcinoma: A cohort study in high prevalence area of hepatitis virus infection.

This study aimed to elucidate the relationship of type 2 diabetes, other known risk factors, and primary hepatocellular carcinoma (HCC) in countries with a high prevalence of hepatitis infection. We followed a prospective cohort of 54,979 subjects who participated in the Keelung Community-Based Integrated Screening program between 1999 and 2002. A total of 5,732 subjects with type 2 diabetes cases were identified at enrollment on the basis of fasting blood glucose level, and a total of 138 confirmed HCC cases were identified either through two-stage liver cancer screening or linkage with the National Cancer Registry. The independent effect of type 2 diabetes on the incidence of HCC and the interaction between type 2 diabetes and hepatitis infection or lipids profile were assessed using the Cox proportional hazards regression model. After controlling for age, sex, hepatitis B virus (HBV), hepatitis C virus (HCV), smoking, and alcohol consumption, the association between type 2 diabetes and incidence of HCC (excluding 33 prevalent cases identified at enrollment) was modified by HCV status and cholesterol level. The associations were only statistically significant (adjusted hazard ratio [HR] = 2.08 [1.03-4.18]) for being HCV negative and for having hypercholesterolemia (adjusted HR = 2.81 [1.20-6.55]). These statistically significant findings remained even excluding cases of diabetes newly diagnosed at enrollment. In conclusion, in an area with a high prevalence of hepatitis virus infection, type 2 diabetes increases the risk of developing HCC in those who are HCV negative or have a high level of total cholesterol.

Adult↗

PubMed2006

A predictive model for postoperative intraocular pressure among patients undergoing laser in situ keratomileusis (LASIK).

PURPOSE: The aim of this study was to develop a predictive model based on preoperative variables for estimating postoperative intraocular pressure (IOP) of those eyes undergoing LASIK surgery, to predict the amount of underestimated IOP after LASIK for myopia and myopic astigmatism. DESIGN: Pretest-post-test longitudinal study. METHODS: Both eyes of 193 eligible subjects who underwent LASIK procedures at the Department of Ophthalmology, National Taiwan University Hospital, from July 2000 to December 2002 for myopia and myopic astigmatism were identified to build up the predictive models. IOPs were measured with noncontact air-puff tonometry. Information on age, gender, preoperative central corneal thickness (CCT), preoperative central corneal curvature (CCK), preoperative spherical equivalent refractive error, and ablation depth was collected and applied for predicting postoperative IOP after LASIK based on linear mixed model. RESULTS: Significant predictors for postoperative IOP after myopic LASIK procedures included age, gender, preoperative IOP, ablation depth, preoperative CCT, and preoperative spherical equivalent refractive errors. The linear mixed model, taking into account these significant preoperative correlates and the correlation of IOPs between both eyes of the same patient, explained 91% of the variation of postoperative IOP. CONCLUSIONS: A statistical model was developed for predicting the amount of underestimated IOP after LASIK for myopia and myopic astigmatism, which is of clinical importance to uncover ocular hypertension among patients whose information on postoperative IOP immediately after LASIK is not available.

Adult↗

PubMed2006

Overweight and obesity-related metabolic disorders in hospital employees.

BACKGROUND: Obesity is associated with metabolic disorders and cardiovascular diseases. This study investigated the relationship between overweight and obese status and the incidence of type 2 diabetes, hypertension, hyperlipidemia and hyperuricemia. METHODS: This prospective cohort study comprised 1749 hospital employees who received baseline health check-ups in 1993. Data from the 1027 participants (832 women, 195 men; mean age, 36 +/- 7 years) who repeated check-ups in 2003 were used in the analysis. Relative risks (RRs) for development of metabolic disorders during follow-up associated with different body mass index (BMI) categories at baseline as defined by Asia-Pacific recommendations and the Department of Health in Taiwan were calculated after adjustment for covariates. RESULTS: The prevalence of overweight and obesity at baseline check-up were 17.6% and 14.5%, respectively. Obese subjects with baseline BMI >or= 25 kg/m2 had a significant multivariate-adjusted RR of 2.7 for hypertension, 14.8 for type 2 diabetes, 3.2 for hypertriglyceridemia, and 2.8 for hyperuricemia, compared to subjects with baseline BMI < 23.0 kg/m2. RR for diabetes was higher in women than in men, but RR for hypertriglyceridemia was higher in men. The risks of hypertension and hyperuricemia significantly increased for subjects with baseline BMI >or= 23 kg/m2, while RRs for type 2 diabetes increased significantly for baseline BMI >or= 24 kg/m2 and hypertriglyceridemia increased for baseline BMI >or= 25 kg/m2. The risks attributable to obesity (baseline BMI >or= 25 kg/m2) were 23.0% for hypertension, 70.8% for diabetes, 27.9% for hypertriglyceridemia, and 24.1% for hyperuricemia. CONCLUSION: This study revealed that a high prevalence of overweight and obesity was associated with significantly increased risk of development of type 2 diabetes, hypertension, hypertriglyceridemia and hyperuricemia in hospital employees, suggesting the need for programs to improve weight management.

