Feasibility of Family-Centered Workshops for Children Aged 18-36 Months with Language Developmental Delay.

BACKGROUND: Family-centered workshops' effects on children with language developmental delay remain unknown. This study assessed the feasibility of workshops for children with language developmental delay. METHODS: A total of 122 children aged 18-36 months with language developmental delays and their parents participated in six sessions of 2-h family-centered multidisciplinary workshops for 6 weeks. The Mandarin-Chinese Communicative Development Inventory, Peabody Developmental Motor Scale, Emotional Competency Rating Scales, Pediatric Outcomes Data Collection Instrument, Child Health Questionnaire, Pediatric Quality of Life Inventory, Caregiver Strain Index, Impact on Family Scale, PedsQL Family Impact Module, and World Health Organization Quality of Life (QOL) were administered to the children and their parents before and after the workshop. RESULTS: We found improvement of emotion (P = 0.037), upper extremity and physical function (P = 0.038), and transfer and basic mobility (P = 0.019) in children and parental QOL related to children's conditions (P = 0.049), with no effect on communication ability and QOL in children and family strain and function. We also noted more significant improvement in children with pure developmental language delay than in children with nonpure developmental language delay concerning the success rates (from delayed to normal development) for expressive vocabulary (P < 0.001) and word combination (P = 0.002). Satisfaction levels toward the workshop were high. CONCLUSIONS: Family-centered workshops improved children's emotions, functional performance, and parental QOL. Although the samples were too small to test different conditions of the developmental delay, the workshops for children with language developmental delays are acceptable and feasible.

The role of cross-border power transmission in a renewable-rich power system - A model analysis for Northwestern Europe.

This study quantifies the economic potential of cross-border transmission to a decarbonized future Northwestern European power system through the energy model Balmorel. A scenario with modelled optimal transmission capacity at lowest total system costs is compared to the scenario with given capacity level of existing and planned projects. Increased transmission investments decrease total system costs and regional price difference. It benefits particularly wind power deployment and thus, lowers CO2 emissions in the power and heat sector. The impacts are, nevertheless, distributed asymmetrically to northern and western stakeholders. Northern consumers receive higher power prices, but the revenues of wind and hydropower producers also increases. Meanwhile, western consumers receive lower power prices, but gas power producer revenues decrease.

Bis-Tridentate Iridium(III) Phosphors with Very High Photostability and Fabrication of Blue-Emitting OLEDs.

Sky-blue and blue-emitting, carbazolyl functionalized, bis-tridentate Ir(III) phosphors Cz-1-Cz-3 with bright emission and short radiative lifetime are successfully synthesized in a one-pot manner. They exhibit very high photostability against UV-vis irradiation in degassed toluene, versus both green and true-blue-emitting reference compounds, i.e., fac-[Ir(ppy)3] and mer-[Ir(pmp)3]. Organic light-emitting diodes (OLEDs) based on Cz-2 exhibit maximum external quantum efficiency (EQE) of 21.6%, EQE of 15.1% at 100 cd m-2, and with CIE x,y coordinates of (0.17, 0.25). This study provides a conceptual solution to the exceedingly stable and efficient blue phosphor. It is promising that long lifespan blue OLED based on these emitters can be attained with further engineering of devices suitable for commercial application.

Association of bladder pain syndrome/interstitial cystitis with urinary calculus: a nationwide population-based study.

INTRODUCTION AND HYPOTHESIS: Although one prior study reported an association between bladder pain syndrome/interstitial cystitis (BPS/IC) and urinary calculi (UC), no population-based study to date has been conducted to explore this relationship. Therefore, using a population-based data set in Taiwan, this study set out to investigate the association between BPS/IC and a prior diagnosis of UC. METHODS: This study included 9,269 cases who had received their first-time diagnosis of BPS/IC between 2006 and 2007 and 46,345 randomly selected controls. We used conditional logistic regression analysis to compute the odds ratio (OR) and its corresponding 95 % confidence interval (CI) for having been previously diagnosed with UC between cases and controls. RESULTS: There was a significant difference in the prevalence of prior UC between cases and controls (8.1 vs 4.3 %, p < 0.001). Conditional logistic regression analysis revealed that cases were more likely to have been previously diagnosed with UC than controls (OR = 1.70; 95 % CI = 1.56-1.84) after adjusting for chronic pelvic pain, irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, depression, panic disorder, migraine, sicca syndrome, allergy, endometriosis, and asthma. BPS/IC was found to be significantly associated with prior UC regardless of stone location; the adjusted ORs of kidney calculus, ureter calculus, bladder calculus, and unspecified calculus when compared to controls were 1.58 (95 % CI = 1.38-1.81), 1.73 (95 % CI = 1.45-2.05), 3.80 (95 % CI = 2.18-6.62), and 1.83 (95 % CI = 1.59-2.11), respectively. CONCLUSIONS: This work generates the hypothesis that UC may be associated with BPS/IC.

