J Formos Med Assoc
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Pyogenic liver abscess in Taiwan is most commonly due to Klebsiella pneumoniae infection in diabetic patients, and less frequently due to biliary tract infections. Liver abscess caused by ventriculoperitoneal (VP) shunt is very rare. We report a case of liver abscess caused by methicillin-resistant Staphylococcus aureus (MRSA), which developed as a complication of an infected VP shunt. ⋯ Liver abscess in patients with a VP shunt should be considered a possible abdominal complication of the VP shunt, and may be caused by unusual pathogens. Diagnosis requires CT scan and direct aspiration and culture of the liver abscess. Treatment requires management of both the liver abscess and the infected shunt.
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Quality of life (QOL) is the paramount goal of end-of-life care. However, there is no Chinese language instrument for measuring QOL that has been shown to have adequate psychometric properties for Taiwanese patients with terminal cancer. The purpose of this study was to examine the psychometric properties of a Chinese language version of the McGill Quality of Life questionnaire (MQOL-Taiwan version) in this population. ⋯ The MQOL-Taiwan version demonstrated an acceptable level of reliability, validity and equivalency in the initial cross-cultural validation. These findings indicate the suitability of this QOL measure for clinical and research use in Taiwanese patients with terminal cancer.
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Chronic liver disease (CLD) is a major cause of death in Taiwanese aborigines. The roles of substance-use habits and hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in the development of CLD are not well understood in this indigenous population. ⋯ Our data suggest that chronic HBV and HCV infections, alcohol drinking, cigarette smoking, and betel quid chewing play important roles in the development of CLD in Taiwanese aborigines.
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Case Reports
Small-cell lung cancer presenting with Lambert-Eaton myasthenic syndrome and respiratory failure.
Lambert-Eaton myasthenic syndrome (LEMS) is a neuromuscular disorder characterized by defective neurotransmitter release at presynaptic terminals. It is caused by an IgG autoantibody reacting against voltage-gated calcium channels. Severe LEMS complicated by ventilatory failure is rare. ⋯ Cytologic examination of ultrasound-guided fine needle aspiration disclosed SCLC. Successful treatment in combination with plasma exchange and chemotherapy resulted in dramatic tumor regression and LEMS remission, which were confirmed by chest radiography and electrophysiologic studies. This case suggests that plasma exchange and chemotherapy can be effective in treating SCLC with severe LEMS that produces ventilatory failure.
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Comparative Study
Colorectal cancer screening in asymptomaic adults: comparison of colonoscopy, sigmoidoscopy and fecal occult blood tests.
Fecal occult blood tests (FOBT) and flexible sigmoidoscopy have previously been recommended for colon cancer screening. More recently, studies have recommended colonoscopy due to the high rates of advanced neoplasm not detected by FOBT and sigmoidoscopy. Previous studies of the effectiveness of colonoscopic screening in Taiwan were limited to families of patients with colorectal cancer. This study compared colonoscopy, sigmoidoscopy and FOBT for colorectal cancer screening in asymptomatic adults. ⋯ Colonoscopy can detect neoplastic lesions undetectable by FOBT and sigmoidoscopy in asymptomatic subjects. These results suggest that colonoscopy should be the method of choice in colon cancer screening.