J Formos Med Assoc
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Controlling hypertension has become an important issue in the elderly population in whom neurological comorbidities are highly prevalent. Most of the large-scale trials focusing on hypertension management in older populations have excluded patients with comorbid neurological disorders. However, this population requires special considerations, as the benefits of antihypertensive agents are mostly uncertain and there is a higher risk of adverse events. ⋯ For patients with neurodegenerative disorders such as cognitive dysfunction and Parkinson's disease, achieving adequate blood pressure control may be beneficial in reducing cardiovascular risks, although the higher risk of adverse events from antihypertensive treatment may offset some of these benefits. Special considerations for factors such as orthostatic hypotension, risk of falls, polypharmacy, and significant drug-drug interactions are required but frequently neglected in clinical practice. More efforts are warranted to determine the optimal treatment strategy for elderly populations with neurological disorders.
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Biliary atresia (BA) is a progressive liver disease even after Kasai portoenterostomy (KPE), and the most common cause of liver transplant (LT) in the pediatric population. This study aimed to unveil the risk factors for LT in BA patients post-KPE. ⋯ Higher direct bilirubin 3 months post-KPE (≥1.1 mg/dL) and higher peak annual cholangitis frequency predict LT in BA patients. The first cholangitis occurring 61-120 days post-KPE predicts higher peak annual cholangitis frequency. In patients who achieved JF, peak annual cholangitis episodes with a threshold of ≥3 independently predict LT. Bacteremia and higher serum AST levels at six months post-KPE predict higher peak annual cholangitis frequency.
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Quality of life (QOL) is important for evaluating medical care outcomes. In chronic kidney disease (CKD) population, generic instruments, such as WHOQOL-BREF and EQ-5D, are commonly used for comparing various medical conditions for policy-making purposes. However, their psychometric properties have not yet been validated in non-dialysis CKD population. ⋯ Both WHOQOL-BREF (TW) and EQ-5D have relatively good psychometric properties in non-dialysis CKD population. The direct use of original WHOQOL-BREF (TW) domain scores/EQ-5D utility score for parametric analyses is acceptable non-dialysis in CKD population. However, when using the EQ-5D for cost-effective comparison in CKD patients with different stages or characteristics potential bias should be concerned.
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Osteoporosis fracture is a common and most serious complication of osteoporosis. ⋯ MiR-4534 is a new potential diagnostic biomarker for osteoporotic fractures. MiR-4534 can regulate osteoblast differentiation, proliferation, and migration by targeting CFTR.