Reflux esophagitis increased the risk of bladder pain syndrome/interstitial cystitis: a 3-year follow-up study.

AIMS: Reflux esophagitis (RE) is a common disease which has been recognized to be associated with several medical co-morbidities. However, the association between RE and bladder pain syndrome/interstitial cystitis (BPS/IC) is still unknown. The present study aimed to explore the association between these two diseases. METHODS: We identified 8,962 female patients who had received a diagnosis of RE as the study cohort. We randomly selected 44,810 subjects to be included as the comparison cohort. Each patient in this study was individually tracked for a 3-year period to identify those who subsequently received a diagnosis of BPS/IC. Cox proportional hazards regressions were carried out to estimate the 3-year risk of BPS/IC following a diagnosis of RE. RESULTS: The incidence of BPS/IC following a diagnosis of RE was 4.3% during the follow-up period for all subjects. The incidence rate of BPS/IC was 2.38 [95% confidence interval (CI): 2.21-2.57] per 100 person-years in patients with RE, and 1.24 (95% CI: 1.18-1.30) per 100 person-years in controls. Cox proportional analysis indicated that the hazard ratio (HR) of BPS/IC for patients with RE was 2.00 (95% CI = 1.82-2.20, P < 0.001) that of controls. The adjusted HR of BPS/IC for patients with RE was 1.40 (95% CI = 1.27-1.55, P < 0.001) after taking age group, urbanization level, and medical comorbidity into consideration. CONCLUSION: We found that patients with RE were at a higher risk than with comparison patients for having been subsequently diagnosed with BPS/IC during longitudinal follow-up.

Comorbidities of bladder pain syndrome/interstitial cystitis: a population-based study.

UNLABELLED: Study Type--System prevalence (cohort) Level of Evidence 2a. What's known on the subject? and What does the study add? Compared with the general population, patients with BPS/IC often experience difficulties in performing normal activities owing to physical limitations, decreased energy, greater pain and impaired social functioning With the exception of metastatic cancer, separate conditional logistic regression analyses in this study suggested that subjects with BPS/IC were consistently more likely than subjects without BPS/IC to have all the medical comorbidities investigated. When compared with subjects without BPS/IC, subjects with BPS/IC had particularly higher odds of comorbid neurological diseases, rheumatological diseases and mental illnesses. OBJECTIVE: • To explore the comorbid medical conditions of patients with bladder pain syndrome/interstitial cystitis (BPS/IC) in Taiwan using a cross-sectional study design and a population-based administrative database. SUBJECTS AND METHODS: • The study included 9269 subjects with BPS/IC and 46,345 randomly selected comparison subjects. • Conditional logistic regression analyses were performed to calculate the odds ratio for each of the 32 medical comorbidities (hypertension, congestive heart failure, cardiac arrhythmias, blood loss anaemia, peripheral vascular disorders, stroke, ischaemic heart disease, hyperlipidaemia, hepatitis B or C, migraines, headaches, Parkinson's disease, rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis, pulmonary circulation disorders, chronic pulmonary disease, diabetes, hypothyroidism, renal failure, fluid and electrolyte disorders, liver diseases, peptic ulcers, deficiency anaemias, depressive disorder, psychoses, metastatic cancer, solid tumour without metastasis, alcohol abuse, drug abuse and asthma) between subjects with and without BPS/IC. RESULTS: • With the exception of metastatic cancer, the subjects with BPS/IC had a significantly higher prevalence of all the medical comorbidities analysed than subjects without BPS/IC. • With the exception of metastatic cancer, separate conditional logistic regression analyses suggested that subjects with BPS/IC were consistently more likely than subjects without BPS/IC to have any of the medical comorbidities investigated in this study. • When compared with subjects without BPS/IC, subjects with BPS/IC had particularly higher odds of comorbid neurological diseases, rheumatological diseases and mental illnesses. CONCLUSION: • Our results indicated that subjects with BPS/IC had an increased prevalence of multiple comorbidities.

