RESUMEN
Patients with chronic spontaneous urticaria (CSU) have a higher risk of developing hypertension. This study aimed to determine whether acupuncture could decrease the risk of hypertension in patients with CSU. We enrolled patients newly diagnosed with CSU between 1 January 2008, and 31 December 2018, from the Taiwanese National Health Insurance Research Database. The claims data were assessed from the index date to 31 December 2019. A Cox regression model was used to compare the hazard ratios (HRs) of the two cohorts. The cumulative incidence of hypertension was estimated using the Kaplan-Meier method. After propensity score matching with a 1:1 ratio, 43,547 patients with CSU who received acupuncture were matched with 43,547 patients with CSU who did not receive acupuncture in this study. After considering potential confounding factors, patients who received acupuncture had a significantly lower risk of hypertension than those in the control group (adjusted hazard ratio = 0.56, 95% confidence interval = 0.54-0.58). Patients who received medications combined with acupuncture tended to have the lowest risk of hypertension. This study revealed that acupuncture decreases the risk of hypertension in patients with CSU in Taiwan. The detailed mechanisms can be further clarified through prospective studies.
RESUMEN
BACKGROUND/PURPOSE: Tuberculosis (TB) is an endemic disease in Taiwan and it usually affects the lung. Spinal TB accounts for 1-3% of all TB infections. The purpose of this study was to investigate the clinical manifestations, management, outcomes and drug susceptibility of Mycobacterium tuberculosis in non-HIV-infected patients with spinal TB. METHODS: From January 1998 to December 2007, we retrospectively reviewed the medical charts of adult patients with a diagnosis of spinal TB. Only those with positive culture results and/or characteristic pathologic findings were enrolled. Demographic data, clinical manifestations and susceptibility to anti-TB drugs were reviewed and analyzed. RESULTS: During the study period, 38 patients (23 men, 15 women) with spinal TB were identified and the mean age was 68 years. The median duration of symptoms was 60 days (range, 3-720 days). Amongst the 38 patients, back pain (100%) was the most common clinical symptom, followed by weakness (53%) and numbness (26%). The lumbar spine (15 patients, 39%) was the most commonly involved site, followed by the thoracic spine (14 patients, 37%). Concomitant pulmonary TB was found in 12 patients (32%). Three patients (8%) had concurrent bacterial or fungal infections. Almost all of the patients (35 patients, 92%) were successfully treated with surgery and anti-TB medications. The erythrocyte sedimentation rate was followed up in 16 patients before and after therapy and a significant decline was observed after treatment (p = 0.004). No mortality was related to spinal TB. CONCLUSION: Insidious clinical course and ambiguous manifestations of spinal TB often delay and hinder the accuracy of diagnosis of spinal TB. In addition to pyogenic osteomyelitis, spinal TB should be included in the differential diagnosis especially in elderly patients with chronic back pain accompanied by elevated erythrocyte sedimentation rate, and those living in the TB endemic area.