Chien-yu Chen

Taipei Medical University | TMU · School of Medicine

Background To implement the ACGME Anesthesiology Milestone Project in a non-North American context, a process of indigenization is essential. In this study, we aim to explore the differences in perspective toward the anesthesiology competencies among residents and junior and senior visiting staff members and co-produce a preliminary framework for t...

Background: The incidence of chronic kidney disease is increasing, but most cases are not diagnosed until the accidental finding of abnormal laboratory data or the presentation of severe symptoms. Patients with chronic kidney disease are reported to have an increased risk of postoperative mortality and morbidities, but previous studies mainly targ...

The aim of systematic review and meta-analysis was to investigate whether APOE4 was associated with postoperative neurologic dysfunction occurrence in short- or medium-term among surgical patients and to study the potential genetic association among these two entities. We searched electronic databases for reserch studies to evaluate the association...

Objectives During the COVID-19 outbreak, medical educators’ main concern has been how to prepare new physicians and medical students to meet their obligations as healthcare providers under novel circumstances. This study aims at exploring how trainees perceive their commitments as physicians under the threat of a pandemic. Design A qualitative met...

Background The COVID-19 pandemic brought a new challenge to medical education—health-care students had fewer opportunities to interact with and treat real patients in clinical settings. Interpersonal communication skills are often developed through human interaction and communication in person, and few studies have proposed feasible digital solutio...

International guidelines do not recommend surgery for the first episode of primary spontaneous pneumothorax (PSP), except in cases of persistent air leak, hemopneumothorax, bilateral pneumothorax, or occupations at risk. However, these recommendations have been challenged because of a significant reduction in the recurrence rate in emerging studies...

The aim of this study was to reveal the effects of anaesthesia strategies on maternal mean arterial pressure (MAP), heart rate, vasopressor consumption, adverse events, and neonatal resuscitation when women with preeclampsia (PE) undergo caesarean section (CS). Three major databases were searched for randomized controlled trials (RCTs) and prospect...

當今臺灣失智症人口逐年增加，因失智所衍生出之生命尊嚴難題與善終需求，現行安寧緩和醫療及預立醫囑能否滿足受到質疑。近期，在野黨團提出《尊嚴善終法》草案，其中欲將「安樂死」成為失智症病人的選項之一。本文嘗試從醫療照顧者的角度，探討失智病人欲落實其自主權來選擇安樂死時，可能會遭遇到的倫理與臨床實務困境，包含：一、失智病人在罹病後是否仍具備選擇安樂死之行為能力？其能力又該如何客觀評估？二、如何保障失智病人的自主權不因外界壓力（如愧疚或經濟因素）而遭受侵害？三、如何客觀判定失智病人正遭受難以忍受的痛苦？四、預立安樂死醫囑出現矛盾或衝突時該如何解決？若《尊嚴善終法》欲通過三讀，尚需解決上述之問題，方能真正捍衛失智者的自主權與落實追求善終之理想。

Purpose: Many instructional strategies for cooperative learning have been used in medical education, such as team-based education, inter-professional education, and problem-based learning. However, useful assessment tools for investigating students' readiness for cooperative learning are lacking. Therefore, the present study developed the Positive...

Background: Hypothermia and shivering are undesirable morbidities that occur commonly during cesarean section. Although some active warming strategies, such as the use of forced-air, mattresses, and fluid warming, can attenuate such adverse events, no studies have yet performed multiple contrast assessments of these strategies. We, therefore, cond...

We aimed to evaluate the response rate of migraines by using anti-calcitonin gene-related peptide (anti-CGRP) for patients with migraines. We searched three main medical databases up to 29 March 2019. No restriction on language and publication time were applied. Eligible trials included randomized clinical trials investigating a 50%, 75%, and 100%...

Purpose Postoperative sore throat (POST) is a relatively common morbidity. Topical lidocaine lubricants have been proposed to prevent POST; however, their effectiveness remains uncertain. This meta-analysis aimed to evaluate the prophylactic effect of lidocaine lubrications against POST, cough, and hoarseness in adult patients after surgery. Metho...

Background: Early clinical exposure (ECE) is viewed as a way to provide contexts of basic science and highlight its relevance to medical practice. However, very few studies have specifically looked into how the ECE experience contributes to students' academic performance. The purpose of this study was to investigate whether ECE experiences (extern...

Background Learning self-efficacy, defined as learners’ confidence in their capability to learn specific subjects, is crucial for the enhancement of academic progress, because it is positively correlated with academic achievements and effective learning strategy use. In this study, we developed a universal scale called the Learning Self-Efficacy Sc...

Background: The relationship between chronic obstructive pulmonary disease (COPD) and perioperative outcomes remains incompletely understood. Our purpose is to evaluate the features of postoperative adverse outcomes for geriatric surgical patients with chronic obstructive pulmonary disease (COPD) receiving non-thoracic surgeries. Methods and proc...