Association between chronic kidney disease and urinary calculus by stone location: a population-based study.

UNLABELLED: Study Type--Disease prevalence study (cohort design) Level of Evidence 2a. What's known on the subject? and What does the study add? Several studies have estimated the potential association of urinary calculus (UC) with chronic kidney disease (CKD). However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system. We found that patients with CKD were consistently more likely than comparison subjects to have been previously diagnosed with kidney calculus (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.95-2.27), ureter calculus (OR 1.68, 95% CI 1.51-1.85), bladder calculus (OR 1.49, 95% CI 1.13-1.98), and unspecified calculus (OR 1.89, 95% CI 1.74-2.06). We concluded that there was an association between CKD and UC regardless of stone location. OBJECTIVE: • To explore the association of chronic kidney disease (CKD) with prior kidney calculus, ureter calculus, and bladder calculus using a population-based dataset in Taiwan. Several studies have estimated the potential association of urinary calculus (UC) with CKD. However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system. PATIENTS AND METHODS: • We identified 21,474 patients who received their first-time diagnosis of CKD between 2001 and 2009. • The 21,474 controls were frequency-matched with cases for sex, age group, and index year. • We used conditional logistic regression analyses to compute the odds ratio (OR) and corresponding 95% confidence interval (CI) as an estimation of association between CKD and having been previously diagnosed with UC. RESULTS: • The results show that compared with controls, the OR of prior UC for cases was 1.91 (95% CI 1.81-2.01, P < 0.001) after adjusting for potential confounders. • Furthermore, cases were consistently more likely than controls to have been previously diagnosed with kidney calculus (OR 2.10, 95% CI 1.95-2.27), ureter calculus (OR 1.68, 95% CI 1.51-1.85), bladder calculus (OR 1.49, 95% CI 1.13-1.98), and unspecified UC (OR 1.89, 95% CI 1.74-2.06). CONCLUSION: • We concluded that there was an association between ckd and UC regardless of stone location.

Monthly variation in acute urinary retention incidence among patients with benign prostatic enlargement in Taiwan.

Acute urinary retention (AUR) is characterized by a sudden and painful inability to pass urine and is the most common urological emergency. However, according to our knowledge, no study to date has attempted to explore the monthly variation of AUR after adjusting for climatic parameters. This study aimed to examine the monthly variation of AUR due to benign prostatic enlargement (BPE) in Taiwan. The data used in this study were sourced from 2 datasets: the Longitudinal Health Insurance Database 2005 and a meteorological dataset supplied by the Taiwan Central Weather Bureau. We identified 1406 patients aged 40 years or more with a diagnosis of BPE that could all be followed throughout a 6-year study period (2003-2008). We used the autoregressive integrated moving average (ARIMA) method to examine the incidence of AUR for seasonality. The results show that January (midwinter) had the highest rates, decreasing in March to a trough in June (early summer). The incidence then increased again and reached a peak in December (early winter). The ARIMA test also revealed significant monthly variation in the incidence of AUR. In addition, the ARIMA regression revealed that January, February, August, October, November, and December had significantly higher monthly incidence rates of AUR compared with June, after adjusting for the time trend effect and climatic parameters. Our study concluded that significant monthly variation in the incidence of AUR occurred, and January (midwinter) had the highest rates.

Varicocele is associated with erectile dysfunction: a population-based case-control study.

