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1.
Osteoporos Int ; 30(4): 837-843, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30734067

RESUMO

Osteoporosis is a well-known bone disorder affecting people worldwide. Patients with osteoporosis have an increased risk of bone fracture. This study provides new information on the risk of developing osteoporosis post burn injury and the risk of fracture among those with osteoporosis developed. INTRODUCTION: The relationship between burn injury and hip fracture risk is unclear. Population-based evaluation on relationships between burn injury and osteoporosis development and subsequent fractures is limited. We conducted a retrospective cohort study as the investigation. METHODS: From the insurance data of Taiwan, we established a cohort of 43,532 patients with a burn injury in 2000-2012 and a comparison cohort of 174,124 individuals without such an injury, frequency matched by sex, age, and diagnosis date. Both cohorts were followed up to the end of 2013 to evaluate the occurrence of osteoporosis and hip fracture. RESULTS: The incidence of osteoporosis was greater in the burn cohort than in the comparison cohort (6.40 vs. 4.75 per 1,000 person-years) with an adjusted IRR of 1.35 (95% confidence interval = 1.32-1.39). The incidence rates in both cohorts were greater in women than in men, increased with age, income, and Charlson comorbidity index. Patients with burns involving 20%-49% of total body surface area and with burns confined to the lower/upper limbs had the greatest incidence rates, 8.32 and 8.58 per 1,000 person-years, respectively. Osteoporosis incidence increased further to 22.7 per 1,000 person-years for burn victims with comorbid diabetes. The risk of fracture was over five-fold greater for burn victims with osteoporosis developed than for comparisons without osteoporosis. CONCLUSION: Patients who have a burn injury deserve prevention intervention to reduce the risk of osteoporosis and fracture.


Assuntos
Queimaduras/complicações , Osteoporose/etiologia , Fraturas por Osteoporose/etiologia , Adulto , Idoso , Queimaduras/epidemiologia , Comorbidade , Bases de Dados Factuais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Fraturas por Osteoporose/epidemiologia , Estudos Retrospectivos , Medição de Risco/métodos , Taiwan/epidemiologia
2.
J Eur Acad Dermatol Venereol ; 33(3): 560-567, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30317664

RESUMO

BACKGROUND: Psoriasis is a common skin disease that has been recently found to be associated with various systemic inflammatory disorders. However, the association between psoriasis and gout has not been well defined. OBJECTIVE: We investigated whether there is an association between psoriasis, psoriatic arthritis and gout in a large population of patients in Taiwan. METHODS: A nationwide population-based cross-sectional study was performed using the Taiwanese National Health Insurance Research Database (NHIRD). A total of 114 623 patients with gout and 114 623 patients without gout (1 : 1 propensity score-matched according to age, sex, income category and urbanization level) were identified. The prevalence of psoriasis, psoriatic arthritis and other comorbid diseases in these two groups of patients was compared. Adjusted odds ratios (OR) were calculated using conditional logistic regression. RESULTS: There was an increased prevalence of psoriasis in patients with gout compared with patients without gout (1.6% vs. 1.1%, P < 0.0001). Subgroup analysis showed an increased prevalence of psoriatic arthritis (0.3% vs. 0.1%, P < 0.0001) in patients with gout compared with patients without gout. In addition, multiple conditional logistic regression analysis showed that gout was significantly associated with psoriasis (adjusted OR 1.30, 95% CI 1.20-1.42) and psoriatic arthritis (adjusted OR 2.50, 95% CI 1.95-3.22). After stratification by age and sex, it was found that the strength of the association between gout and psoriasis was similar among males and females but varied according to age group, with patients aged 41-50 years having the strongest association. CONCLUSION: Gout is significantly associated with psoriasis and psoriatic arthritis in the Taiwanese population, and the strength of the association varies with the patient's age. Further studies are warranted to elucidate the molecular mechanisms underlying this association.


