Chin-Wang Hsu

Background The use of mechanical cardiopulmonary resuscitation device has been very prevalent in out-of-hospital cardiac arrest rescue. This study aimed to investigate whether the timing of mechanical cardiopulmonary resuscitation device set-up correlated with the the outcome of cardiac arrest patients. Methods We retrospectively reviewed adult no...

Background Acquiring proficiency in medicine typically necessitates a combination of foundational knowledge and hands-on experience. However, how do lecture and hands-on practice affect the psychological learning process in ultrasound education remains unclear. The purpose of this research was to test how the different learning activities associate...

Introduction: The detrimental effects of air pollution on the brain are well established. However, few studies have examined the effect of air pollution on traumatic brain injury (TBI). This pilot study evaluated the association between short-term air pollution exposure and traumatic intracranial hemorrhage (TIH). Methods: Hospital data of patient...

Introduction The detrimental effects of air pollution on the brain are well established. However, few studies have examined the effect of air pollution on traumatic brain injury (TBI). This pilot study evaluated the association between short-term air pollution exposure and traumatic intracranial hemorrhage (TIH). Methods Hospital data of patients...

We read with interest the review by Chen et al. They intended to examine the diagnostic accuracy of blood-based biomarkers for detecting Alzheimer's disease and amnestic mild cognitive impairment. We believe that there were substantial methodological flaws in their meta-analysis. These methodological flaws included no comprehensive literature searc...

Objectives: To explore the validity of the Chinese version of the Identification of Seniors at Risk (ISAR) screening tool in emergency rooms (ERs) to identify elderly patients prone to adverse outcomes after being discharged from the ER. Methods: A prospective single-center observational study design was adopted and included 497 elderly (aged ≥65...

Preconditioning has a powerful protective potential against myocardial ischemia-reperfusion injury (I/R). Our prior work demonstrated that baicalein, a flavonoid derived from the root of Scatellaria baicalensis Georgi (also known as Huangqin), confers this preconditioning protection. This study further explored the mechanisms of baicalein precondit...

Objectives: A total of 74 570 potentially naturally inducible chromosomal AmpC-producing (PNIC-AmpC) Enterobacterales isolates included in the Antimicrobial Testing Leadership and Surveillance Programme were obtained worldwide during 2012-2019 (22 503 from 2012-2014 and 52 067 from 2015-2019). Of these isolates, 117 and 711 obtained during 2012-20...

COVID-19 tests have different turnaround times (TATs), accuracy levels, and limitations, which emergency physicians should be aware of. Nucleic acid amplification tests (NAATs) can be divided into standard high throughput tests and rapid molecular diagnostic tests at the point of care (POC). The standard NAAT has the advantages of high throughput a...

Background As ultrasound has become increasingly prominent in medicine, portable ultrasound is perceived as the visual stethoscope of the twenty-first century. Many studies have shown that exposing preclinical students to ultrasound training can increase their motivation and ultrasound competency. However, few studies have discussed the effect of u...

Background Chronic obstructive pulmonary disease (COPD) is a significant public health concern. The patients with acute exacerbations of COPD (AECOPD) and pneumonia have similar clinical presentations. The use of conventional diagnostic markers, such as complete blood count with differential and C-reactive protein (CRP), is the current mainstream m...

Return of spontaneous circulation (ROSC) from out-of-hospital cardiac arrest (OHCA) is critical for the Emergency Medical Services System. When compared to other developed countries, Taiwan has lower rate of ROSC in OHCA patients. We conducted a retrospective study of cardiac arrest using The Emergency Medical Service Dispatching Center in Northern...

Study objective The purpose of this feasibility study is to develop and validate a new assessment tool and scoring system for multitasking competency for physicians in-training in a timed simulated setting. The multitasking competency includes ability to appropriately prioritize and implement tasks for different patients who present simultaneously....

Background Chlamydia trachomatis infection is the most common sexually transmitted infectious disease and carries a risk of complications. However, the optimal treatment for rectal chlamydial infection remains unclear. Objectives To compare the efficacy of doxycycline and azithromycin for the treatment of rectal chlamydia by undertaking a systemat...

