Psychiatric disorders significantly impact surgical outcomes,presenting unique challenges in perioperative care.The intricate relationship between preoperative psychiatric conditions and surgical complications involve...Psychiatric disorders significantly impact surgical outcomes,presenting unique challenges in perioperative care.The intricate relationship between preoperative psychiatric conditions and surgical complications involves complex mechanisms,including altered coagulation,cardiovascular function,and pain perception.Common psychiatric disorders in surgical patients,such as anxiety,depression,and substance use disorders,vary in prevalence and manifestation.Demographic factors,comorbidities,and psychotropic medications further modulate these effects on surgical outcomes.Effective screening and assessment strategies are crucial,yet they present both opportunities and limitations in the preoperative setting.Preoperative psychological interventions,including cognitive-behavioral therapy,supportive care,and mind-body techniques,show promise in mitigating psychological distress and improving surgical outcomes.Multidisciplinary approaches,involving collaborative efforts between psychiatric and surgical teams,are essential to provide comprehensive patient care.Emerging inter-ventions,technological innovations,and personalized medicine approaches offer exciting possibilities to advance preoperative psychiatric care.By understanding the complex interplay between psychiatric disorders and surgical outcomes,healthcare professionals can implement integrated,patient-centered approaches to optimize perioperative care and improve overall patient outcomes.展开更多
Objective:We aimed to evaluate an integrated screening program for female migrants to Taiwan.Method:We performed a mixed methodological evaluation of a public health nurse(PHN)-led intervention to promote an integrate...Objective:We aimed to evaluate an integrated screening program for female migrants to Taiwan.Method:We performed a mixed methodological evaluation of a public health nurse(PHN)-led intervention to promote an integrated screening program for female migrants to Taiwan.The clini-cal case yield was determined by an audit,and staff/client questionnaires were used for the evalua-tion.Screening comprised surveillance for four untreated chronic diseases(hypertension,diabetes mellitus,tuberculosis,and liver disease),four cancers(mouth,bowel,liver,and cervix),parasitic infection,and hyperlipidemia.Results:Three hundred and thirty-six PHNs and 4751 immigrant women-with an average age of 29.2 years,most of whom were from Vietnam(44%)or China's Mainland(41%)-took part in the programme.Two thirds of screened women had no abnormalities.Further investigation was required in 1523 women,of whom 1220 were found to have significant disease.The majority of 280 PHNs(85%)found the content,processes,and waiting time to be‘highly acceptable’and thought the program was worthwhile and could be incorporated into standard care.Conclusions:The Taipei County Comprehensive Health Screening Programme provided an accessible,free-of-charge,and preventative intervention for female migrants to Taiwan and had a good clinical case yield.展开更多
BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)is a recently proposed term that highlights the role of metabolic dysfunction in hepatic steatosis.It currently affects more than one-third of adul...BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)is a recently proposed term that highlights the role of metabolic dysfunction in hepatic steatosis.It currently affects more than one-third of adults worldwide and is associated with liver fibrosis,hepatocellular carcinoma,cardiovascular disease,and chronic kidney disease.Given its high prevalence,asymptomatic progression,and revised definition,evaluating its epidemiology and risk profile remains an important public health priority.AIM To assess the prevalence and characteristics of MAFLD among Vietnamese individuals undergoing health check-ups.METHODS This retrospective study included 331 adults undergoing routine health check-ups at The Health Evaluation and Promotion Center,International University of Health and Welfare Center,Cho Ray Hospital,from June to October 2023.MAFLD was diagnosed based on the 2020 international expert consensus.Data collected included demographic,clinical,laboratory information,and metabolic risk factors from routine health check-up records.Descriptive statistics,χ^(2) tests,and ttests/Mann-Whitney tests were applied as appropriate.Significance was defined as P<0.05.RESULTS MAFLD was identified in 97 of 331 individuals(29.31%).Prevalence was significantly higher in men than women(44.51%vs 14.37%;P<0.001).In females,prevalence increased sharply after age 50(P=0.008).According to body mass index groups,prevalence was 0%(underweight),9.27%(normal),and 48.26%(overweight/obese).The MAFLD group had significantly higher rates of hypertension(19.59%vs 2.99%),dyslipidemia(98.96%vs 89.32%),prediabetes/diabetes(65.98%vs 28.20%),hyperuricemia(64.95%vs 31.19%),and metabolic syndrome(54.64%vs 7.69%)compared to the non-MAFLD group(all P<0.001).CONCLUSION MAFLD is prevalent in Vietnamese adults undergoing health screening.It is strongly associated with sex,age,body mass index,and metabolic disorders,indicating the importance of early detection and integrated management.展开更多
AIM: To evaluate the current state-of-the-art of gastric electrical stimulation to treat obesity. METHODS: Systematic reviews of all studies have been conducted to evaluate the effect of different types of gastric ele...AIM: To evaluate the current state-of-the-art of gastric electrical stimulation to treat obesity. METHODS: Systematic reviews of all studies have been conducted to evaluate the effect of different types of gastric electrical stimulation(GES) on obesity.RESULTS: Thirty-one studies consisting of a total of 33 different trials were included in the systematic review for data analysis. Weight loss was achieved in most studies, especially during the first 12 mo, but only very few studies had a follow-up period longer than 1 year. Among those that had a longer follow-up period, many were from the Transcend(Implantable Gastric Stimulation) device group and maintained significant weight loss. Other significant results included changes in appetite/satiety, gastric emptying rate, blood pressure and neurohormone levels or biochemical markers such as ghrelin or HbA1 c respectively. CONCLUSION: GES holds great promises to be an effective obesity treatment. However, stronger evidence is required through more studies with a standardized way of carrying out trials and reporting outcomes, to determine the long-term effect of GES on obesity.展开更多
文摘Psychiatric disorders significantly impact surgical outcomes,presenting unique challenges in perioperative care.The intricate relationship between preoperative psychiatric conditions and surgical complications involves complex mechanisms,including altered coagulation,cardiovascular function,and pain perception.Common psychiatric disorders in surgical patients,such as anxiety,depression,and substance use disorders,vary in prevalence and manifestation.Demographic factors,comorbidities,and psychotropic medications further modulate these effects on surgical outcomes.Effective screening and assessment strategies are crucial,yet they present both opportunities and limitations in the preoperative setting.Preoperative psychological interventions,including cognitive-behavioral therapy,supportive care,and mind-body techniques,show promise in mitigating psychological distress and improving surgical outcomes.Multidisciplinary approaches,involving collaborative efforts between psychiatric and surgical teams,are essential to provide comprehensive patient care.Emerging inter-ventions,technological innovations,and personalized medicine approaches offer exciting possibilities to advance preoperative psychiatric care.By understanding the complex interplay between psychiatric disorders and surgical outcomes,healthcare professionals can implement integrated,patient-centered approaches to optimize perioperative care and improve overall patient outcomes.
