J Formos Med Assoc
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Cirrhotic patients with refractory ascites exhibit severe portal hypertension and hemodynamic disturbances. The risks associated modest-volume paracentesis (<5 L) for refractory ascites remains unclear. We aimed to explore the impact of modest-volume paracentesis in refractory ascites. ⋯ Cirrhotic patients with refractory ascites face a high risk of complications from modest-volume paracentesis, even with albumin infusion. Paracentesis ≥3 L increases AKI risks, while higher MELD scores are linked to greater overall complications, leading to poor short-term survival.
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The coronavirus Disease 2019 (COVID-19) pandemic has disproportionately impacted long-term care facilities (LTCFs), revealing vulnerabilities due to residents' advanced age, comorbidities, and facility infrastructures. In Taiwan, the Central Epidemic Control Center implemented a range of strategies to protect LTCF residents. These included early containment measures to allow time for preparing pharmaceutical intervention, the establishment of infection prevention and control guidelines, the implementation of comprehensive screening and testing protocols, the prioritization of vaccination for both residents and staff, and the expansion of the national stockpile of oral antiviral agents. ⋯ All measures were made and adjusted based on community prevalence, evolving knowledge about the virus, and balancing the negative impacts on LTCF residents. These multifaceted efforts effectively mitigated transmission, maintained essential healthcare services, and supported LTCF staff, demonstrating the critical importance of coordinated, adaptive strategies in managing the impact of COVID-19 on vulnerable populations in LTCFs. By learning from the COVID-19 pandemic, we can develop more effective and resilient responses for managing future epidemics in LTCFs in Taiwan.