學術出版;;Publications

Permanent URI for this communityhdl:11536/1

收集所有交通大學研究人員與學生個人或團體所發表之各項學術著作，涵蓋期刊論文、教師專書、學位論文等項。;;Collections of Publications of NCTU Researchers and Students Like Journal Papers and Thesis.

Browse

🏛️國立陽明交通大學機構典藏

Search Results

Now showing 1 - 8 of 8

Significant predictive factors of the severity and outcomes of the first attack of acute angioedema in children
(2019-11-11)
Syue, Yuan-Jhen
;
Li, Chao-Jui
;
Chen, Wen-Liang
;
Lee, Tsung-Han
;
Huang, Cheng-Chieh
Background The initial episode of angioedema in children can be potential life-threatening due to the lack of prompt identification and treatment. We aimed to analyze the factors predicting the severity and outcomes of the first attack of acute angioedema in children. Methods This was a retrospective study with 406 children (< 18 years) who presented in the emergency department (ED) with an initial episode of acute angioedema and who had subsequent follow-up visits in the out-patient department from January 2008 to December 2014. The severity of the acute angioedema was categorized as severe (requiring hospital admission), moderate (requiring a stay in the short-term pediatric observation unit [POU]), or mild (discharged directly from the ED). The associations among the disease severity, patient demographics and clinical presentation were analyzed. Result In total, 109 (26.8%) children had severe angioedema, and the majority of those children were male (65.1%). Most of the children were of preschool age (56.4%), and only 6.4% were adolescents. The co-occurrence of pyrexia or urticaria, etiologies of the angioedema related to medications or infections, the presence of respiratory symptoms, and a history of allergies (asthma, allergic rhinitis) were predictors of severe angioedema (all p < 0.05). Finally, the duration of angioedema was significantly shorter in children who had received short-term POU treatment (2.1 +/- 1.1 days) than in those who discharged from ED directly (2.3 +/- 1.4 days) and admitted to the hospital (3.5 +/- 2.0 days) (p < 0.001). Conclusion The co-occurrence of pyrexia or urticaria, etiologies related to medications or infections, the presence of respiratory symptoms, and a history of allergies were predictors of severe angioedema. More importantly, short-term POU observation and prompt treatment might be benefit for patients who did not require hospital admission.
A Novel and Simple Algorithm Using Surface Electrocardiogram That Localizes Accessory Conduction Pathway in Wolff-Parkinson-White Syndrome in Pediatric Patients
(2019-09-01)
Li, Hsing-Yuan
;
Chang, Shih-Lin
;
Chuang, Chi-Hsi
;
Lin, Ming-Chih
;
Lin, Yenn-Jiang
Background: The location of the accessory pathway (AP) can be precisely identified on surface electrocardiography (ECG) in adults with Wolff-Parkinson-White (WPW) syndrome. However, current algorithms to locate the AP in pediatric patients with WPW syndrome are limited. Objective: To propose an optimal algorithm that localizes the AP in pediatric patients with WPW syndrome. Methods: From 1992 to 2016, 180 consecutive patients aged below 18 years with symptomatic WPW syndrome were included. After the exclusion of patients with non-descriptive electrocardiography (ECG), multiple APs, congenital heart diseases, non-inducible tachycardia, and those who received a second ablation, 104 patients were analyzed retrospectively. Surface ECG was obtained before ablation and evaluated by using previously documented algorithms, from which a new pediatric algorithm was developed. Results: Previous algorithms were not highly accurate when used in pediatric patients with WPW syndrome. In the new algorithm, the R/S ratio of V1 and the polarity of the delta wave in lead I could distinguish right from the left side AP with 100% accuracy. The polarity of the delta wave of lead V1 could distinguish free wall AP from septal AP with an accuracy of 100% in left-side AP, compared to 88.6% in leads III and V1 for right-side AP. The overall accuracy was 92.3%. Conclusions: This simple, novel algorithm could differentiate left from right AP and septal from free wall AP in pediatric patients with WPW syndrome.
Increased risks of tic disorders in children with epilepsy: A nation-wide population-based case control study in Taiwan
(2016-04-05)
Weng, Wen-Chin
;
Huang, Hui-Ling
;
Wong, Lee Chin
;
Jong, Yuh-Jyh
;
Yin, Yun-Ju