文摘Objective:We aimed to evaluate an integrated screening program for female migrants to Taiwan.Method:We performed a mixed methodological evaluation of a public health nurse(PHN)-led intervention to promote an integrated screening program for female migrants to Taiwan.The clini-cal case yield was determined by an audit,and staff/client questionnaires were used for the evalua-tion.Screening comprised surveillance for four untreated chronic diseases(hypertension,diabetes mellitus,tuberculosis,and liver disease),four cancers(mouth,bowel,liver,and cervix),parasitic infection,and hyperlipidemia.Results:Three hundred and thirty-six PHNs and 4751 immigrant women-with an average age of 29.2 years,most of whom were from Vietnam(44%)or China's Mainland(41%)-took part in the programme.Two thirds of screened women had no abnormalities.Further investigation was required in 1523 women,of whom 1220 were found to have significant disease.The majority of 280 PHNs(85%)found the content,processes,and waiting time to be‘highly acceptable’and thought the program was worthwhile and could be incorporated into standard care.Conclusions:The Taipei County Comprehensive Health Screening Programme provided an accessible,free-of-charge,and preventative intervention for female migrants to Taiwan and had a good clinical case yield.
文摘BACKGROUND Metabolic dysfunction-associated fatty liver disease(MAFLD)is a recently proposed term that highlights the role of metabolic dysfunction in hepatic steatosis.It currently affects more than one-third of adults worldwide and is associated with liver fibrosis,hepatocellular carcinoma,cardiovascular disease,and chronic kidney disease.Given its high prevalence,asymptomatic progression,and revised definition,evaluating its epidemiology and risk profile remains an important public health priority.AIM To assess the prevalence and characteristics of MAFLD among Vietnamese individuals undergoing health check-ups.METHODS This retrospective study included 331 adults undergoing routine health check-ups at The Health Evaluation and Promotion Center,International University of Health and Welfare Center,Cho Ray Hospital,from June to October 2023.MAFLD was diagnosed based on the 2020 international expert consensus.Data collected included demographic,clinical,laboratory information,and metabolic risk factors from routine health check-up records.Descriptive statistics,χ^(2) tests,and ttests/Mann-Whitney tests were applied as appropriate.Significance was defined as P<0.05.RESULTS MAFLD was identified in 97 of 331 individuals(29.31%).Prevalence was significantly higher in men than women(44.51%vs 14.37%;P<0.001).In females,prevalence increased sharply after age 50(P=0.008).According to body mass index groups,prevalence was 0%(underweight),9.27%(normal),and 48.26%(overweight/obese).The MAFLD group had significantly higher rates of hypertension(19.59%vs 2.99%),dyslipidemia(98.96%vs 89.32%),prediabetes/diabetes(65.98%vs 28.20%),hyperuricemia(64.95%vs 31.19%),and metabolic syndrome(54.64%vs 7.69%)compared to the non-MAFLD group(all P<0.001).CONCLUSION MAFLD is prevalent in Vietnamese adults undergoing health screening.It is strongly associated with sex,age,body mass index,and metabolic disorders,indicating the importance of early detection and integrated management.
文摘AIM: To evaluate the current state-of-the-art of gastric electrical stimulation to treat obesity. METHODS: Systematic reviews of all studies have been conducted to evaluate the effect of different types of gastric electrical stimulation(GES) on obesity.RESULTS: Thirty-one studies consisting of a total of 33 different trials were included in the systematic review for data analysis. Weight loss was achieved in most studies, especially during the first 12 mo, but only very few studies had a follow-up period longer than 1 year. Among those that had a longer follow-up period, many were from the Transcend(Implantable Gastric Stimulation) device group and maintained significant weight loss. Other significant results included changes in appetite/satiety, gastric emptying rate, blood pressure and neurohormone levels or biochemical markers such as ghrelin or HbA1 c respectively. CONCLUSION: GES holds great promises to be an effective obesity treatment. However, stronger evidence is required through more studies with a standardized way of carrying out trials and reporting outcomes, to determine the long-term effect of GES on obesity.