Assuntos
Gota/epidemiologia , Psoríase/epidemiologia , Adulto , Fatores Etários , Idoso , Transtornos Relacionados ao Uso de Álcool/epidemiologia , Artrite Psoriásica/epidemiologia , Comorbidade , Estudos Transversais , Bases de Dados Factuais , Diabetes Mellitus/epidemiologia , Dislipidemias/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Nefropatias/epidemiologia , Cirrose Hepática/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Obesidade/epidemiologia , Prevalência , Taiwan/epidemiologia , Adulto Jovem
4.
Conf Proc IEEE Eng Med Biol Soc ; 2019: 1998-2002, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31946292

RESUMO

In radiology practices, the ultrasound-guided breast biopsy is among the most commonly performed minimally invasive procedures. However, many radiology residents in their graduate residencies are found with little or no hands-on experience with ultrasound-guided breast procedures. To enhance safety, the problem can be solved by the use of anthropomorphic training phantoms which can provide the resident with realistic ultrasound imaging and needle insertion haptic feedback. Stiffness and acoustic properties of breast tissues vary between different people. The training breast phantom should be able to possess different acoustic and mechanical properties which conform the inconsistencies found in real tissues among people. Therefore, this paper investigates the tunability of acoustic and mechanical behaviors in breast tissue mimicking materials (TMMs). Experiments of central composite design (CCD) with a center point, four corner points, and an additional four axis points were used to fit the non-linear regression model of the speed of sound. The same design of experiment approach was then used to fit the second-order response surface of the attenuation coefficient. Suitable series of tissue mimicking materials for the glandular tissue and malignant lesion were suggested. Latin hypercube design method was conducted to evaluate the main factors that affected the mechanical property (Young's modulus) of tissue mimicking materials. The results showed that the recipe of tissue mimicking materials could be customized to possess different acoustic and mechanical properties which conform the inconsistencies found in real breast tissues.


Assuntos
Acústica , Mama , Modelos Anatômicos , Ultrassonografia de Intervenção , Mama/diagnóstico por imagem , Educação Médica , Módulo de Elasticidade , Feminino , Humanos , Imagens de Fantasmas , Ultrassonografia , Ultrassonografia de Intervenção/métodos
5.
Eur Rev Med Pharmacol Sci ; 22(20): 6959-6964, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30402862

RESUMO

OBJECTIVE: Atrial fibrillation (AF) is one of the most common arrhythmias affecting the patient's quality of life, and its complications of thromboembolism can lead to serious consequences. AF patients are often in hypercoagulation status that can affect the prognosis. GPIIb/IIIa is a fibrinogen receptor that can bind to the ligands of platelet and cause aggregation. Therefore, GPIIb/IIIa can be treated as a marker of hemagglutination. This work aims to analyze the changes of GPIIb/IIIa after radiofrequency ablation of atrial fibrillation, and to investigate its relationship with recurrence. PATIENTS AND METHODS: A total of AF 80 patients in our hospital received radiofrequency ablation from January 2017 to August 2017. Peripheral blood was collected 1 week after surgery. A total of 40 healthy volunteers were enrolled as control group. GPIIb/IIIa was analyzed by enzyme-linked immunosorbent assay (ELISA). High-sensitivity troponin (hs-cTnT), fasting plasma glucose (FPG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), total cholesterol (TC), and triglyceride levels (TG) were analyzed by using electrochemical luminescence assay. Body mass index (BMI), smoking index, and age were recorded. RESULTS: Compared with the non-recurrence group, GPIIb/IIIa, hs-cTnT, FPG, LDL, TC, and TG levels increased, whereas HDL level declined in the recurrence group (p < 0.05). There was a positive correlation between GPIIb/IIIa and hs-cTnT, FPG, LDL, TC, TG, BMI, and smoking index, and a negative correlation with HDL (p < 0.05). GPIIb/IIIa was positively correlated with postoperative recurrence (p < 0.05). CONCLUSIONS: Increased GPIIb/IIIa expression after radiofrequency ablation of AF is associated with myocardial injury, suggesting a risk of postoperative recurrence.


Assuntos
Fibrilação Atrial/terapia , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/genética , Qualidade de Vida , Ablação por Radiofrequência/métodos , Idoso , Biomarcadores/sangue , Plaquetas/metabolismo , Feminino , Traumatismos Cardíacos/sangue , Humanos , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Masculino , Pessoa de Meia-Idade , Recidiva
7.
Phys Rev Lett ; 120(24): 243002, 2018 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-29957009

RESUMO

We show that a system of three species of one-dimensional fermions, with an attractive three-body contact interaction, features a scale anomaly directly related to the anomaly of two-dimensional fermions with two-body contact forces. We show, furthermore, that those two cases (and their multispecies generalizations) are the only nonrelativistic systems with contact interactions that display a scale anomaly. While the two-dimensional case is well known and has been under study both experimentally and theoretically for years, the one-dimensional case presented here has remained unexplored. For the latter, we calculate the impact of the anomaly on the equation of state, which appears through the generalization of Tan's contact for three-body forces, and determine the pressure at finite temperature. In addition, we show that the third-order virial coefficient is proportional to the second-order coefficient of the two-dimensional two-body case.