INTRODUCTION: While many studies have been conducted investigating the efficacy of varicocele treatment on fertility, the literature is comparatively sparse concerning the association between varicocele, varicocelectomy, and erectile dysfunction (ED). AIM: This study aimed to estimate the associations between varicocele, varicocelectomy, and ED using a population-based dataset. METHODS: This study used data from the Longitudinal Health Insurance Database 2000 in Taiwan. A total of 32,856 cases and 98,568 randomly selected controls were included in this study. Conditional logistic regression analyses were used to examine associations between ED and having been previously diagnosed with varicocele or having underwent a varicocelectomy. MAIN OUTCOME MEASURE: The odds of prior varicocele or having underwent a varicocelectomy between cases and controls. RESULTS: Of the sampled patients, the prevalence of prior varicocele was 3.3% and 1.2% for cases and controls, respectively (P < 0.001). Conditional logistic regression analysis suggested that the odds ratio (OR) of being previously diagnosed with varicocele for cases was 3.09 (95% confidence interval [CI] = 2.67-3.49) when compared with controls after adjusting for monthly income, geographic location, hypertension, diabetes, coronary heart disease, hyperlipidemia, hypogonadism, obesity, and alcohol abuse/alcohol dependence syndrome. Furthermore, cases were 1.92 (95% CI = 1.52-2.43) times more likely to have undergone a varicocelectomy than controls. Furthermore, subjects aged between 18 and 29 had the highest ORs for prior varicocele among cases when compared with controls (OR = 5.20; 95% CI = 3.27-8.28). CONCLUSION: This investigation succeeded in identifying an association between both varicocele and ED. We also realized that varicocele patients who underwent a varicocelectomy had lower magnitudes of association with ED than those who did not.

A case-control analysis on the association between erectile dysfunction and sudden sensorineural hearing loss in Taiwan.

INTRODUCTION: Although the cause of sudden sensorineural hearing loss (SSNHL) is yet to be elucidated, many theories have been proposed regarding potentially contributory etiologies. One increasingly well-supported theory purports an underlying vascular pathomechanism. If this is the case, SSNHL may also associate with conditions comorbid with vascular diseases, such as erectile dysfunction (ED). However, no studies to date have investigated the association between ED and SSNHL. AIM: This study set out to estimate a putative association between ED and having been previously diagnosed with SSNHL using a population-based dataset with a case-control design. METHODS: This study used administrative claim data from the Taiwan National Health Insurance program. We identified 4,504 patients with ED as the study group and randomly selected 22,520 patients as the comparison group. Conditional logistic regression was used to examine the association between ED and having previously received a diagnosis of SSNHL. MAIN OUTCOME MEASURE: The prevalence and risk of SSNHL between cases and controls were calculated. RESULTS: Of the sampled patients, 41 (0.15%) had been diagnosed with SSNHL before the index date; 22 (0.49% of the cases) were from the study group and 19 (0.08% of controls) were from the control group. Conditional logistic regression analysis revealed that after adjusting for the patient's monthly income, geographic location, hypertension, diabetes, hyperlipidemia, coronary heart disease, obesity, and alcohol abuse/alcohol dependence syndrome status, patients with ED were more likely than controls to have been diagnosed with SSNHL before the index date (odds ratio = 6.06, 95% confidence interval = 3.25-11.29). CONCLUSIONS: There was an association between ED and prior SSNHL. The results of this study add to the evidence supporting an underlying vascular pathomechanism regarding the development of SSNHL and highlight a need for clinicians dealing with SSNHL patients to be alert to the development of ED.

Association between epilepsy and erectile dysfunction: evidence from a population-based study.

INTRODUCTION: Although the association between epilepsy and sexual disorders has long been known, very few studies have attempted to explore the association between epilepsy and erectile dysfunction (ED). AIM: This population-based case-control study aimed to investigate the association between ED and a prior diagnosis with epilepsy. METHODS: This study used data from the Longitudinal Health Insurance Database 2000 in Taiwan. The cases comprised 6,427 patients with a diagnosis of ED and 32,135 controls who were frequency matched with cases based on 10-year age groups and index year. Conditional logistic regression was used to calculate the odds ratios (ORs) for prior epilepsy. MAIN OUTCOME MEASURE: The prevalence and risk of epilepsy between cases and controls. RESULTS: Of the sampled patients, 3,861 (14%) were diagnosed before the index date: 1,358 individuals (19.7%) were cases and 2,503 (12.1%) were controls. After adjusting for hypertension, diabetes, hyperlipidemia, renal disease, coronary heart disease, obesity, alcohol abuse/alcohol dependence syndrome, and socioeconomic status, conditional logistic regression analysis revealed that patients with ED were more likely to have been diagnosed with prior epilepsy than controls (OR = 1.83, 95% CI = 1.51-2.21). Compared with controls, the adjusted ORs for prior generalized epilepsy and partial epilepsy for cases were 2.13 (95% CI = 1.52-3.00) and 1.64 (95% CI = 1.31-2.06), respectively. The most pronounced associations were detected in ED cases aged between 30 and 39 who were 3.04 (95% CI = 1.67-5.50) times more likely than controls to have been previously diagnosed with epilepsy. CONCLUSIONS: Our findings suggest a positive correlation between ED and a prior diagnosis with epilepsy.