Objective: The aim of this meta-analysis is to verify the effectiveness of postoperative pain relief by perioperative parecoxib, a selective intravenous cyclooxygenase-2 (COX-2) inhibitor, for patients receiving laparoscopic cholecystectomy (LC) surgery. Methods: Electronic databases were searched for the randomized controlled trials (RCTs) to e...

Intracytoplasmic sperm injection (ICSI) is well established and provides patients with severely impaired sperm quality with an opportunity to father a child. However, previous studies do not clearly indicate whether male with cryptozoospermia should use testicular sperm or ejaculated sperm for ICSI. The newest systematic review of this topic also g...

The aim of this systematic review and meta-analysis is to evaluate the pros and cons of adjuvant low dose intrathecal meperidine for spinal anaesthesia. We searched electronic databases for randomized controlled trials using trial sequential analysis (TSA) to evaluate the incidence of reduced rescue analgesics, shivering, pruritus, nausea and vomit...

Tracheal bronchus is a congenital anatomical variant of patients with accessory bronchus in the right upper lobe deriving directly from the supracarinal trachea. Pre-operative consultation with the anesthesiologist is important for patient safety and can avoid adverse effects induced by endotracheal intubation. In this report, we described a case o...

Evidence-based health care informs clinicians of choices regarding the most effective care based on the best available research evidence. However, concepts or instruments of evidence-based medicine are still fragmented for most clinicians. Substantial gaps between evidence and clinical practice remain. A knowledge translation roadmap may help clini...

Background This is the first meta-analysis to compare the treatment effects and safety of administering donepezil alone versus a combination of memantine and donepezil to treat patients with moderate to severe Alzheimer Disease, particularly regarding cognitive functions, behavioral and psychological symptoms in dementia (BPSD), and global function...

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Objectives To evaluate the optimal dose of succinylcholine for laryngeal mask airway (LMA) insertion and all related morbidities. Design Systematic review, meta-analysis and metaregression of randomised controlled trials (RCTs). Data source and study eligibility criteria A comprehensive search of RCTs in the PubMed, Embase, the Cochrane Library a...

Background: Hemorrhoidectomy is commonly associated with postoperative pain. Calcium channel blockers are known to cause relaxation of gastrointestinal smooth muscle and oral diltiazem has also been shown to reduce the resting anal pressure. Objective: We attempted to analyze efficacy and side effects of topical diltiazem oint. in post-operative...

In order to develop a training program for continuous reflective learning in TMU within CanMEDS roles framework, we conduct this exploratory research. This Study aims at evaluating the compatibility of the CanMEDS roles descriptions with local clinical setting. Method of this study was the template analysis and content analysis approach with purpos...

Postoperative sore throat and other airway morbidities are common and troublesome after endotracheal tube intubation general anesthesia (ETGA). We propose lidocaine as endotracheal tube (ETT) cuff inflation media to reduce the postintubation-related emergence phenomenon. We searched PubMed, EMBASE, and Cochrane databases systematically for randomiz...

Sedation during gastrointestinal endoscopy is often achieved using propofol or midazolam in general population. However, impaired protein synthesis, altered drug metabolism, and compromised hepatic blood flow in patients with liver cirrhosis might affect the pharmacokinetics of sedatives, placing cirrhotic patients undergoing endoscopy at a greater...

Background Postoperative nausea and vomiting ( PONV ) is a common complication after pediatric strabismus surgery. Steroids and ondansetron (a 5‐ HT 3 antagonist) can effectively reduce nausea, vomiting, and pain and thus might be useful agents for the prevention of PONV in pediatric patients. The aim of this study was to conduct a systematic revie...

Sore throat is a common postoperative complaint. The etiology of postoperative sore throat (POST) is considered the result of damage to airway mucosa after insertion of a laryngeal mask airway device or endotracheal tube. This paper proposes benzydamine hydrochloride (BH), a topical nonsteroidal anti-inflammatory drug (NSAID) with additional analge...

Weak opioid combined with acetaminophen (APAP) has been proven to provide better analgesic efficacy and cause fewer complications than either drug alone. However, there are questions about whether different opioids, tramadol and propoxyphene, provide similar efficacy or safety. Thus, we investigated Ultracet (37.5 mg tramadol/325 mg APAP) and Depai...

An implantable venous access device (IVAD) is routinely implanted for long-term intravenous access. Despite its reliability and safety, catheter-related thrombosis remains the most common complication leading to irreversible dysfunction. Thrombosis incidence is underestimated because clinical manifestation is usually asymptomatic. In this evidence-...

A biphasic pattern in the effects of increasing dose of ketamine on mean arterial blood pressure (MBP) and renal sympathetic nerve activities (RSNA) was shown in previous study. We hypothesized that if renal vascular resistance (RVR) and renal blood flow (RBF) are mainly controlled by RSNA, they will show a similar biphasic pattern under increasing...