8.
Aliment Pharmacol Ther ; 48(1): 5-14, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29722445

RESUMO

BACKGROUND: Ample evidence indicates an aetiological association of persistent hepatitis B virus (HBV) infection with hepatocellular carcinoma (HCC). Several viral, host and external risk factors for the development of HBV-related HCC have been documented. AIMS: To summarise and discuss the risk stratification and the preventive strategies of HBV-related HCC. METHODS: Recent published studies identified from PubMed were comprehensively reviewed. The key words included chronic hepatitis B, HBV, hepatocellular carcinoma, prevention and antiviral therapy. RESULTS: The incidence of HCC is extremely high in HBV hyperendemic areas. For HBV patients left untreated, significant risk factors for HCC include male gender, aging, advanced hepatic fibrosis, persistent serum transaminase elevation, specific HBV entry receptor (NTCP) genotype, PM2.5 exposure, HBeAg positivity, HBV genotype C/D/F, high proportion of core promoter mutation, pre-S deletion, high serum levels of HBV DNA and HBsAg as well as co-infection with HCV, HDV and HIV. Primary prevention of HBV-related HCC can be achieved through universal HBV vaccination and anti-viral prophylaxis for high viraemic mothers. The goal of secondary prevention has been reached by effective anti-viral therapy to reduce the risk of HCC development in chronic hepatitis B patients. However, whether HCC is prevented or delayed deserves further examination. Finally, several studies confirmed the tertiary preventive effect of anti-viral therapy in reducing risk of HCC recurrence after curative therapies. CONCLUSIONS: Through the strategies of three-level prevention, the global burden of HBV-related HCC should decline over time and even be eliminated in conjunction with HBV cure.


Assuntos
Carcinoma Hepatocelular/prevenção & controle , Hepatite B/complicações , Hepatite B/terapia , Neoplasias Hepáticas/prevenção & controle , Antivirais/uso terapêutico , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/virologia , Hepatite B/epidemiologia , Vírus da Hepatite B/genética , Hepatite B Crônica/complicações , Hepatite B Crônica/epidemiologia , Hepatite B Crônica/terapia , Humanos , Incidência , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/virologia , Medicina Preventiva/métodos , Fatores de Risco
9.
Lupus ; 27(8): 1240-1246, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29554836

RESUMO

Objective We conducted this study to assess the role of CHA2DS2-VASc score in predicting ischemic stroke among systemic lupus erythematosus (SLE) patients without atrial fibrillation (AF). Methods We selected the SLE patients from the Registry of Catastrophic Illnesses Patient Database in Taiwan. We excluded the SLE patients with AF or atrial flutter. The patients were followed up until the occurrence of ischemic stroke, censored for death or withdrawal from the dataset, or the end of follow-up. Cox models were performed to obtain the hazard ratios (HRs) and the 95% confidence intervals (CIs) of ischemic stroke associated with the CHA2DS2-VASc score. A receiver operating characteristic (ROC) curve was generated to evaluate the predictive ability of CHA2DS2-VASc score for ischemic stroke in SLE patients without AF. Results A total of 11,962 study participants were included in this study. The incidence of ischemic stroke increased from 4.00 per 1000 person-years (PYs) for patients with a CHA2DS2-VASc score of 0 to 87.4 per 1000 PYs for those with a CHA2DS2-VASc score of ≧6. Moreover, patients with a CHA2DS2-VASc score of ≧2 were 3.98-fold (95% CI 3.15-5.04) more likely to develop ischemic stroke than those with a CHA2DS2-VASc score of <2 (14.0 vs. 2.99 per 1000 PYs). ROC curve analysis of the CHA2DS2-VASc score demonstrated a moderate discrimination power for ischemic stroke development with a c-statistic of 0.65(95% CI 0.62-0.69). Conclusions We found that a CHA2DS2-VASc score greater than or equal to 2 in SLE patients without AF is associated with a significantly higher rate of ischemic stroke.