Background: In recent years, point-of-care ultrasound (POCUS) has become an essential field of medical education. Bedside ultrasound has become a necessary skill for clinical physicians. Previous studies have already discussed the importance of advancements in ultrasound education. However, learning motivations for ultrasound education have seldom...

Background: Poloxamer 188 (P188) possesses anti-inflammatory properties and can help to maintain plasma membrane function. P188 has been reported to exert beneficial effects in the treatment of various disorders. However, the effects of P188 in ischemia/reperfusion (IR)-induced acute lung injury have not been examined. Methods: We investigated the...

Background: Although tranexamic acid (TXA), a readily accessible antifibrinolytic agent, is widely adopted in hemorrhage scenarios, its role on mortality in patients with hemoptysis remains uncertain. New evidence is yet to be generated to evaluate the risk of mortality after using TXA in patients with hemoptysis. Methods: PubMed, EMBASE, Cochra...

Foreign body (FB) ingestion is a common clinical problem in acute settings. Detecting FBs in the upper digestive tract is challenging. The conventional X-ray is usually the first-line imaging tool to detect FBs. However, its diagnostic performance is inconsistent in the literature. In this study, we performed a systematic review and meta-analysis t...

Scaphoid fractures are the most common carpal fractures. Diagnosing scaphoid fractures is challenging. Recently, cone-beam computed tomography (CBCT) has been shown to be a promising strategy for diagnosing scaphoid fractures. The diagnostic performance of CBCT remains inconclusive in the literature. Through a systematic review and meta-analysis, o...

Epidemiological studies have suggested the effects of ambient fine particles (PM2.5) on asthma, but the effects of specific components of PM2.5 on asthma remain to be explored. Here, we studied the effect of PM2.5-bound polycyclic aromatic hydrocarbons (PAHs) on asthma acute exacerbation. The data on daily counts of emergency room visits (ERVs) wer...

Purpose The use of Virtual Reality (VR) in health professions education has increased dramatically in recent years, yet there is limited evidence of its impact on educational outcomes. The purpose of the study was to assess the impact of VR anatomy instruction on the ultrasound competency of novice learners participating in a ultrasonography worksh...

Background: Magnesium sulfate (MgSO4) is widely used in analgesia for different conditions. Recent randomized controlled trials (RCTs) have evaluated the effects of MgSO4 on renal colic; however, this new evidence has not been synthesized. Thus, we conducted a systematic review and meta-analysis to assess the efficacy and safety of MgSO4 in compar...

Background Common complications of pediatric strabismus surgery, including emergence agitation (EA), postoperative nausea and vomiting (PONV), and postoperative pain, may be prevented using dexmedetomidine, which is an anxiolytic and analgesic. This systematic review and meta-analysis assessed the effects of dexmedetomidine in patients who had unde...

Background: Cardiovascular diseases (CVDs) and aortic aneurysms (AAs) share several clinical risk factors. However, the potential effects on future CVDs of surgical treatments involving the open surgical repair (OSR) of AAs are unknown. We hypothesize that the OSR of AAs is associated with subsequent CVDs. Methods: The data for this nationwide p...

Background Intranasal lidocaine has been shown to be effective in treating patients with acute migraines; however, its efficacy is still controversial. In this study, we intend to assess the efficacy and safety of intranasal lidocaine compared with a placebo or an active comparator for the treatment of migraines. Method PubMed, EMBASE, Cochrane li...

Introduction: Pneumonia is one of the leading causes of death worldwide, represents a potentially life-threatening condition. In recent studies, adjuvant corticosteroids therapy has been shown to improve outcome in severe community-acquired pneumonia (CAP); however, the treatment response to corticosteroids vary. It is important to select patients...

Background: Postoperative vomiting and pain are common, unpleasant phenomena in pediatric patients undergoing ophthalmic surgery. Clonidine has antiemetic and analgesic properties and thus may be used as premedication to reduce postoperative vomiting and pain. Aims: To assess whether clonidine premedication may safely decrease POV and postoperat...