Both epilepsy and tic disorders may share common mechanisms with the involvement of abnormal cortical-basal ganglion circuit connection and dopaminergic dysfunction. However, the association between epilepsy and tic disorders has never been studied. This study investigated the risks of developing tic disorders among children with epilepsy using databases of a universal health insurance system in Taiwan. The data analyzed in this study were retrieved from the National Health Insurance Research Database in Taiwan. The study cohort included children with epilepsy between 2001 and 2007 (n = 2629) and a three-fold age- and gender-matched controls (n = 7887). All subjects were followed up for 3 years from the date of cohort entry to identify their admissions due to tic disorders (ICD-9-CM codes 307.2, 307.20-307.23). Cox hazard regression analysis was performed to estimate the effect of epilepsy on the occurrence of tics. The epilepsy cohort had a higher prevalence of tics (1.7% vs. 0.2%), and a 8.70-fold increased risk of developing a tic disorder compared with the controls (adjusted hazard ratio (AHR) 8.70, 95% confidence interval (CI) 4.26-16.37, p < 0.001). Male patients were observed to have a higher risk of developing a tic disorder (AHR 1.90, 95% CI = 1.04-3.46, p < 0.001) compared to female individuals. Patients with multiple antiepileptic drugs treatment also exhibited higher crude OR for developing tic disorders. This nationwide population-based cohort study, for the first time, demonstrated that there is a significantly increased risk for tic disorders among children with epilepsy. We also found males, attention deficit disorder and the use of multiple AEDs to be independent risk factors of tic disorders. Closely evaluating possible tic disorders would be crucial for improving the outcome and life quality in children with epilepsy. (C) 2015 Elsevier Ltd. All rights reserved.
Increased risk of epilepsy in children with Tourette syndrome: A population-based case-control study
(2016-04-05)
Wong, Lee Chin
;
Huang, Hui-Ling
;
Weng, Wen-Chin
;
Jong, Yuh-Jyh
;
Yin, Yun-Ju
The association between epilepsy and Tourette syndrome has rarely been investigated. In this retrospective cohort study, we analyzed a dataset of 1,000,000 randomly sampled individuals from the Taiwan National Health Insurance Research Database to determine the risk of epilepsy in children with Tourette syndrome. The study cohort consisted of 1062 patients with Tourette syndrome aged <= 18 years, and the control group consisted of three times the number of age- and sex-matched patients without Tourette syndrome, who were insurants, from the same database during the same period. The Tourette syndrome group had an 18.38-fold increased risk of epilepsy than the control group [hazard ratio = 18.38, 95% confidence interval (Cl) = 8.26-40.92; P < 0.001]. Even after adjusting for the comorbidities, the risk of epilepsy in the Tourette syndrome group with comorbidities remained high (hazard ratio = 16.27, 95% CI = 6.26-18.46; P < 0.001), indicating that the increased risk was not associated with comorbidities. This population-based retrospective cohort study provides the first and strong evidence that Tourette syndrome is associated with a higher risk of epilepsy. A close follow-up of children with Tourette syndrome for the development of epilepsy is warranted. (C) 2015 Elsevier Ltd. All rights reserved.
A Cross-Cultural Study on the Perception of Sociability within Human-Computer Interaction
(2009)
Tung, Fang-Wu
;
Sato, Keiichi
;
Deng, Yi-Shin
;
Lin, Tsai-Yi
;
應用藝術研究所
This study tries to use speech and dynamic emoticons as social cues to create a more sociable human-computer interaction. A cross-cultural study was conducted to investigate the influence of cultural backgrounds (Taiwan and America) on children\'s perceptions of sociability within human-computer interaction and explore how the management of social cues affects their engagement in e-learning environments. A 2x2 (Taiwan/America, speech/dynamic emoticon) quasi experiment was conducted to investigate the effects of the independent variables on children\'s perception of social presence and intrinsic motivation. Cultural differences in the perception of social presence are observed. American children reported higher perceived social presence than Taiwanese children did. No differences of effects of speech and dynamic emoticons oil children\'s feelings of social presence and motivation are found. It suggests that children\'s social responses and learning motivations are triggered equally strongly by the two social cues. These findings suggest that designers of educational technology could use speech or dynamic emoticons to build more sociable interfaces that could boost children\'s motivation in learning.
Clinical spectrum of rhabdomyolysis presented to pediatric emergency department
(2013-09-03)
Chen, Chun-Yu
;
Lin, Yan-Ren
;
Zhao, Lu-Lu
;
Yang, Wen-Chieh
;
Chang, Yu-Jun
Background: Rhabdomyolysis is a potentially life-threatening syndrome that can develop from a variety of causes. The aim of the work is to analyze the clinical spectrum and to evaluate the prevalence of various etiologies in children, who present to the emergency department (ED) with rhabdomyolysis. Methods: During a 6-year study period, we retrospectively analyzed the medical charts of patients, aged 18 years or younger, with a definite diagnosis of rhabdomyolysis and serum creatinine phosphokinase (CK) levels greater than 1000IU/L. We analyzed the clinical spectrum and evaluated the potential risk factors of acute renal failure (ARF). Results: Thirty-seven patients (mean age = 10.2 +/- 5.5 years), including 26 males and 11 females, were enrolled in the study. Two of the most common presented symptoms in these 37 patients were muscle pain and muscle weakness (83.8% and 73%, respectively). Dark urine was reported in only 5.4% of the patients. The leading cause of rhabdomyolysis in the 0- to 9-year age group was presumed infection, and the leading cause in the 10- to 18-year age group was trauma and exercise. The incidence of ARF associated with rhabdomyolysis was 8.1 % and no child needed for renal replacement therapy (RRT). We did not identify any reliable predictors of ARF or need for RRT. Conclusions: The classic triad of symptoms of rhabdomyolysis includes myalgia, weakness and dark urine are not always presented in children. The cause of rhabdomyolysis in younger age is different from that of teenager group. However, the prognosis of rhabdomyolysis was good with appropriate management.