Assuntos
Isquemia Encefálica/epidemiologia , Lúpus Eritematoso Sistêmico/complicações , Índice de Gravidade de Doença , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Fibrilação Atrial , Isquemia Encefálica/etiologia , Comorbidade , Bases de Dados Factuais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Curva ROC , Medição de Risco , Fatores de Risco , Acidente Vascular Cerebral/etiologia , Taiwan/epidemiologia
10.
QJM ; 110(12): 815-820, 2017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-29025006

RESUMO

BACKGROUND: Subdural hematoma (SDH) is associated with a high mortality rate. The risk of SDH in cirrhotic patients has not been well studied. AIM: The aim of the study was to examine the risk of SDH in cirrhotic patients. DESIGN: A retrospective study from a universal insurance claims database of Taiwan. METHODS: A cohort of 9455 liver cirrhotic patients from 2000 to 2011 and an age-and sex-matched control cohort of 35992 subjects without cirrhosis were identified. The severity of liver cirrhosis was classified into uncomplicated and complicated according to presence of complications or not. The incidence and hazard ratio of SDH were measured by the end of 2011. RESULTS: The mean follow-up years were 4.34 ± 3.45 years in the cirrhosis cohort and 6.36 ± 3.28 years in the non-cirrhosis cohort. The incidence of SDH was 2.73-fold higher in the cirrhosis cohort than in the control cohort (29.3 vs. 10.9 per 10 000 person-years), with an adjusted hazard ratio of 2.73 (95% CI = 2.19-3.42), 2.42 (95% CI = 1.89-3.08), and 5.07 (95% CI = 3.38-7.60) in the all liver cirrhosis, the uncomplicated liver cirrhosis, and the complicated liver cirrhosis patients compared to the control cohort. The adjusted hazard ratios were 2.65 (95% CI = 2.06-3.41) for traumatic SDH and 3.09 (95% CI 1.91-5.02) for non-traumatic SDH in liver cirrhosis patients, compared to the controls. CONCLUSIONS: This study demonstrates that patients with cirrhosis are at higher risk of both traumatic and non-traumatic SDH than individuals without cirrhosis. The risk increases further in patients with complicated liver cirrhosis.

11.
Ann Oncol ; 28(10): 2575-2580, 2017 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-28961846

RESUMO

Background: Prostate cancer (PC) can be related to increased systemic oxidative stress and dihydrotestosterone level, which are also reported to be involved in the pathogenesis of age-related macular degeneration (AMD). We conducted a cohort study to determine whether patients with PC have an increased risk of AMD. Patients and methods: Data were collected from the Taiwan Longitudinal Health Insurance Database for the 1999-2010 period. The study PC cohort comprised 22 084 patients aged ≥18 years with a first diagnosis of PC. The comparison cohort consisted of age-, occupation-, and urbanization level-matched patients at a ratio of 1 : 1. The primary outcome was the incidence of AMD, which was evaluated using Kaplan-Meier survival analysis and proportional hazards modeling. Results: The mean follow-up periods (standard deviation) for the patients with AMD in the age-, occupation-, and urbanization level-matched PC cohort and non-PC cohorts were 4.69 (2.90) and 5.51 (2.82) years. The mean age of the PC cohort was 73.9 years and that of the non-PC cohort was 73.2 years, with approximately 85.9% of the patients aged >65 years. The PC cohort had a higher risk of AMD than did the propensity score-matched non-PC cohort with an adjusted hazard ratio of 1.25 (95% confidence interval, 1.12-1.39). Compared with PC cohort receiving no injection hormone therapy, the PC cohort receiving injection hormone therapy had a lower risk of AMD (adjusted hazard ratio, 0.56; 95% confidence interval, 0.41-0.76). Conclusion: PC is associated with an increased risk of AMD. Patients with PC receiving injected form of androgen deprivation therapy had a lower risk of AMD than patients with PC not receiving injected form of androgen-deprivation therapy.


