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The antidepressant effect of low-dose ketamine infusion on Taiwanese patients with anxious vs nonanxious treatment-resistant depression (ANX-TRD vs NANX-TRD) has remained unknown.
In total, 71 patients with TRD were randomized to three groups. Each group had participants who received saline infusions mixed with 0 (a normal saline infusion), 0.2, and 0.5 mg/kg of ketamine. Participants were followed up for 2 weeks. Anxious depression was defined as major depressive disorder with a total score of 7 or more on the 17-item Hamilton Depression Rating Scale Anxiety-Somatization factor. Generalized estimating equation models were used to investigate the effects of treatment (ketamine vs placebo) and depression type (ANX-TRD vs NANX-TRD) in the reduction of depressive symptoms during the follow-up period.
Patients with ANX-TRD were less likely to respond to a single low-dose ketamine infusion than those with NANX-TRD. Among patients with NANX-TRD, low-dose ketamine infusion was significantly superior to placebo for reducing depressive symptoms. However, among patients with ANX-TRD, ketamine was not superior to placebo; nonetheless, approximately 30% of the patients responded to ketamine infusion compared to 13% who responded to the placebo.
Low-dose ketamine infusion was effective for Taiwanese patients with NANX-TRD but not so effective for those with ANX-TRD. A higher level of anxiety severity accompanying depression was related to greater depression severity. This may confound and reduce the antidepressant effect of ketamine infusion.
To assess the relative validity and reproducibility of the quantitative FFQ used in the Tzu Chi Health Study (TCHS).
The reproducibility was evaluated by comparing the baseline FFQ with the 2-year follow-up FFQ. The validity was evaluated by comparing the baseline FFQ with 3 d dietary records and biomarkers (serum folate and vitamin B12). Median comparison, cross-classification and Spearman correlation with and without energy adjustment and deattenuation for day-to-day variation were assessed.
TCHS is a prospective cohort containing a high proportion of true vegetarians and part-time vegetarians (regularly consuming a vegetarian diet without completely avoiding meat).
Subsets of 103, seventy-eight and 1528 TCHS participants were included in the reproducibility, dietary record-validity and biomarker-validity studies, respectively.
Correlations assessing the reproducibility for repeat administrations of the FFQ were in the range of 0·46–0·65 for macronutrients and 0·35–0·67 for micronutrients; the average same quartile agreement was 40%. The correlation between FFQ and biomarkers was 0·41 for both vitamin B12 and folate. Moderate to good correlations between the baseline FFQ and dietary records were found for energy, protein, carbohydrate, saturated and monounsaturated fat, fibre, vitamin C, vitamin A, K, Ca, Mg, P, Fe and Zn (average crude correlation: 0·47 (range: 0·37–0·66); average energy-adjusted correlation: 0·43 (range: 0·38–0·55); average energy-adjusted deattenuated correlation: 0·50 (range: 0·44–0·66)) with same quartile agreement rate of 39% (range: 35–45%), while misclassification to the extreme quartile was rare (average: 4% (range: 0–6%)).
The FFQ is a reliable and valid tool to rank relative intake of major nutrients for TCHS participants.
The association between autoimmune diseases and schizophrenia has rarely
been systematically investigated.
To investigate the association between schizophrenia and a variety of
autoimmune diseases and to explore possible gender variation in any such
Taiwan's National Health Insurance Research Database was used to identify
10 811 hospital in-patients with schizophrenia and 108 110 age-matched
controls. Univariate and multiple logistic regression analyses were
performed, separately, to evaluate the association between autoimmune
diseases and schizophrenia. We applied the false discovery rate to
correct for multiple testing.
When compared with the control group, the in-patients with schizophrenia
had an increased risk of Graves' disease (odds ratio (OR) = 1.32, 95% CI
1.04–1.67), psoriasis (OR = 1.48, 95% CI 1.07–2.04), pernicious anaemia
(OR = 1.71, 95% CI 1.04–2.80), celiac disease (OR = 2.43, 95% CI
1.12–5.27) and hypersensitivity vasculitis (OR = 5.00, 95% CI
1.64–15.26), whereas a reverse association with rheumatoid arthritis (OR
= 0.52, 95% CI 0.35–0.76) was also observed. Gender-specific variation
was found for Sjögren syndrome, hereditary haemolytic anaemia, myasthenia
gravis, polymyalgia rheumatica and dermatomyositis.
Schizophrenia was associated with a greater variety of autoimmune
diseases than was anticipated. Further investigation is needed to gain a
better understanding of the aetiology of schizophrenia and autoimmune
To describe the epidemiology of vancomycin-resistant enterococci (VRE) in a university hospital in Taipei, Taiwan.
Retrospective review over a 27-month period, from March 1996 to May 1998.
A tertiary-care teaching hospital in Taiwan.
Patients with VRE isolated from any body site.
Patients were identified through hospital microbiology and infection control records. Patient charts were reviewed for clinical and epidemiology data, including age, gender, previous hospital admissions, underlying diseases, types of infection, and recent antibiotic use. VRE isolates were characterized by their typical biochemical reactions, cellular fatty acid profiles, and the presence of van genes. Antibiotypes using the E-test and randomly amplified polymorphic DNA (RAPD) patterns of these isolates were used to determine the clonality.
Twenty-five isolates of VRE recovered from 12 patients were identified. One patient with a perianal abscess had 12 isolates of VRE (4 Enterococcus faecalis, 7 Enterococcus faecium, and 1 Enterococcus casseliflavus) recovered from perianal lesions. Among 3 patients who were hospitalized in the same room, 1 had a community-acquired cellulitis over the left leg caused by E faecalis, and the other 2 patients both had anal colonization with 2 isolates of E faecalis. The other 8 patients had 1 E faecalis isolate each from various clinical specimens. All isolates possessed vanA resistance phenotype and vanA genes. Different antibiotypes and RAPD patterns of the isolates from different patients excluded the possibility of nosocomial spread at the hospital.
Multiple species of VRE (E faecalis, E faecium, and E casseliflavus) and multiple clones of E faecium could colonize or infect hospitalized patients. In addition, clones of VRE can persist long-term in patients' lower gastrointestinal tracts. These results extend our knowledge of the coexistence and the persistence of multiple species and multiple clones of VRE in hospitalized patients.
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