Baicalein is a natural flavonoid with anti-oxidant activities protecting against ischemia/reperfusion (I/R) injury. Previous studies suggest that oxidative burst early after reperfusion accelerates cell death. We therefore investigated the critical therapeutic window of baicalein by examining the timing of baicalein treatment in relation to its oxi...

Early determination of the severity of Community-Acquired Pneumonia (CAP) is essential for better disease prognosis. Current predictors are suboptimal, and their clinical utility remains to be defined, highlighting the need for developing biomarkers with efficacious prognostic value. Sphingosine-1-phosphate (S1P) is a bioactive sphingolipid with a...

Background The evidence supporting the benefit of femoral nerve block (FNB) for positioning before spinal anesthesia (SA) in patients suffering from a femur fracture remains inconclusive. In the present study, the authors intended to determine the efficacy and safety of FNB versus an intravenous analgesic (IVA) for positioning before SA in patients...

Background: Intranasal lidocaine has been shown to be effective in treating patients with acute migraines; however, its efficacy is still controversial. The aim of our study is to assess the efficacy and safety of intranasal lidocaine compared with a placebo or an active comparator for the treatment of acute migraine. Methods: We will use PubMed...

Background: Fascia iliaca compartment block (FICB) provides an analgesic option for positioning before spinal anesthesia in patients suffering from a femur fracture. The evidence supporting FICB is still not well established. The aim of our study is to assess the efficacy and safety of FICB comparing with intravenous analgesic (IVA) on the quality...

Clinical introduction A 69-year-old woman presented to the ED with a chief complaint of recurrent vomiting for 3 weeks. She was afebrile, blood pressure was 100/67 mm Hg, HR was 114/min, RR was 19/min and oxygen saturation was 98%. On physical examination, she had mild epigastric tenderness without guarding. Blood tests were normal except for hypon...

A ruptured cavernous carotid aneurysm (CCA) with carotid cavernous fistula can appear as a benign headache but progress to a swollen and bloodshot eye overnight. A 66-year-old woman visited emergency department with sudden onset of pain behind her left forehead and vomiting. She was treated for a migraine-like headache and discharged. She presented...

Objectives: The aim of this study (PROSPERO ID: CRD42017081952) was to evaluate medical treatment for epistaxis from hereditary hemorrhagic telangiectasia (HHT). Data sources: PubMed, Embase, Scopus, and Cochrane Library databases were interrogated from their inceptions to November 2017. Review methods: Randomized clinical trials comparing med...

Few therapeutic options exist for various infections caused by extensively drug-resistant Acinetobacter calcoaceticus-Acinetobacter baumannii (XDR-Acb) complex isolates, including pneumonia. This study investigated the clinical efficacy between aerosolized colistimethate sodium (AS-CMS, 2 million units thrice a day) treatment alone or in combinatio...

Silodosin, a recently introduced selective α-blocker, has a much higher selectivity for the α-1A receptor. The efficacy and safety of silodosin compared to tamsulosin in medical expulsive therapy (MET) are controversial. The objective of this study was to assess the efficacy and safety of silodosin compared to tamsulosin for treating ureteral stone...

Baseline characteristics of the included studies. (DOCX)

Purpose: The present study compared the risk of ischemic stroke in atrial fibrillation (AF) patients receiving digoxin and amiodarone. Methods: A retrospective cohort study was conducted using the longitudinal population-based database of Taiwan’s National Health Insurance program. Patients with AF who received amiodarone or digoxin and were consid...

Objective Marfan syndrome (MFS) involves a deficiency of the structural extracellular matrix component fibrillin-1 and overactivation of the transforming growth factor-β (TGF-β) signalling pathway. The TGF-β signalling pathway also actively participates in malignant transformation. Although anecdotal case reports have suggested associations between...