Assuntos
Degeneração Macular/epidemiologia , Neoplasias da Próstata/epidemiologia , Idoso , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Risco , Taiwan/epidemiologia
12.
Osteoporos Int ; 28(12): 3415-3420, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28875313

RESUMO

This work aimed to evaluate the hip fracture risk for patients with burn injury. A total of 16,430 patients with burn injury had an adjusted hazard ratio of 1.54 to encounter a hip fracture, compared with controls without the injury. These results encourage future studies focusing on mechanisms leading to fracture associated with burn injury. INTRODUCTION: The relationship between burn injury and hip fracture risk is unclear. We conducted a retrospective cohort study to investigate this relationship. METHODS: From insurance data of Taiwan, we identified a cohort with 16,430 burn patients in 2000-2010 and a comparison cohort of 65,716 persons without the history of burn, frequency matched by sex, age, and diagnosis date. Both cohorts were followed up to the end of 2011 to evaluate the risk of hip fracture. RESULTS: Patients with burn injury were 1.62-fold more likely than comparisons to encounter a hip fracture (6.95 vs. 4.28 per 1000 person-years), with an adjusted hazard ratio (aHR) of 1.54 (95% confidence interval (CI) = 1.40-1.68). The fracture incidence increased with age and is slightly greater for women than for men in both cohorts. The fracture risk was greater for patients with burn in the eyes, face, and head with an incidence of 7.14 per 1000 person-years, or an aHR of 2.09 (95% CI = 1.53, 2.86). Diabetes and osteoporosis were also associated with an increased hip fracture risk. CONCLUSION: Burn injury is associated with an increased risk of hip fracture. Diabetes and osteoporosis are associated with an enhanced risk.


Assuntos
Queimaduras/epidemiologia , Fraturas do Quadril/epidemiologia , Fraturas por Osteoporose/epidemiologia , Adulto , Queimaduras/complicações , Comorbidade , Bases de Dados Factuais , Feminino , Fraturas do Quadril/etiologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Osteoporose/complicações , Osteoporose/epidemiologia , Fraturas por Osteoporose/etiologia , Estudos Retrospectivos , Medição de Risco/métodos , Fatores de Risco , Taiwan/epidemiologia
13.
Bone Joint Res ; 6(4): 253-258, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28450318

RESUMO

OBJECTIVES: Osteoarthritis (OA) is the most common form of arthritis, affecting approximately 15% of the human population. Recently, increased concentration of nitric oxide in serum and synovial fluid in patients with OA has been observed. However, the exact role of nitric oxide in the initiation of OA has not been elucidated. The aim of the present study was to investigate the role of nitric oxide in innate immune regulation during OA initiation in rats. METHODS: Rat OA was induced by performing meniscectomy surgery while cartilage samples were collected 0, 7, and 14 days after surgery. Cartilage cytokine levels were determined by using enzyme-linked immunosorbent assay, while other proteins were assessed by using Western blot RESULTS: In the time course of the study, nitric oxide was increased seven and 14 days after OA induction. Pro-inflammatory cytokines including tumour necrosis factor (TNF)-α, interleukin (IL)-1ß, and IL-6 were decreased. L-NG-Nitroarginine methyl ester (L-NAME, a non-specific nitric oxide synthase inhibitor) significantly decreased cartilage nitric oxide and blocked immune suppression. Further, L-NAME decreased Matrix metalloproteinase (MMPs) and increased tissue inhibitor of metalloproteinase (TIMP) expression in meniscectomised rats. CONCLUSION: Nitric oxide-dependent innate immune suppression protects cartilage from damage in the early stages of OA initiation in rats.Cite this article: C-C. Hsu, C-L. Lin, I-M. Jou, P-H. Wang, J-S. Lee. The protective role of nitric oxide-dependent innate immunosuppression in the early stage of cartilage damage in rats: Role of nitric oxide in ca rtilage da mage. Bone Joint Res 2017;6:253-258. DOI: 10.1302/2046-3758.64.BJJ-2016-0161.R1.

