J Formos Med Assoc
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In order to provide better quality of care at Taipei Veterans General Hospital, 13,911 emergency patients coming into the medical emergency room were studied using the computer to key in all demographic data including registration time, time to be seen, desposition time, impression, triage category, discipline as well as daily dynamic status in the observation room from August through December 1989. The study showed that 8.6% were triage category 1 (life-threatening cases) and 22.08% were triage 4 (pseudo-emergency patients). ⋯ In general, the daily dynamic status of the patients in the observation room were: (1) Out of 45 overnight patients, 12 (27%) were waiting for admission; and (2) 9 (20.14%) were waiting for a transfer to other convalescent hospitals. We conclude that less than one-tenth of the emergency patients were really emergencies in such a large and busy emergency department, and there was enormous patients stasis in the observation room causing overcrowding of the emergency department, which is the main issue we have to resolve if the quality assurance of the emergency department is to be improved.
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Comparative Study
Ethnic comparison of haloperidol and reduced haloperidol plasma levels: Taiwan Chinese versus American non-Chinese.
Steady-state haloperidol (HAL) and reduced HAL (RHAL) plasma levels were measured in Chinese and non-Chinese schizophrenic patients. The patients (n = 38) were matched according to age (+/- 1 yr) and by HAL dose. In general, Chinese patients had higher mean plasma HAL levels and lower RHAL/HAL ratios compared to non-Chinese patients (23.6 +/- 14.9 ng/ml versus 17.1 +/- 10.1 ng/ml, p less than 0.05; 0.52 +/- 0.44 versus 0.82 +/- 0.62, p less than 0.05). ⋯ RHAL/HAL ratios were generally lower in the Chinese patients than in the non-Chinese patients, with a strong trend toward the significance level in the 20 mg and 30 mg groups (0.22 +/- 0.13 versus 0.58 +/- 0.57, p = 0.066 and 0.43 +/- 0.26 versus 0.71 +/- 0.34, p = 0.062). This study further suggests the possibility of different metabolic rates between Chinese and non-Chinese patients. Possible differences in the enzyme systems which relate to the metabolism of HAL and RHAL between Chinese and non-Chinese populations are discussed.
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Comparative Study
Prevalence of antibody to hepatitis C virus in pregnant Taiwanese.
To assess the prevalence of an antibody to hepatitis C virus (anti-HCV) in pregnant women in Taiwan, and elucidate whether or not there is superinfection of the hepatitis B virus (HBV) in such cases, we investigated two independent groups of pregnant women. Group A included 294 without serum alanine aminotranferase (ALT) screening, and group B included 171 pregnant women with an abnormal ALT level (greater than 45 IU/L) who were recruited from 9,523 pregnant women screened for ALT. Blood samplings were taken at early gestation and each serum sample was tested with an HCV EIA kit for anti-HCV. ⋯ Therefore, the prevalence of anti-HCV in pregnant women by current assay in Taiwan is 0.34% without ALT screening, but increases to 2.3% among abnormal ALT cases. The prevalence rate is less than the rates reported in other countries. If confirmed by subsequent study, the results suggest that infection with HCV is low among healthy young females in Taiwan today.
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Comparative Study
The prognostic value of blood glucose in patients with acute stroke.
We prospectively studied levels of blood glucose and glycohemoglobin, and their correlations with types, severity, and prognosis of stroke in 37 patients with brain infarction (BI) and 35 patients with brain hemorrhage (BH). We found that in the BH group, patients with an elevated glucose level due to stress, diabetes, or both, had a lower consciousness level on admission, larger hematoma size, higher incidence of rupture into the ventricles, and a worse 1-month outcome than patients with a normal glucose level (p less than 0.05). ⋯ However, it seems to be the severity of the stroke, not the hyperglycemia, that causes the poor outcome. Hyperglycemia may be an epiphenomenon of stroke severity.
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To study the causes of burn injuries and the nature of their medical treatment, we investigated the medical histories of hospitalized patients admitted to the burn center of Taipei City Ho-Ping Hospital from June 6, 1983 to June 6, 1987. Additionally, a phone interview follow-up on recovery conditions was made. Among the 300 patients admitted, the majority (53.7%) were burned by scalding water, while fire was the second most common cause of burns. ⋯ Those with severe burns average 26.5 days. Half (50.7%) of the patients recovered by the time they left the hospital. Examining the death rate by type of burn, we found that the death rate for chemical burns was the highest (10.34%), while the rate was lowest for scalding.(ABSTRACT TRUNCATED AT 250 WORDS)