Journal of the Chinese Medical Association : JCMA
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A hospital-based global budget (GB) program was implemented by the Taiwan Bureau of National Health Insurance (TBNHI) to control the rising costs of medical care. We investigated whether the introduction of the GB program affected prescriptions for second-generation antipsychotics (SGAs) for schizophrenic outpatients in public and private medical and psychiatric centers. ⋯ We concluded that the GB implementation reduced SGA expenditures significantly. The extent of influence varied among hospitals (i.e., public versus private, medical versus psychiatric centers), which was most likely caused by financial factors.
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Suicide is a serious public health problem worldwide. The emergency department (ED) is often the first place of contact with medical and mental health care for suicidal patients. This study aimed to determine the characteristics, management, and aftercare of patients who attempted suicide and then were taken to the ED of a general hospital in Taipei, Taiwan. ⋯ Individuals who harmed themselves had a high rate of psychiatric morbidity and interpersonal problems. However, their adherence to psychiatric outpatient aftercare was low. Improved identification of the needs of patients with suicidal tendencies who did not attend outpatient services will have implications for future services provided to this patient population, and will better enable medical personnel to most effectively assist in suicide attempt interventions.
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Acute liver damage is primarily induced by one of several causes, among them viral exposure, alcohol consumption, and drug and immune system issues. Agents with the ability to inhibit tyrosinase and protect against DNA damage caused by reactive oxygen species (ROS) may be therapeutically useful for the prevention or treatment of ROS-related diseases. ⋯ To the best of our knowledge, this was the first study of the hepatoprotective effects of phloretin and PIH on D-GalN-induced acute liver damage in Kunming mice as well as the possible mechanisms. This was also the first study of the lipid peroxidation inhibition activity of phloretin and PIH in liver mitochondria induced by the Fe(2+)/vitamin C (Vc) system in vitro, the protective effects on supercoiled pBR322 plasmid DNA, and the antityrosinase activity of phloretin and PIH.
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Glaucoma is the second leading cause of blindness worldwide and East Asian people account for almost half of those affected. Vertical elongation of the optic cup is a characteristic feature of glaucoma. However, there is a significant overlap in the vertical cup-to-disc ratio (VCDR) between normal eyes and eyes affected by glaucoma. The purpose of this study was to determine the distribution of VCDR and vertical disc diameter (VDD) and their predictive factors in a population of elderly Chinese residents in Taiwan. ⋯ A greater VCDR was related to a longer axial length. A greater VDD was related to a higher BMI and a longer axial length.
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Lumbar spinal cysts often present with backache and may be accompanied by lower extremity weakness as well as radiation pain if root compression occurs. The treatment regimens include anti-inflammatory drugs, physical therapy, procedures guided by fluoroscopy or computed tomography, and surgery. ⋯ The symptoms immediately remitted after ultrasound-guided steroid-lidocaine injection into the L4-L5 facet joint. Magnetic resonance imaging follow up 4 months after injection showed complete resolution of the cyst.