scholarly journals Migraines and keloids: a 15-year Taiwan claim database analysis

2021 ◽  
pp. postgradmedj-2020-139550
Author(s):  
Ying-Yi Lu ◽  
Hao Qin ◽  
Chun-Ching Lu ◽  
Ming-Kung Wu ◽  
Cong-Liang Zhang ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Transforming Growth Factor ◽  
Subsequent Development ◽  
Transforming Growth Factor Β1 ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Claim Database ◽  
Research Database ◽  
Hazard Ratios ◽  
Taiwan National Health Insurance

BackgroundFibroproliferative lesions with intractable pruritus, pain and hyperesthesia that cause uncontrolled scar growth are known as keloids. Migraines are common upsetting headache disorders characterised by frequent recurrence and attacks aggravated by physical activity. Both keloids and migraines can cause physical exhaustion and discomfort in patients; they have similar pathophysiological pathways, that is, the transforming growth factor-β1 gene and neurogenic inflammation.ObjectiveTo investigate subsequent development of migraines in patients with keloids.MethodsData were retrieved from the Taiwan National Health Insurance Research Database. The keloids group included patients aged 20 years and older with a recent diagnosis of keloids(n=9864). The non-keloids group included patients without keloids matched for gender and age at 1–4 ratio (n=39 456). Migraine risk between groups was measured by Cox proportional hazards regression models. Incidence rates and hazard ratios were calculated.ResultsDuring the study period, 103 keloids patients and 323 non-keloids patients developed migraines. The keloids patients had a 2.29-fold greater risk of developing migraines compared with the non-keloids group after adjustment for covariates (1.81 vs 0.55 per 1000 person-years, respectively). In the keloids group, female or patients younger than 50 years were prone to developing migraines.ConclusionThe higher tendency to develop migraines in the keloids group in comparison with the non-keloids group suggests that keloids could be a predisposing risk factor for migraine development in adults. Keloids patients who complain of headaches should be examined for migraines.

scholarly journals Association of Exposure to Hydrocarbons Air Pollution with Incidence of Atopic Dermatitis in Children

2020 ◽  
Author(s):  
Chieh Wang ◽  
Jeng-Dau Tsai ◽  
Lei Wan ◽  
Cheng-Li Lin ◽  
Chang-Ching Wei
Keyword(s):  
Air Pollution ◽  
Atopic Dermatitis ◽  
Proportional Hazards ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Air Pollutant ◽  
Research Database ◽  
Cox Proportional Hazards Models ◽  
Increased Risk ◽  
Taiwan National Health Insurance

Abstract Background:There is growing evidence that air pollution may act as an important environmental risk factor in the development and aggravation of childhood atopic dermatitis (AD). Methods:We collected data from the Taiwan National Health Insurance research database and linked the data to the Taiwan Air Quality-Monitoring Database. Children younger than 18 years old between January 1st, 2000 and until the diagnosis of AD was made, or December 31st, 2012, were selected from the database. We measured the incidence rate and hazard ratios for AD, and stratified by quartiles (Q1-Q4) of air pollutant concentration. Multivariable Cox proportional hazards models were also applied by adjusting for age, sex, monthly income, and level of urbanization. Results:Compared with those exposed to the concentrations in the Q1 quartile, the adjusted hazard ratio (HR) for AD increased, and total hydrocarbon (THC), non-methane hydrocarbon (NMHC), and methane (CH4) exposure concentrations ranged from 1.65 to 10.6, from 1.14 to 2.47, and from 1.70 to 11.9, respectively. Patients exposed to higher levels of THC, NMHC, and CH4 had greater accumulative incidence rates of childhood AD. Conclusions:The current study demonstrated that exposure to higher concentrations of THC, NMHC, and CH4 were associated with an increased risk of childhood AD.

Association of Scrub Typhus With the Risk of Autoimmune Diseases: A Population-Based Cohort Study

2019 ◽  
Vol 188 (7) ◽  
pp. 1311-1318 ◽  
Author(s):  
Kuo-An Chu ◽  
Weishan Chen ◽  
Chung Y Hsu ◽  
Yao-Min Hung ◽  
James Cheng-Chung Wei
Keyword(s):  
Autoimmune Diseases ◽  
Proportional Hazards ◽  
Scrub Typhus ◽  
Population Based ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
Research Database ◽  
Hazard Ratios ◽  
Taiwan National Health Insurance ◽  
The Relationship