A population-based case-control analysis of the association between herpes zoster and erectile dysfunction.

PURPOSE: To date, the occurrence of erectile dysfunction (ED) associating with herpes zoster (HZ) is only based on limited case reports. This case-control study aimed at examining the association between HZ and ED using a population-based dataset in Taiwan. METHODS: A total of 6429 adults newly diagnosed with ED were identified as cases, and 38,574 subjects without any medical history of ED were extracted as controls. Conditional logistic regression models were performed. RESULTS: In total, 1.03% out of the sampled subjects had been diagnosed with HZ within one year prior to the index date; a higher proportion of prior HZ was found among cases than controls (2.04% vs. 0.86%, p < 0.001). After adjusting for demographic characteristics, hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity, and alcohol abuse/alcohol dependence syndrome, conditional logistic regression suggested that cases were more likely to have previously been diagnosed with HZ than controls (OR = 2.24, 95% CI = 1.82-2.75). Furthermore, the odds of having been diagnosed with an HZ infection within one year prior to the index date were dramatically higher among patients with ED than controls among subjects aged 18-29 (OR = 6.07). CONCLUSIONS: We conclude that ED was associated with having been previously diagnosed with HZ, particularly among younger males.

Hormone therapy for prostate cancer and the risk of stroke: a 5-year follow-up study.

OBJECTIVE: To examine the 5-year risk of stroke among patients with prostate cancer (PC) receiving androgen deprivation therapy (ADT) in Taiwan, using a population-based dataset. PATIENTS AND METHODS: This prospective case-control study used data sourced from the Longitudinal Health Insurance Database. The study included 365 patients with PC; 64 (17.6%) received ADT for more than 1 month. Cox proportional hazards regression was used to evaluate the association between ADT and the risk of stroke during the subsequent 5-year follow-up period, after adjusting for sociodemographic characteristics and hypertension, diabetes, coronary heart disease, heart failure, atrial fibrillation and hyperlipidaemia. RESULTS: In the total sample of 365 patients with PC, 68 (18.6%) patients had strokes during the 5-year follow-up period. These included 11 patients with PC who received ADT (17.2% of all patients who received ADT) and 57 patients who did not receive ADT (18.9% of patients who did not receive ADT). After adjusting for potential confounders, no significant difference in the hazard of stroke was found between patients with PC who did and did not receive ADT (hazard ratio, 1.09; 95% confidence interval, 0.80-1.50). CONCLUSION: There was no significant difference in the risk of stroke between ethnic Chinese patients with PC who did and did not receive ADT, after adjusting for potential confounders.

Association between obstructive sleep apnea and urinary calculi: a population-based case-control study.

OBJECTIVE: To hypothesize an association between obstructive sleep apnea (OSA) and urinary calculi (UC) and assess the presence of such an association using a national population-based dataset. Elevated systemic proinflammatory pathways found in OSA patients may be linked to increased cardiovascular risk. Similar pathways have been identified in patients with UC. MATERIALS AND METHODS: We identified 53,791 patients who had received a new diagnosis of UC between 2003 and 2008 from a dataset based on Taiwan's National Health Insurance program. We randomly selected 161,373 controls and then identified subjects with prior OSA in both groups. Odds ratios (ORs) for prior OSA in UC patients compared with controls were estimated in conditional logistic regression analyses by sex and by age group. RESULTS: Prevalences of prior OSA were 1.2% in all subjects, 1.5% in patients with UC, and 1.1% in controls. After adjusting for patients' monthly income, geographic location, urbanization level, hypertension, diabetes, coronary heart disease and hyperlipidemia, and obesity, the OR for prior OSA in UC patients was 1.38 (95% CI 1.30-1.49) compared with controls. Prior OSA was associated with UC both in both males (OR 1.30, 95% CI 1.18-1.41) and females (OR 1.45, 95% CI 1.22-1.67). Notably, the adjusted OR was most pronounced in the youngest age group, <35 years (OR 2.57, 95% CI 1.97-3.34). CONCLUSIONS: We conclude that patients with UC had a higher prevalence of prior OSA. The OR for prior OSA was most pronounced in the youngest age group.