Ambient air pollution poses a significant risk for a group of common and often debilitating respiratory diseases, but its direct impact on cause-specific respiratory diseases using emergency room visit (ERV) as an indicator remains to be fully explored. In this study, we conducted a time-series study of ambient PM2.5, NO2, SO2 and their association...

Relative risks of ERVs for asthma with an increase of (a) 10 ppm of NO2 and (b) of 1 ppb of SO2 during the Spring season. (PPTX)

Relative risks of ERVs for COPD with an increase of (a) 10 ppm of NO2 and (b) of 1 ppb of SO2 during the Summer season. (PPTX)

Lag-response curve for various diseases as indicated, with a 10-unit increase of NO2 (panel a through c) and SO2 (panel d to f). (PPTX)

The data set underlying the findings in our study in the manuscript. (TXT)

Acute hyperglycemia is a common finding in patients presenting to emergency departments (EDs) with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Several studies have argued against the association between hyperglycemia at admission and adverse outcomes in patients with diabetes and an acute illness. Recent studies have shown...

The effect of glycemic control on the prognosis of nondiabetic patients after acute myocardial infarction (AMI) remains uncertain. We investigated whether glycated hemoglobin (HbA1c) is associated with adverse outcomes after AMI in nondiabetic patients. In this observational study, we enrolled nondiabetic patients with AMI in the emergency departme...

Acute hyperglycemia is a common condition among patients with diabetes who are admitted to the emergency department (ED) for acute ischemic stroke (AIS). Previous findings regarding the association between hyperglycemia at admission and adverse outcomes among patients with diabetes and AIS have been inconsistent. When investigating this association...

Purpose: To investigate the relationship between chronic pancreatitis (CP) and inflammatory bowel disease (IBD) in a large population-based cohort study. Methods: Data were obtained from the Taiwan National Health Insurance Research Database. The cohort study comprised 17 796 patients newly diagnosed with CP between 2000 and 2010 and 71 164 matched...

Baicalein is a flavonoid with excellent oxidant scavenging capability. It has been reported to protect against a variety of oxidative injuries including ischemia/reperfusion (I/R). However, the optimal treatment strategy for I/R injury and the protective mechanisms are not fully understood. In this study we employed an established chick cardiomyocy...

BACKGROUND/PURPOSE: To compare the clinical efficacy between salvage antimicrobial regimen consisting of tigecycline plus extended-infusion imipenem/cilastatin (TIC) and regimen of sulbactam plus imipenem/cilastatin (SIC) for patients with ventilator-associated pneumonia and pneumonic bacteremia due to extensively drug-resistant (XDR) Acinetobacter...

Background: Thyroid storm, an endocrine emergency, remains a diagnostic and therapeutic challenge. It is recognized to develop as a result of several factors, including infection, surgery, acute illness, and rarely, trauma. Recognition of thyroid storm in a trauma patient is difficult because the emergency physician usually focuses on managing mor...

Acute hyperglycemia is a frequent finding in patients presenting to the emergency department (ED) with acute myocardial infarction (AMI). The prognostic role of hyperglycemia in diabetic patients with AMI remains controversial. We retrospectively reviewed patients' medical records to obtain demographic data, clinical presentation, major adverse car...

Objectives: Inflammatory bowel disease (IBD) is a chronic inflammatory disorder. Previous studies have suggested that chronic systemic inflammation increases the risk of Parkinson's disease (PD). This study examined the effects of IBD on the development of PD. Methods: In a nationwide population-based cohort of 23.22 million insured residents of...

Purpose: This large population-based cohort study evaluated the association between certain critical illnesses and the incidence of newly diagnosed type 2 diabetes mellitus (T2DM) in Taiwan. Methods: Data were obtained from the Taiwan National Health Insurance Research Database. According to age, sex, and propensity score-matching, a cohort comp...

Stress-induced hyperglycemia (SIH) has been independently associated with an increased risk of mortality in critically ill patients without diabetes. However, it is also necessary to consider preexisting hyperglycemia when investigating the relationship between SIH and mortality in patients with diabetes. We therefore assessed whether the gap betwe...