14.
QJM ; 110(7): 425-430, 2017 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-28062748

RESUMO

Background: Empyema is a rare but important complication among patients with end-stage renal disease (ESRD). However, a nationwide, propensity-matched cohort study has never been performed. Methods: We conducted a retrospective cohort study using data from the National Health Insurance Research Database of Taiwan. The ESRD group consisted of 82 765 patients diagnosed between 2000 and 2008. The comparison group consisted of individuals without kidney disease selected at a 1:1 ratio matched by propensity score estimated with age, gender, year of diagnosis and comorbidities. The occurrence of empyema was monitored until the end of 2011. The hazard ratios (HRs) of empyema were estimated using the Cox proportional hazards model. Results: The incidence of empyema was 2.76-fold higher in the ESRD group than in the comparison group (23.7 vs. 8.19/10 000 person-years, P <0.001), with an adjusted HR of 3.01 [95% confidence interval (CI) = 2.67-3.39]. There was no difference of the incidence of empyema between hemodialysis (HD) and peritoneal dialysis (PD) (adjusted HR = 0.96, 95% CI = 0.75-1.23). In addition, 30-day mortality rate since empyema diagnosis was significantly higher in ESRD group than the comparison group (15.9% vs. 10.9%), with an adjusted OR of 1.69 (95% CI = 1.17-2.44). Conclusion: The risk of empyema was significantly higher in patients with ESRD than in those without kidney disease. The occurrence of empyema was without difference in patients undergoing HD compared to those undergoing PD. The 30-day mortality rate since empyema diagnosis was also significantly higher in patients with ESRD.


Assuntos
Empiema/epidemiologia , Falência Renal Crônica/complicações , Falência Renal Crônica/mortalidade , Diálise Peritoneal/efeitos adversos , Diálise Renal/efeitos adversos , Adulto , Distribuição por Idade , Idoso , Comorbidade , Bases de Dados Factuais , Feminino , Humanos , Incidência , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Programas Nacionais de Saúde , Pontuação de Propensão , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Distribuição por Sexo , Taiwan/epidemiologia , Adulto Jovem
15.
Acta Neurol Scand ; 135(2): 197-203, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26932875

RESUMO

OBJECTIVE: We conducted a cohort study to investigate whether benign paroxysmal positional vertigo (BPPV) is correlated with an increased risk of dementia. METHODS: We established a case cohort comprising 7818 patients aged over 20 years who were diagnosed with BPPV from 2000 to 2010. In addition, we formed a control cohort by randomly selecting 31,272 people without BPPV and matched them with the BPPV patients according to gender, age, and index year. Cox proportional hazard regressions were performed to compute the hazard ratio (HR) of dementia after we adjusted for demographic characteristics and comorbidity. RESULTS: The prevalence of comorbidity was higher among patients with BPPV than among those without BPPV. In addition, patients with BPPV exhibited a 1.24-fold (95% confidence interval, CI 1.09-1.40; P < 0.001) higher risk of dementia than those without BPPV after we adjusted for age, gender, and comorbidity. An analysis stratified according to demographic factors revealed that women with BPPV exhibited a 1.36-fold (95% CI 1.16-1.59; P < 0.001) higher risk of dementia. Patients with BPPV aged over 65 years exhibited a significantly higher risk of dementia (adjusted HR: 1.26; 95% CI 1.10-1.43; P < 0.001) than those without BPPV. CONCLUSIONS: Patients with BPPV exhibited a higher risk of dementia than those without BPPV.


Assuntos
Vertigem Posicional Paroxística Benigna/diagnóstico , Vertigem Posicional Paroxística Benigna/epidemiologia , Demência/diagnóstico , Demência/epidemiologia , Adulto , Idoso , Estudos de Coortes , Comorbidade , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Distribuição Aleatória
16.
J Hum Hypertens ; 31(3): 220-224, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27511477

RESUMO

There is insufficient evidence to assess the risk for hypertension in patients with sleep disorders (SDs) in a large population-based cohort study. The aim of this study was to examine the risk of hypertension in groups both with and without SDs. Taiwan's National Health Insurance Research Database (NHIRD) data from 2005 to 2010 were used in a retrospective cohort study. A Cox proportional hazard regression analysis was used to evaluate the effects of SDs on hypertension risk. The overall incidence of hypertension was 120.7 per 1000 person-years for patients with SDs, which was significantly higher than that of the non-SD comparison cohort (76.4 per 1000 person-years). Overall, patients with SDs had a higher risk of hypertension compared with comparison cohort (adjusted hazard ratio (HR)=1.58, 95% confidence interval (CI)=1.26-1.79). Among patients aged <40 years, patients with SDs had a higher risk for hypertension than the comparison cohort (adjusted HR, 2.90 (95% CI, 2.46-3.14)). Compared with the cohort without insomnia, patients with insomnia had a 21% higher risk for hypertension (adjusted HR, 1.21 (95% CI, 1.01-1.76)). Compared with non-SD comparison cohort, patients with SDs had a higher risk for developing hypertension, particularly pronounced among those who were younger adults (age ⩽40 years) and who had insomnia. We suggest that possible persisting exposure to sleep problems was correlated with a greater risk of hypertension.