Population-based estimates of medical comorbidities in erectile dysfunction in a Taiwanese population.

INTRODUCTION: Erectile dysfunction (ED) is usually associated with systemic disorders. This population-based study supports and expands on previous research. It also presents data in a Taiwanese male population where existing data on this topic remain sparse. AIM: The aim of this study is to analyze the prevalence and risk of 36 medical comorbidities in patients with ED compared with the general population. METHODS: A total of 2,213 patients with ED and 11,065 matching controls were selected from the Taiwan National Health Insurance Research Dataset. We chose 22 comorbidities from the Elixhauser comorbidity index, 10 highly prevalent medical conditions in an Asian population, and four male gender-specific comorbidities for analysis. MAIN OUTCOME MEASUREMENT: Conditional logistic regression analyses conditioned on age group and monthly income were performed to investigate the risk of various comorbidities for patients with and without ED, after adjusting for the geographic region and level of urbanization of the patient's community. RESULTS: Patients with ED were at an increased risk for multiple systemic comorbidities. Conditional regression analyses showed that patients with ED were at a higher risk for hypertrophy of the prostate (odds ratio [OR] = 12.87), chronic prostatitis (OR = 9.36), alcohol abuse (OR = 3.60), drug abuse (OR = 2.62), urinary incontinence (OR = 2.58), ankylosing spondylitis (OR = 2.19), peripheral vascular disorder (OR = 1.98), ischemic heart disease (OR = 1.94), psychoses (OR = 1.97), depression (OR = 1.88), uncomplicated diabetes (OR = 1.91), complicated diabetes (OR = 1.84), hepatitis B or C (OR = 1.71), hyperlipidemia (OR = 1.69), and chronic pulmonary disease (OR = 1.55) than patients without ED. CONCLUSION: The results show that patients with ED have a higher prevalence of multiple noncardiovascular comorbidities than the general population in Taiwan.

Increased risk of diabetes in patients with urinary calculi: a 5-year followup study.

PURPOSE: No prospective followup study to date to our knowledge has evaluated the relationship between stone disease and the subsequent risk of diabetes mellitus. In this population based study we examine the relationship between a history of urinary calculi and the risk of diabetes mellitus in Taiwan. MATERIALS AND METHODS: A total of 23,569 adult patients with new diagnoses of urinary calculi from 2001 to 2003 were recruited together with 70,707 matched enrollees as a comparison cohort. All patients were tracked for a 5-year period from the index health care encounter to identify those who had a subsequent diagnosis of diabetes mellitus. Cox proportional hazards models were used to compute the risk of diabetes mellitus for the study and comparison cohorts. RESULTS: Of a total of 94,276 patients 2,921 (12.39%) from the urinary calculi group and 6,171 (8.73%) from the comparison group received a subsequent diagnosis of diabetes mellitus during the followup period. The stratified Cox proportional analysis showed that, after censoring individuals who died during followup, and adjusting for patient monthly income, geographic location, urbanization level, hypertension, hyperlipidemia and obesity, the hazard of receiving a first diagnosis of diabetes during the 5-year followup was 1.32 times greater for patients with urinary calculi than for those in the comparison cohort (95% CI 1.26-1.39, p <0.001). CONCLUSIONS: Our results suggest that patients who receive a diagnosis of urinary calculi are at increased risk for diabetes mellitus at 5-year followup.

Hyperthyroidism and female urinary incontinence: a population-based cohort study.

OBJECTIVE: The imbalanced autonomic nervous system present in hyperthyroidism may cause lower urinary tract symptoms. Urinary incontinence (UI) is the most bothersome lower urinary tract symptom; however, in the literature, reports regarding urinary dysfunction and/or incontinence among hyperthyroid patients are scarce. This population-based cohort study aimed to examine the relationship between hyperthyroidism in women and the risk of developing UI in Taiwan. DESIGN: This study used data from the Longitudinal Health Insurance Database. For this study, 10,817 female patients diagnosed with hyperthyroidism from 2001 to 2005 were recruited together with a comparison cohort of 54,085 matched enrollees who did not have a history of hyperthyroidism. All patients were tracked for a 3-year period from their index date to identify those who had a subsequent UI. The stratified Cox proportional hazards models were used to compute the risk of UI between study and comparison cohorts. RESULTS: During the follow-up period, of 64,169 patients, 173 (1·60%) from the hyperthyroidism group and 560 (1·04%) from the comparison group, had a diagnosis of UI. The regression analysis showed that, after adjusting for monthly income, geographic region, urbanization level of the community in which the patient resided, obesity and hysterectomy, patients with hyperthyroidism were more likely to have UI during the 3-year follow-up period than the comparison patients (hazard ratio = 1·54; 95% CI = 1·30-1·83; P < 0·001). CONCLUSION: Our results suggest an increased risk of UI in patients with hyperthyroidism at the 3-year follow-up.