Epidemiology and outcome analysis of children with traumatic out-of-hospital cardiac arrest compared to nontraumatic cardiac arrest
(2013-05-01)
Chen, Chun-Yu
;
Lin, Yan-Ren
;
Zhao, Lu-Lu
;
Wu, Yung-Kang
;
Chang, Yu-Jun
This study aimed to determine predictive factors for sustained return of spontaneous circulation (ROSC) in pediatric patients with traumatic out-of-hospital cardiac arrest (OHCA) and compared to those with nontraumatic OHCA. This was a retrospective prognostic study of children with OHCA presenting to the emergency department (ED) was conducted from 2005 to 2010. Related clinical factors that influenced sustained ROSC in traumatic OHCA patients were identified and compared to nontraumatic cases. Significant parameters in predicting sustained ROSC in traumatic OHCA children were also determined using multivariate logistic regression analysis, and etiologies of the ICU admissions were analyzed in patients with sustained ROSC. Among 2,978 critically ill children admitted to the ED, 150 were pediatric OHCA patients, including 76 traumatic cases and 74 nontraumatic cases. Of children with OHCA, initial sustained ROSC was achieved in 51 cases (34.0 %), including 31 traumatic cases and 20 of nontraumatic cases. Head and neck injuries were the majority of traumatic cases in the traumatic OHCA children, followed by abdominal injuries and chest injuries. However, abdominal injuries accounted for the highest rate to gain sustained ROSC, while chest injuries had the lowest rate for successful sustained ROSC. Significant factors associated with sustained ROSC in traumatic OHCA included initial cardiac rhythm (P < 0.05), the period from scene to hospital (P < 0.05), and the duration of in-hospital cardiopulmonary resuscitation (CPR) (P < 0.05). Significant factors related to sustained ROSC have been identified as initial cardiac rhythm, duration of in-hospital CPR, and the period from scene to hospital. Head and neck injuries were the majority of traumatic cases and the prevention in head and neck trauma may play an important part in public health aspects.
Post-resuscitative clinical features in the first hour after achieving sustained ROSC predict the duration of survival in children with non-traumatic out-of-hospital cardiac arrest
(2010-04-01)
Lin, Yan-Ren
;
Li, Chao-Jui
;
Wu, Tung-Kung
;
Chang, Yu-Jun
;
Lai, Shih-Chang
Aim of the study: Although sustained return of spontaneous circulation (ROSC) can be initially established after resuscitation from non-traumatic out-of-hospital cardiac arrest (OHCA) in some children, many of the children lose spontaneous circulation during hospital stay and do not survive to discharge. The aim of this study was to determine the clinical features during the first hour after ROSC that may predict survival to hospital discharge. Methods: We retrospectively evaluated the medical records of 228 children who presented to the emergency department without spontaneous circulation following non-traumatic OHCA during the period January 1996 to December 2008. Among these children, 80 achieved sustained ROSC for at least 20 min. The post-resuscitative clinical features during the first hour after achieving sustained ROSC that correlated with survival, median duration of survival, and death were analyzed. Results: Among the 80 children who achieved sustained ROSC for at least 20 min, 28 survived to hospital discharge and 6 had good neurologic outcomes (PCPC scale = 1 or 2). Post-resuscitative clinical features associated with survival included sinus cardiac rhythm (p = 0.012), normal heart rate (p = 0.008), normal blood pressure (p < 0.001), urine output > 1 ml/kg/h (p = 0.002), normal skin color (p = 0.016), lack of cardiopulmonary resuscitation (CPR)-induced rib fracture (p = 0.044), initial Glasgow Coma Scale score > 7 (p < 0.001), and duration of in-hospital CPR <= 10 min (p < 0.001). Furthermore, these variables were also significantly associated with the duration of survival (all p < 0.05). Conclusions: The most important predictors of survival to hospital discharge in children with OHCA who achieve sustained ROSC are a normal heart rate, normal blood pressure, and an initial urine output > 1 ml/kg/h. (C) 2010 Elsevier Ireland Ltd. All rights reserved.

學術出版;;Publications

Browse

Filters

Settings

Sort By

Results per page

🏛️國立陽明交通大學機構典藏

Search Results