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Computed tomography (CT) with rapid injection of contrast medium is important for the diagnosis of many diseases. To obtain good diagnostic accuracy, a power injector is recommended and routinely used to achieve a consistent injection rate of contrast medium. Although rapid contrast injection improves diagnostic accuracy, it increases the risk of extravasation of contrast medium. The aim of this study was to evaluate the extravasation rate of contrast medium using a power injector and determine if using a saline test injection mode can reduce the rate.
Patients and The records of 10,310 computed tomography (CT) examinations with contrast administration by a dual-syringe power injector were retrospectively reviewed. Before contrast administration, the same volume of saline was injected with a higher injection rate than that for contrast medium and the protocol was defined as “saline test injection mode”. The incident reports of patients with extravasations were reviewed and the extravasation rate and prevention rate were calculated. Extravasations occurred in 12 (0.12%) of 10310 patients, and follow-up information was available for all patients. Five (41.67%) of 12 extravasations occurred during the saline test injection period, and the CT examinations were completed after creation of a new venous access. Contrast medium extravasation occurred in only six (0.06%) patients. One of the patients with contrast medium extravasation developed compartment syndrome and required decompression surgery. Other cases with extravasation had only mild symptoms and improved within 5 days. The saline test injection mode may reduce the risk of contrast medium extravasation and improve the safety of using a power injector.

Infection by Toxocara spp. is known to be significantly associated with partial epilepsy. It has become popular for people to raise dogs/cats as pets and consume roasted meat/viscera, and the status of Toxocara spp. infection, epi­lepsy awareness, and associated risk factors among the general population are cur­rently unknown in Taiwan. A seroepidemiological investigation among 203 college students (CSs), consisting of 110 males and 93 females with an average age of 21.5 ± 1.2 years, was conducted in 2009 in Taipei City. A Western blot analysis based on excretory-secre­tory antigens derived from Toxocara canis larvae (TcESs) was applied to determine the positivity of serum immunoglobulin G antibodies. A self-administered question­naire was also given to obtain information about demographic characteris­tics, epilepsy awareness, and risk factors. A logistic regression model was applied for the statistical analysis using SPSS software. The overall seropositive rate of Toxocara spp. infection was 8.4% (17/203). As to epilepsy awareness, a non-significantly higher seroprevalence was found in CSs who claimed to "know" about epilepsy compared to those who did not know (P > 0.05). It appears that appropriate educational programs are urgently needed to provide correct knowledge related to the prevention and control measures against Toxocara spp. infections to avoid potential threats by this parasite to the general population in Taiwan.

Single-nucleotide polymorphisms (SNP) in the inosine triphosphate pyrophosphatase (ITPA) gene correlate with ribavirin (RBV)-induced anemia in patients with chronic hepatitis C (CHC) receiving combination therapy. Managing anemia is an early priority in the treatment process.. The aim was to develop a predictive index based on ITPA SNP status to identify CHC patients at risk of anemia.Patients and A total of 418 eligible East Asian patients diagnosed with CHC genotype 1 (G1) received combination therapy in this study. Participant DNA was genotyped for a functional ITPA SNP (C/C, A/A or C/A) on chromosome 20 at rs1127354. A predictive index was constructed by incorporating independent factors identified for severe anemia events (hemoglobin < 10 g/dL). Areas under the receiver-operating characteristic curves (AUCs) represented the diagnostic accuracies of the predictive index in randomly assigned development and validation cohorts. Multiple logistic regressions identified age (≥ 50 y: OR = 9.7, 95% CI = 5.0 - 18.6), ITPA rs1127354 (C/C: OR = 3.3, 95% CI = 1.8 - 5.8) and baseline hemoglobin (< 14.0 g/dL: OR 6.4, 95% CI = 3.3 - 12.1; 14.0 - 14.9: OR = 2.4, 95% CI = 1.2 - 4.6) as predictors of severe anemia throughout the treatment. For severe anemia, the predictive index incorporating age, ITPA SNP status and baseline hemoglobin yielded diagnostic accuracies (AUCs) of 0.830 (95% CI = 0.783 - 0.871) in the development (n = 324) and 0.902 (0.826 - 0.925) in the validation (n = 81) cohorts. In patients with CHC G1 and receiving combination therapy, ITPA SNP-based index was an accurate and practical solution for prediction of severe anemia..

Visfatin (also known as pre-B cell colony-enhancing factor) is increased in patients with chronic kidney disease and has been linked with coronary atherosclerosis. Given that it has been reported that visfatin plays a role in endothelial dysfunction in chronic kidney disease patients, we examined associations between visfatin levels and several markers related to atherosclerosis. The association between visfatin and atherosclerotic risk factors was studied in 173 chronic kidney disease patients (130 men and 43 women). Serum levels of visfatin were measured by the enzyme-linked immunosorbent assay. With increasing visfatin tertiles, patients proved to have a larger number of vessels with stenosis and a higher likelihood of coronary artery disease, as well as having incrementally lower estimated glomerular filtration rate and serum albumin and higher total leukocyte, neutrophil, and monocyte counts; high-sensitivity C-reactive protein; and brain natriuretic peptide levels. Visfatin showed significant positive correlations with low-density lipoprotein cholesterol, uric acid, blood urea nitrogen, creatinine, brain natriuretic peptide, E-selectin, total leukocyte count, neutrophil count, and high-sensitivity C-reactive protein, and a significant negative correlation with estimated glomerular filtration rate and albumin. Only E-selectin was independently associated with visfatin in multiple linear regression analysis. This study indicates that plasma visfatin levels are significantly higher in the presence of coronary artery disease and are correlated with E-selectin levels, which suggest that increased plasma visfatin may be involved in the pathogenesis of coronary atherosclerosis in CKD patients.

Hypolipidemic agent fenofibrate has recently been demonstrated to improve carbohydrate metabolism in animal and cell models. The purpose of this study was to determine its clinical effects on glycemic control and the relationship with its hypolipidemic action in type 2 diabetic patients with hyperlipidemia. Forty-eight type 2 diabetic patients with hyperlipidemia were recruited from the Endocrine Division’s outpatient clinic of a tertiary-care university-affiliated centre and randomly assigned micronised fenofibrate 200mg daily or placebo in a doubleblinded, placebo-controlled study for three months. A total of 44 patients completed the study. Main outcome measured were changes from the baseline in fasting and postprandial lipid and glycemic variables. Treatment with micronised fenofibrate resulted in a significant decrease in fasting (3.81 ± 1.86 to 1.90 ± 0.77 mmol/L, p< 0.0001) and postprandial triglyceride (5.36±2.640 to 2.30±1.33 mmol/L, p< 0.0001), total cholesterol (6.18±1.17 to 5.23±0.97 mmol/L, p<0.0001) and non-HDL cholesterol (5.09±1.12 to 3.96±1.11 mmol/L, p<0.0001). After treatment the placebo group showed no significant changes in serum lipid levels. Both groups did not alter in fasting and postprandial plasma glucose, mean HbA1c, fasting insulin, QUICKI index and proinsulin-to-insulin ratio. Micronised fenofibrate significantly improved both fasting and postprandial lipid profiles, but did not affect glycemic variables, insulin resistance, and β cell function in patients with type 2 diabetes.