Adult↗

PubMed2006

Effect of availability of a parturient-elective regional labor pain relief service on the mode of delivery.

BACKGROUND/PURPOSE: Regional analgesia for labor pain relief is effective and widely used. This study evaluated the controversial association between mode of operative delivery and patient-elective labor regional analgesia. METHODS: We retrospectively compared the rates of instrumental vaginal and cesarean deliveries in parturients before the introduction, in the first 15 months after, and in the subsequent 36 months after the implementation of an elective labor regional analgesia service. A total of 9779 low-risk singleton cephalic pregnancies above 36 weeks of gestation were included. The maternal and fetal outcomes for parturients before the service was implemented and in those with or without pain relief service in the two postimplementation periods were analyzed. Multivariate logistic regression analyses were used to investigate the effects of maternal age, gestational weeks and newborn weight, in addition to regional analgesia, on the mode of delivery in nulliparous women. RESULTS: After adjusting for maternal age, gestational weeks, and newborn weight, no significant association was found between regional analgesia and cesarean delivery in nulliparas. Further, this lack of association was not affected by the receipt of regional analgesia in the early period of program implementation or in the period after staff had become familiar with the service. A higher rate of instrumental vaginal delivery was noted in nulliparas given regional analgesia. CONCLUSION: Regional analgesia for pain relief increased the likelihood of instrumental vaginal delivery, but did not increase the likelihood of cesarean delivery.

Adult↗

PubMed2006

A population-based study of the association between betel-quid chewing and the metabolic syndrome in men.

BACKGROUND: Betel-quid chewing, an established risk factor for oropharyngeal malignancy, is associated with hyperglycemia and obesity. Associations with other characteristics of the metabolic syndrome have not been reported. OBJECTIVE: This study examined associations between betel-quid chewing and the metabolic syndrome, allowing for recognized risk factors and exploring dose-response effects in a population-based study. DESIGN: Age-specific prevalence rates of the metabolic syndrome were examined in betel-quid chewing and nonchewing men (n = 19,839) recruited into the Keelung Community-based Integrated Screening program in 2001-2003. The independent effect of betel-quid chewing on metabolic syndrome risk was examined by using multiple logistic regression with control for well-recognized risk factors (eg, education, physical activity, and dietary factors) and dose-response effects were examined by using trend tests. RESULTS: The age-adjusted prevalence of the metabolic syndrome was highest in current chewers (25.13%), next highest in ex-chewers (22.04%), and lowest in nonchewers (15.73%) (P < 0.0001). Odds ratios (95% CIs) for the metabolic syndrome were 1.38 (1.19, 1.60) and 1.78 (1.53, 2.08) in ex-chewers and current chewers, respectively, adjusted for other significant correlates such as a family history of hypertension and diabetes mellitus. Meaningful odds ratios for the metabolic syndrome components ranged from 1.24 for hyperglycemia (95% CI: 1.09, 1.64) to 1.90 (95% CI: 1.66, 2.19) for hypertriacylglycerolemia. Increasing odds ratios for the metabolic syndrome with higher consumption of betel quid (whether by rate of use, duration of use, or cumulative exposure) suggest dose-response effects. CONCLUSIONS: After adjustment for well-established risk factors, our study showed independent predictive dose-response effects of betel-quid chewing for the metabolic syndrome and its components in a population-based study of men with a 15% prevalence of betel-nut chewing.

Adult↗

PubMed2006

Progression of pre-hypertension, stage 1 and 2 hypertension (JNC 7): a population-based study in Keelung, Taiwan (Keelung Community-based Integrated Screening No. 9).

