Current status and regulatory aspects of pesticides considered to be persistent organic pollutants (POPs) in Taiwan

Organochlorine pesticides (OCPs) are capable of persisting in the environment, transporting between phase media and accumulating to high levels, implying that they could pose a risk of causing adverse effects to human health and the environment. Consequently, most OCPs are designated as persistent organic pollutants (POPs) and even as endocrine disrupting chemicals (EDCs). The objective of this paper was to review the current status of pesticide POPs in Taiwan, including aldrin, chlordane, chlordecone, DDT, dieldrin, endrin, heptachlor, hexachlorobenzene, α/β-hexachlorocyclohexanes, lindane, mirex, pentachloro-benzene, and toxaphene. The information about their environmental properties, banned use, carcinogenic toxicity and environmental levels, can be connected with the regulatory infrastructure, which has been established by the joint-venture of the central competent authorities (i.e., Environmental Protection Administration, Department of Health, Council of Agriculture, and Council of Labor Affairs). The significant progress to be reported is that the residual levels of these pesticide-POPs, ranging from trace amounts to a few ppb, have declined notably in recent years.     

Generalized mastocytosis; to be considered following resuscitation

This case report describes a male patient aged 44 with recurrent hypotensive shock and severe pulmonary obstruction. The diagnosis of systemic mastocytosis was suggested by the presence of small pigmented maculae (urticaria pigmentosa) and intolerance to NSAIDs. The diagnosis was confirmed by microscopic investigation of the pigmented maculae and bone. The patient was advised to avoid certain foods and drugs and has so far been free of symptoms. In patients with hypotensive shock and (or) severe pulmonary obstruction without a clear cause, systemic mastocytosis should be included in the differential diagnosis.     

Factors to be considered in integrated programs for young children: A review

The following paper outlines the elements to be considered in the process of integration in preschool, day care, and early school programs. This review of research focuses, in particular, on the attitudes and behaviours of teachers and the opinions and concerns of parents involved in the process. The authors contend that the roles of the teacher and the parents of all children must be considered for a successful integration experience.     

研究和实施DRGs时应考虑的若干问题

研究和实施结合我国国情的疾病诊断相关分组（DRGs），对控制我国医疗费用不合理增长具有重要的现实意义。作者简要介绍了DRGs的概念和原理、国内外的发展和应用情况以及国外实施DRGs的成效和不足之处，并结合我国医院的现状及运行特点，提出在我国现阶段研究和实施结合我国国情的DRGs需要考虑的若干因素：即信息系统的统一完善、医疗资源消耗的度量、疾病严重程度的度量、统计学方法的选择、支付标准的制定及临床诊疗规范的建立等因素。     

Risk factors to be considered at the beginning of antihypertensive therapy in diabetes mellitus

The treatment of hypertension in diabetic patients due to its high prevalence rate belongs to the everyday clinical practice of internists, diabetologists and general practitioners. The main points of the initiation on of antihypertensive treatment in diabetic patients are reviewed. In order to decrease the target organ damages the treatment of early recognized cardiovascular risk factors are of great importance. The target value of antihypertensive treatment in diabetic patients is < 130/80 mmHg (in case of proteinuria > 1 g daily: < 125/75 mmHg). The global cardiovascular risk is high or very high in diabetic patients both with grade I-III hypertension and with high normal blood pressure, therefore, treatment with antihypertensive drug (besides life style optimalisation) should be initiated promptly in these cases. In case of micro- or macroalbuminuria antihypertensive drug (mainly with characteristics of blocking the renin-angiotensin-system) should be given to each diabetic subject irrespective of actual blood pressure values. Success of antihypertensive treatment in diabetic patients could be achieved mainly with combination therapy only. It is reasonable to initiate antihypertensive therapy primarily with a low dose combination of two agents in diabetic patients with hypertension.