To compare the clinical efficacy between salvage antimicrobial regimen consisting of tigecycline plus extended-infusion imipenem/cilastatin (TIC) and regimen of sulbactam plus imipenem/cilastatin (SIC) for patients with ventilator-associated pneumonia and pneumonic bacteremia due to extensively drug-resistant (XDR) Acinetobacter baumannii (Ab) isol...

Several studies argue against the association between admission hyperglycemia and adverse outcomes in infected diabetic patients. When investigating the association, it is necessary to consider preexisting hyperglycemia. The objective of this study was to assess whether stress-induced hyperglycemia, determined by the glycemic gap between admission...

The aim of this study was to assess whether acetaminophen poisoning is associated with a higher risk of acute pancreatitis. We conducted a retrospective cohort study by using the longitudinal population-based database of Taiwan's National Health Insurance (NHI) program between 2000 and 2011. The acetaminophen cohort comprised patients aged ≥20 year...

Purpose To define the pattern of therapeutic approaches for pediatric appendicitis and compare their benefits in Taiwan, we analyzed a research-oriented dataset released by the Bureau of National Health Insurance in Taiwan through the Collaboration Center for Health Information Application (CCHIA) to document the impact of the rise of laparoscopic...

Aortic coarctation complicated with spinal artery aneurysm rupture is exceptionally rare and can be source of intraspinal hemorrhage with markedly poor prognosis. A 21-year-old man visited the emergency department because of chest and back pain along with immobility of bilateral lower limbs immediately after he woke up in the morning. Complete flac...

ABSTRACT Carbapenemases, with versatile hydrolytic capacity against β-lactams, are now an important cause of resistance of Gram-negative bacteria. The genes encoding for the acquired carbapenemases are associated with a high potential for dissemination. In addition, infections due to Gram-negative bacteria with acquired carbapenemase production wou...

Pneumocephalus is a rare complication after using loss-of-resistance to air (LOR-A) technique of epidural anesthesia, and is usually caused by inadvertent dural puncture. Most patients with pneumocephalus have headache, motor weakness, seizures, and focal neurologic deficits depend on the distribution and amount of intracranial air. Consciousness d...

Data on susceptibility to ceftobiprole and colistin, and the complete evolutionary trends of minimum inhibitory concentrations (MICs) of important carbapenem agents among important pathogens collected in intensive care units (ICUs) in Taiwan are lacking. We surveyed the MIC distribution patterns of ceftobiprole and colistin and susceptibility profi...

With great interest, we read the article by Kuo et al1 in the Journal of Microbiology, Immunology and Infection, which report that Burkholderia cepacia is an important pathogen of elderly patients, and the successful rate of tigecycline therapy for osteomyelitis is only 50%. Here we report a case of recurrent osteomyelitis and bacteremia caused by...

To investigate the evolutionary trends in non-susceptibility of carbapenems against the isolates of Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae from patients hospitalized in intensive care units (ICUs) of major teaching hospitals throughout Taiwan during 2005-2009, we applied the breakpoints of MICs recommended by Clinical and...

Background: Rescuers that undergo acute ascent without acclimatization can experience acute mountain sickness. Although performing cardiopulmonary resuscitation (CPR) for a short period requires intensive effort at sea level, performing CPR at high altitude is even more exhausting and can endanger the rescuer. Therefore, we conducted a pilot study...

Background and Objective Patients who visit emergency department (ED) may have symptoms of occult cancers. Methods We studied a random cohort of one million subjects from Taiwan National Health Insurance Research Database between 2000 and 2008 to evaluate the ED utilization of individuals who were subsequently diagnosed with digestive tract cancer...

BACKGROUND AND OBJECTIVE: Patients who visit emergency department (ED) may have symptoms of occult cancers. METHODS: We studied a random cohort of one million subjects from Taiwan National Health Insurance Research Database between 2000 and 2008 to evaluate the ED utilization of individuals who were subsequently diagnosed with digestive tract cance...