OBJECTIVE: To investigate the prevalence and progression of, and identify risk factors for, pre-hypertension, stage 1 and 2 hypertension in a population-based study. DESIGN: A prospective cohort study. SETTING: An integrated community-based multiple screening program in Keelung, Taiwan. PARTICIPANTS: A total of 67 011 individuals aged 20-79 years between 1999 and 2003 were included. Of these, 22 111 re-attended, yielding 53 689 repeated recordings of blood pressure, including movement between normal and pre-hypertension and progression from pre-hypertension to stage 1 or stage 2 hypertension. MAIN OUTCOME MEASURES: Blood pressure was defined and classified according to the JNC 7 Report as normal, pre-hypertension, stage 1, and stage 2 hypertension. RESULTS: Below 50 years of age, males had a higher progression rate, particularly from normal to pre-hypertension, than females. Annual regression rates from pre-hypertension to normal were higher in the young age group than in the old age group, particularly for females. Factors associated with the occurrence of pre-hypertension were old age, male gender, high waist circumference, abnormal blood lipids, smoking, chewing betel nuts, lack of exercise, and having parents with hypertension. Factors associated with regression from pre-hypertension to normal were body mass index, fasting glucose, high-density lipoprotein level, smoking, and parents with hypertension. Progression from pre-hypertension to stage 1 hypertension was positively related to male gender, higher waist circumference, and having parents with hypertension. CONCLUSIONS: The rates of progression and regression of hypertension vary with age and gender, anthropometric and biochemical measurements, and family history.

Age Distribution↗

PubMed2006

A community-based study of Helicobacter pylori therapy using the strategy of test, treat, retest, and re-treat initial treatment failures.

BACKGROUND: Although eradication of Helicobacter pylori infection can decrease the risk of gastric cancer, the optimal regimen for treating the general population remains unclear. We report the eradication rate (intention-to-treat and per protocol) of a community-based H. pylori therapy using the strategy of test, treat, retest, and re-treat initial treatment failures. MATERIALS AND METHODS: In 2004, a total of 2658 residents were recruited for 13C-urea breath testing. Participants with positive results for infection received a standard 7-day triple therapy (esomeprazole 40 mg once daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily), and a 10-day re-treatment (esomeprazole 40 mg once daily, amoxicillin 1 g twice daily, and levofloxacin 500 mg once daily) if the follow-up tests remained positive. Both H. pylori status and side-effects were assessed 6 weeks after treatment. RESULTS: Among 886 valid reporters, eradication rates with initial therapy were 86.9% (95% confidence interval [CI]: 84.7-89.1%) and 88.7% (95%CI: 86.5-90.9%) by intention-to-treat and per protocol analysis, respectively. Re-treatment eradicated infection in 91.4% (95%CI: 86-96.8%) of 105 nonresponders. Adequate compliance was achieved in 798 (90.1%) of 886 subjects receiving the initial treatment and in all 105 re-treated subjects. Mild side-effects occurred in 24% of subjects. Overall intention-to-treat and per protocol eradication rates were 97.7% (95%CI: 96.7-98.7%) and 98.8% (95%CI: 98.5-99.3%), respectively, which were only affected by poor compliance (odds ratio, 3.3; 95%CI, 1.99-5.48; p < .0001). CONCLUSIONS: A comprehensive plan using drugs in which the resistance rate is low in a population combined with the strategy of test, treat, retest, and re-treat of needed can result in virtual eradication of H. pylori from a population. This provides a model for planning country- or region-wide eradication programs.

Anti-Bacterial Agents↗

PubMed2006

Overactive bladder syndrome among community-dwelling adults in Taiwan: prevalence, correlates, perception, and treatment seeking.

PURPOSE: We investigated the prevalence, correlates, perception of overactive bladder syndrome (OAB) and doctor-consultation behavior among community adults. SUBJECTS AND METHODS: This urological survey was part of a government-supported health utilization project conducted in Matsu, Taiwan. Participants (n = 1,827) completed a questionnaire collecting information on OAB, which was defined as urgency with either frequency or nocturia. RESULTS: The age-adjusted prevalence of OAB was 16.9%, including 4.5% with urge incontinence. Age (p = 0.002), diabetes (p = 0.03), and benign prostatic hyperplasia (p < 0.001) in men, whereas diabetes (p = 0.01), hyperlipidemia (p = 0.03), stress incontinence (p < 0.001), and recurrent lower urinary tract infections (p = 0.02) in women were factors independently associated with OAB. Most people with OAB (69.0%) perceived little bother; only 13.0% had consulted doctors for this problem. CONCLUSION: Symptoms related to OAB are common among community-dwelling adults, yet most perceive it as a minor problem. Our results identify several factors that are significantly associated with OAB.

Adult↗