Assuntos
Hipertensão/complicações , Hipertensão/epidemiologia , Transtornos do Sono-Vigília/complicações , Transtornos do Sono-Vigília/epidemiologia , Adulto , Fatores Etários , Idoso , Comorbidade , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Sexuais , Taiwan/epidemiologia
17.
Epidemiol Psychiatr Sci ; 26(6): 664-671, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-27641623

RESUMO

AIM: To examine the incidence of asthma in adult patients with major depressive disorder (MDD). METHODS: From the National Health Insurance database of Taiwan, we identified 30 169 adult patients who were newly diagnosed with MDD between 2000 and 2010. Individuals without depression were randomly selected four times and frequency matched for sex, age and year of diagnosis. Both cohorts were followed-up for the occurrence of asthma up to the end of 2011. Adjusted hazard ratios (aHRs) of asthma were estimated using the Cox proportional hazards method. RESULTS: The overall incidence of asthma was 1.91-fold higher in the MDD cohort than in the non-depression cohort (7.55 v. 3.96 per 1000 person-years), with an aHR of 1.66 (95% confidence interval (CI) 1.55-1.78). In both cohorts, the incidence of asthma was higher in patients and controls who were female, aged, with comorbidities and users of aspirin or beta-adrenergic receptor blockers. No significant difference was observed in the occurrence of asthma between patients with MDD treated with selective serotonin reuptake inhibitors (SSRIs) and those treated with non-SSRIs (SSRIs to non-SSRIs aHR = 1.03, 95% CI 0.91-1.17). CONCLUSION: Adult patients with MDD are at a higher risk of asthma than those without depression are.


Assuntos
Idade de Início , Asma/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Adulto , Fatores Etários , Idoso , Antidepressivos de Segunda Geração/uso terapêutico , Asma/diagnóstico , Estudos de Casos e Controles , Estudos de Coortes , Bases de Dados Factuais , Transtorno Depressivo Maior/tratamento farmacológico , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Vigilância da População , Modelos de Riscos Proporcionais , Inibidores de Captação de Serotonina/uso terapêutico , Fatores Sexuais , Taiwan/epidemiologia
18.
Acta Neurol Scand ; 136(2): 129-137, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27781262

RESUMO

AIMS: Parkinson disease (PD) is a common neurodegenerative disease. The aim of this study was to evaluate the risk of PD in patients with organophosphate (OP) or carbamate (CM) poisoning by using the Taiwan National Health Insurance Research Database. METHODS: We conducted a retrospective study involving a cohort of 45 594 patients (9128 patients with a history of OP or CM poisoning and 36 466 control patients) who were selected from the Taiwan National Health Insurance Research Database. The patients were observed for a maximum of 12 years to determine the rates of new-onset PD, and a Poisson regression model was used to identify the predictors of PD. The cumulative incidence of PD between the two cohorts was plotted through Kaplan-Meier analysis. RESULTS: During the study period, the incidence rate ratio (IRR) of PD in the OP or CM poisoning patients was 1.36-fold [95% confidence interval (CI)=1.26-1.47] higher than that in the control patients in the multivariable model. The absolute incidence of PD was the highest for the group aged ≥75 years in both cohorts (77.4 vs 43.7 per 10 000 person-years). However, the age-specific relative risk was higher for the group aged <50 years (adjusted IRR=3.88; 95% CI=3.44-4.39). CONCLUSION: Our results suggest that the likelihood of developing PD is greater in patients with OP or CM poisoning than in those without poisoning. OP or CM poisoning may be an independent risk factor for PD.


