J Formos Med Assoc
-
The COVID-19 pandemic has had a profound impact globally, particularly in high-risk populations such as those with underlying health conditions. In response to the evolving pandemic landscape and the recent surge in confirmed cases in Taiwan, the Taiwan Association of Family Medicine (TAFM) established a consensus on COVID-19 vaccine recommendations for vulnerable groups through a comprehensive literature review, expert panel discussions, and a practice-oriented formulation procedure to develop evidence-based guidance. Its key findings highlight the increased risk of severe COVID-19 outcomes among individuals with disorders such as diabetes, obesity, chronic kidney disease, cardiovascular disease, and respiratory illness. ⋯ It particularly underscores the critical role of family medicine physicians in the COVID-19 response, including routine screening, health education, vaccination delivery, and continuous research to optimize strategies. Ongoing monitoring, adaptation, and collaborative efforts will be essential to ensure the continued effectiveness of these recommendations in the evolving COVID-19 landscape. In conclusion, the TAFM consensus recommendations provide a robust framework to guide healthcare providers and policymakers in tailoring vaccination efforts to address the unique needs of vulnerable groups in Taiwan and are an applicable template for neighboring countries.
-
The mechanism for long-term hypoxia/ischemia induced bladder underactivity is uncertain. It requires an effectively therapeutic treatment. Therefore, we determined the pathophysiologic mechanisms of long-term bilateral partial iliac arterial occlusion (BPAO)-induced bladder underactivity and explored the therapeutic potential of adipose-derived stem cells (ADSCs) and ADSC-derived microvesicles (MVs) on BPAO-induced bladder dysfunction. ⋯ ADSC-derived MVs were better than ADSCs to improve long-term BPAO-induced detrusor underactivity, bladder ischemia, and oxidative stress. ADSC-MVs through the therapeutic action of ameliorating inflammation, improving purinergic/cholinergic signaling and neuronal regeneration, and decreasing fibrosis improved BPAO-induced bladder underactivity.
-
Yunlin County, Taiwan, faces healthcare challenges given its super-aged population, limited medical accessibility, and a rise in chronic wounds. To address these issues, we introduced the "Fight Out to CARE" project, dispatching wound nurses to patients' locations to perform Cleansing, Avoidance, Removal, and Enhancement (CARE) under tele-supervision from a plastic surgeon. The program was conducted weekly in 2018 and twice monthly in 2019 for 53 weeks. ⋯ Pressure injuries (PIs) comprised 67% of all wounds, with 96% of PIs categorized as full-thickness (FTPIs), including Stage 3, Stage 4, and Unstageable. Overall, 174 wounds healed, with 43% of PIs and 41% of FTPIs healed; 37% of PIs healed within 12 weeks. This innovative approach improved accessibility to chronic wound care and demonstrates promising healing outcomes, providing a valuable reference for chronic wound care policy.