Increased risk of stroke among men with erectile dysfunction: a nationwide population-based study.

INTRODUCTION: Previous cross-sectional studies have suggested that erectile dysfunction (ED) represents an independent risk factor for future cardiovascular events. However, very few studies have attempted to examine the association between ED and subsequent stroke. AIM: The aim of this study is to estimate the risk of stroke during a 5-year follow-up period after the first ambulatory care visit for the treatment of ED using nationwide, population-based data and a retrospective case-control cohort design in Taiwan. METHODS: This study used data sourced from the "Longitudinal Health Insurance Database." The study cohort comprised 1,501 patients who received a principal diagnosis of ED between 1997 and 2001 and 7,505 randomly selected subjects as the comparison cohort. Each patient (N = 9,006) was then individually tracked for 5 years from their index ambulatory care visit to identify those who had diagnosed episodes of stroke. MAIN OUTCOME MEASURE: Stratified Cox proportional hazard regressions were performed as a means of comparing the 5-year stroke-free survival rate for the two cohorts. RESULTS: Of the sampled patients, 918 (10.2%) developed stroke within the 5-year follow-up period, that is, 188 individuals (12.5% of the patients with ED) from the study cohort and 730 individuals (9.7% of patients in the comparison cohort) from the comparison cohort. The log-rank test indicated that patients with ED had significantly lower 5-year stroke-free survival rates than those in the comparison cohort (P < 0.001). After adjusting for the patient's monthly income, geographical location, hypertension, diabetes, coronary heart disease, peripheral vascular disease, atrial fibrillation, and hyperlipidemia, patients with ED were more likely to have a stroke during the 5-year follow-up period than patients in the comparison cohort (hazard ratio = 1.29, 95% confidence interval = 1.08 - 1.54, P < 0.01). CONCLUSIONS: These results suggest that ED is a surrogate marker for future stroke in men.

No increased risk of adverse pregnancy outcomes in women with urinary tract infections: a nationwide population-based study.

OBJECTIVE: To examine the risk of adverse pregnancy outcomes (low birthweight (LBW), preterm birth, and small-for-gestational age (SGA)) in pregnant women with urinary tract infections (UTIs) using a 3-year nationwide population-based database, simultaneously taking characteristics of infant and mother into consideration. Design. Retrospective cross-sectional study. SETTING: Taiwan. SAMPLE: In total, 42,742 mothers with UTIs and 42,742 randomly selected mothers were included. METHODS: Conditional logistic regression analyses to investigate the risk of LBW, preterm birth, and SGA, comparing these two cohorts. MAIN OUTCOME MEASURES: LBW, preterm birth, and SGA. RESULTS: Pearson chi(2) tests show that there were significant differences in the prevalence of preterm births (<37 weeks) (7.2%, 7.7 vs. 8.3%, p = 0.006) and SGA infants (<10th percentile) (16.1%, 16.5 vs. 18.9%, p = 0.003) among pregnant women who were not exposed to UTIs, those exposed to antepartum non-pyelonephritic UTIs and those exposed to pyelonephritis. However, after adjusting for potential confounding factors, the odd ratios (ORs) for LBW were not statistically significant for mothers exposed to antepartum non-pyelonephritic UTIs, compared to women who were not diagnosed with UTIs; neither for <34 or <37 weeks nor SGA <10th percentile and <2 SDs. Similarly, compared to women who were not exposed to UTIs, the adjusted ORs for LBW, <34 weeks, <37 weeks, SGA <10th centile, and <2 SD did not reach a significant level for mothers exposed to pyelonephritis. CONCLUSIONS: Women exposed to antepartum pyelonephritis or non-pyelonephritic UTIs were not at increased risk of having LBW, preterm, and SGA babies, compared to mothers who did not experience UTIs.