Assuntos
Carbamatos/envenenamento , Intoxicação por Organofosfatos/diagnóstico , Intoxicação por Organofosfatos/epidemiologia , Doença de Parkinson/diagnóstico , Doença de Parkinson/epidemiologia , Adulto , Idoso , Estudos de Coortes , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Taiwan/epidemiologia
19.
Eur J Clin Microbiol Infect Dis ; 36(4): 611-617, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27837326

RESUMO

The correlation between hip replacement (Hip-Repl) and chronic osteomyelitis (COM) has not been studied in Asian populations. Thus, we assessed Hip-Repl-related risk of developing COM via a population-based, nationwide, retrospective cohort study. The Hip-Repl cohort was obtained from Taiwan's Longitudinal Health Insurance Database 2000, and included patients who underwent Hip-Repl between 2000 and 2010; the control cohort was also selected from this database. Patients with a history of COM were excluded in both cohorts. We used univariate and multivariate Cox proportional hazards regression models to calculate the adjusted hazard ratios (aHRs) by age, sex, and comorbidities for developing COM. A total of 5349 patients who received a Hip-Repl and 10,372 matched controls were enrolled. In the Hip-Repl group, the risk for COM was 4.18-fold [95 % confidence interval (CI) = 2.24-7.80] higher than that in the control group after adjustment. For patients aged ≤65 years, the risk was 10.0-fold higher (95 % CI = 2.89-34.6). Furthermore, the risk was higher in the Hip-Repl cohort than in the non-Hip-Repl cohort, for both patients without comorbidity (aHR = 16.5, 95 % CI = 2.07-132.3) and those with comorbidity (aHR = 3.49, 95 % CI = 1.78-6.83). The impact of Hip-Repl on the risk for COM was greater among patients not using immunosuppressive drugs, and occurred during the first postoperative year. Patients who received Hip-Repl have an increased risk of developing COM. This risk was higher among males and patients aged 65 years or younger, and during the first postoperative year.


Assuntos
Artroplastia de Quadril/efeitos adversos , Osteomielite/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Grupo com Ancestrais do Continente Asiático , Estudos de Casos e Controles , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição de Risco , Fatores Sexuais , Taiwan/epidemiologia , Adulto Jovem
20.
Aliment Pharmacol Ther ; 44(3): 213-22, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27302653

RESUMO

BACKGROUND: Current anti-viral therapies, interferon and nucleos(t)ide analogues, have been proven to reduce the progression of chronic hepatitis B (CHB). However, covalently closed circular DNA (cccDNA) of hepatitis B virus (HBV) persists, resulting in viral relapse after the discontinuation of treatment. AIM: To discuss and review novel therapies for chronic hepatitis B infection. METHODS: Recent published studies which searched from PubMed were comprehensive reviewed. The key words include chronic hepatitis B, hepatitis B virus cure, covalently closed circular DNA, direct acting anti-virals and host targeting agents. RESULTS: Several novel agents through viral and host targets approaches are under investigations towards functional cure of HBV. On the one hand, direct acting anti-virals targeting virus itself, such as HBV new polymerase inhibitor, entry inhibitor, engineered site-specific nucleases and RNA interference, could inhibit amplification of cccDNA as well as intrahepatic HBV infection and eliminate or silence cccDNA transcription. Inhibitors of HBV nucleocapsid assembly suppress capsid formation and prevent synthesis of HBV DNA. On the other hand, host targeting agents (HTA) include lymphotoxin-ß receptor agonist, toll-like receptor agonist, immune checkpoint inhibitors and adenovirus-based therapeutic vaccine. Through enhancing innate and adaptive immune responses, these agents could induce noncytolytic destruction of cccDNA or attack HBV-infected hepatocytes. CONCLUSION: With these promising approaches, we hope to reach global hepatitis B virus control in the middle of this century.


Assuntos
Hepatite B Crônica/terapia , Hepatite B/terapia , Terapias em Estudo/tendências , Antivirais/uso terapêutico , DNA Circular/análise , DNA Viral/análise , Hepatite B/tratamento farmacológico , Hepatite B/imunologia , Vírus da Hepatite B/genética , Vírus da Hepatite B/imunologia , Hepatite B Crônica/tratamento farmacológico , Hepatócitos/imunologia , Hepatócitos/patologia , Hepatócitos/virologia , Humanos , Imunoterapia Adotiva/métodos , Imunoterapia Adotiva/tendências , Terapias em Estudo/métodos
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