Cheng Ching Hospital

Diabetes Mellitus (DM) is a leading cause of cardiovascular diseases that affects over a hundred million people worldwide, and patients with DM are also known to have significant impairments in cerebral autoregulation. Previous studies have shown a nonlinear relationship between cerebral blood flow velocity (CBFV) and end-tidal carbon dioxide (PETCO2); however, past studies were primarily conducted in stable conditions or healthy subjects, let alone the analysis of gender differences. In this article, DM subjects were further divided into DM males (DM-M) and DM females (DM-F) through gender classification and compared with a normal elder group (NE). Under hyperventilation, gender-based nonlinear CBFV and CVCi (cerebrovascular conductance index) responses to carbon dioxide (CO2) were analyzed and studied. Compared with the normal elder group, in terms of the CBFV to CO2 response, three of the four parameters of the sigmoid function showed significant differences in either the DM-M or DM-F group; in terms of the CVCi to CO2 response, the DM-F group revealed substantial differences in all the four parameters. This study provides a nonlinear assessment of cerebral blood flow regulation in DM patients, analyzing the impact of diabetes on cerebral autoregulation and exploring the gender-specific differences. The findings are expected to offer valuable insights for gender-specific evaluation and quantitative diagnostics in clinical settings.

ObjectivesThe aim was to determine whether different maturity levels and birth weights could change the risk of long-term ophthalmological complications in preterm infants.DesignThis was a cohort study.SettingThis was a nationwide population-based study.ParticipantsNewborns born between 2009 and 2012 were identified; newborns with congenital deformities, newborns with missing data on urban area, sex, gestational week at birth or birth weight and newborns who died before the age of 8 years were excluded.InterventionsInfants were divided into full-term, preterm and preterm with retinopathy of prematurity (ROP) cohorts based on their basic characteristics at birth.Primary outcome measuresThe primary outcomes were ophthalmological complications, including strabismus, refractive error, amblyopia, cataracts and glaucoma.ResultsUltimately, 735 702 infants were included in the analysis. There were 727 403, 7165 and 1134 newborns in the full term, preterm without ROP and preterm with ROP cohorts, respectively. Premature infants, whether without ROP or with ROP, had an elevated risk of various ophthalmic complications, with adjusted ORs (aORs) ranging from 1.48 to 2.74 and 1.90 to 10.34, respectively. Extremely low birth weight contributes to an increased risk of various ophthalmic complications, with aORs ranging from 2.21 to 6.55. Moreover, a higher number of negative variables, such as preterm birth or low body weight, increased the risk of various ophthalmological complications, with the aOR falling within the range of 1.03–23.86.ConclusionsImmaturity and low body weight were risk factors for ophthalmological complications in preterm infants. The presence of both of these two risk factors increased the risk of ophthalmological complications. Our results are essential for caregivers and health policy-makers to design comprehensive follow-up plans for preterm infants.

AimBipolar disorder (BD) and major depression have been associated with an increased risk of developing Parkinson's disease (PD); however, few studies have directly compared the risk of PD development between patients with BD and major depression while considering relevant risk factors and psychotropic medications.MethodsUsing the Taiwan National Health Insurance Research Database, 21,186 patients with BD, 21,188 patients with major depression, and 42,374 controls were enrolled between 2001 and 2009, and followed until the end of 2011. Individuals who developed PD during the follow‐up period were identified. Cox regression models were used to analyze the hazard ratio (HR) of developing PD, adjusting for demographic factors, comorbidities, and psychotropic medication usage.ResultsBoth patients with BD [HR 8.63, 95% confidence interval (CI) 6.35–11.72] and those with major depression (HR 5.68, 95% CI 4.15–7.78) had an elevated risk of subsequent PD compared to the controls. Patients with BD were associated with a 51% increased risk of subsequent PD compared with patients with major depression. Long‐term treatment with antiepileptic mood stabilizers was associated with increased PD risk among patients with late‐onset BD and high Charlson comorbidity index scores. Lithium was not associated with an increased PD risk.ConclusionsThe study highlights an elevated PD risk in patients with BD and major depression compared to the controls, with BD patients at highest risk. Further research is needed to elucidate the complex interplay between psychotropic medications and neurodegenerative processes in BD, aiming to optimize therapeutic strategies and improve patient outcomes.

PurposeAs the proportion of medical radiation exposure increases, the exposure dose has received increasing attention. When performing interventional radiological diagnosis, examiners are often exposed to radiation. Therefore, patients and medical personnel are exposed to higher amounts of radiation dose. Accordingly, we used optically stimulated luminescence dosimeters (OSLDs) to measure the ambient air kerma during abdominal CT scanning to observe the spatial distribution of the doses.MethodsAn abdominal CT scan under a voltage of 120 kVp was performed, and OSLDs were used for the measurement. The measurement range extended from the examination couch that serves as the center point to the walls and was divided into four areas. The OSLD measurements were undertaken at three different heights (i.e., 85, 140, and 150 cm from the floor) for spatial dose detection. The OSLDs were fixed up to lines at the three height levels. Each dosimetry point was 50 cm apart. In addition, the surface incident doses of the prosthesis's mammary gland, liver, and gonad were estimated.ResultsAccording to the spatial dose distribution at the three different heights, the maximum dose and minimum dose in front of the bore were 0.194 ± 0.008 and 0.006 ± 0.001 mGy, respectively; 2 m away from the bore, the dose reduced to 9% of the maximum dose. The surface incident doses of the mammary gland, liver, and gonad were 1.321 ± 0.121, 13.083 ± 0.642, and 13.441 ± 0.658 mGy, respectively.ConclusionThe spatial dose distribution revealed that the dose was the highest at the height of 140 cm and in front of the bore. The dose on the left side was higher than that on the right side. In addition, the dose was inversely proportional to the square of the distance. If the examiners must perform interventional radiological diagnosis during CT scanning, they should put on radiation protection equipment and stand behind the bore to minimize the radiation exposure.

Objective: Laser acupuncture is a non-invasive modality that involves the use of low-intensity, nonthermal laser irradiation of traditional acupuncture sites to elicit stimulation. We aimed to investigate the practical applications of laser acupuncture. Methods: A narrative review of literature and case presentations was conducted. Results: Although the precise mechanism of action remains unclear, the therapeutic applicability of laser acupuncture is broad. The empirical data substantiate the effectiveness of laser acupuncture in the treatment of several medical disorders, including obesity, diabetes mellitus, musculoskeletal and connective tissue diseases, ischemic stroke, vascular dementia, postherpetic neuralgia, acute kidney injury after sepsis, myopia, amblyopia, dry eye, acute lymphoblastic leukemia, chronic kidney disease, atopic dermatitis, opioid use disorders, autism spectrum disorder, sudden sensorineural hearing loss and tinnitus, idiopathic short stature, and pediatric dysphagia. To date, no studies have reported the side effects or complications associated with laser acupuncture. Conclusions: Laser acupuncture has been recognized as a potentially valuable alternative therapeutic modality in contemporary medical practice when administered by competent medical practitioners. Additional investigation is required to more precisely establish ideal treatment parameters, including factors such as wavelength, dosage, and intensity, with the aim of optimizing the physiological advantages and cost-effectiveness of laser acupuncture therapy.