Abstract Infection plays a major role in the development of autoimmune diseases. In this study, we investigated the relationship between scrub typhus and systemic autoimmune diseases. We enrolled 6,928 hospitalized patients with scrub typhus between 2000 and 2012 from the Taiwan National Health Insurance Research Database, and we compared them with 27,712 selected inpatients who had never been diagnosed with scrub typhus (1:4 ratio, matched by age, sex, and index year) in relation to the risk of developing autoimmune diseases. Cox proportional hazards regression analysis was used to analyze the risk of autoimmune diseases by sex, age, and comorbidities, with hazard ratios and 95% confidence intervals. The adjusted hazard ratio for autoimmune diseases for the scrub typhus group was 2.4 (95% confidence interval: 1.66, 3.48, P < 0.0001) compared with the control group. Subgroup analysis showed that women aged <40 years had a significant higher risk of autoimmune diseases. The risk was significantly higher within 3 years after scrub typhus infection. In conclusion, a higher risk of autoimmune diseases was found among the scrub typhus group, especially for female patients, those aged <40 years, and within the first 3 years after getting scrub typhus.

scholarly journals Association of exposure to hydrocarbon air pollution with the incidence of atopic dermatitis in children

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Chieh Wang ◽  
Chang-Ching Wei ◽  
Lei Wan ◽  
Cheng-Li Lin ◽  
Jeng-Dau Tsai
Keyword(s):  
Air Pollution ◽  
Atopic Dermatitis ◽  
Proportional Hazards ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Air Pollutant ◽  
Research Database ◽  
Cox Proportional Hazards Models ◽  
Increased Risk ◽  
Taiwan National Health Insurance

Abstract Background There is growing evidence suggesting that air pollution may act as an important environmental risk factor in the development and aggravation of childhood atopic dermatitis (AD). Methods We collected data from the Taiwan National Health Insurance (NHI) research database and linked the data to the Taiwan Air Quality-Monitoring Database. From January 1, 2000 to December 31, 2012; children aged below 18 years were selected from the database and followed longitudinally until the diagnosis of AD, withdrawal from the NHI, or December 31, 2012. Children with missing data or those diagnosed with AD before enrolment in this study were excluded. We measured the incidence rate and hazard ratios (HRs) for AD and stratified them by quartiles (Q1–Q4) of air pollutant concentration. Multivariable Cox proportional hazards models were also applied by adjusting for age, sex, monthly income, and level of urbanization. Results When compared with the concentrations of pollutants in the Q1 quartile, the adjusted HR for AD increased with an increase in the exposure concentrations of total hydrocarbons (THCs), non-methane hydrocarbons (NMHCs), and methane (CH4) from 1.65 (95% confidence interval [CI]: 1.47–1.84) to 10.6 (95% CI: 5.85–7.07), from 1.14 (95% CI: 1.06–1.24) to 2.47 (95% CI: 2.29–2.66), and from 1.70 (95% CI: 1.52–1.89) to 11.9 (95% CI: 10.8–13.1), respectively. Patients exposed to higher levels of THCs, NMHCs, and CH4 exhibited greater incidence rates of childhood AD. Conclusions The present study demonstrated that exposure to higher concentrations of THCs, NMHCs, and CH4 were associated with an increased risk of childhood AD.

scholarly journals Risk of Appendicitis among Children with Different Piped Water Supply: A Nationwide Population-Based Study

2018 ◽  
Vol 15 (8) ◽  
pp. 1601
Author(s):  
Hao-Ming Li ◽  
Shi-Zuo Liu ◽  
Ying-Kai Huang ◽  
Yuan-Chih Su ◽  
Chia-Hung Kao
Keyword(s):  
Water Supply ◽  
Proportional Hazards ◽  
Population Based ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Study Cohort ◽  
Research Database ◽  
Piped Water ◽  
Increased Risk

Appendicitis is a common surgical condition for children. However, environmental effects, such as piped water supply, on pediatric appendicitis risk remain unclear. This longitudinal, nationwide, cohort study aimed to compare the risk of appendicitis among children with different levels of piped water supply. Using data from Taiwan Water Resource Agency and National Health Insurance Research Database, we identified 119,128 children born in 1996–2010 from areas of the lowest piped water supply (prevalence 51.21% to 63.06%) as the study cohort; additional 119,128 children of the same period in areas of the highest piped water supply (prevalence 98.97% to 99.63%) were selected as the controls. Both cohorts were propensity-score matched by baseline variables. We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) of appendicitis in the study cohort compared to the controls by Cox proportional hazards regression. The study cohort had a raised overall incidence rates of appendicitis compared to the control cohort (12.8 vs. 8.7 per 10,000 person-years). After covariate adjustment, the risk of appendicitis was significantly increased in the study cohort (adjusted HR = 1.46, 95% CI: 1.35, 1.58, p < 0.001). Subgroup and sensitivity analyses showed consistent results that children with low piped water supply had a higher risk of appendicitis than those with high piped water supply. This study demonstrated that children with low piped water supply were at an increased risk of appendicitis. Enhancement of piped water availability in areas lacking adequate, secure, and sanitized water supply may protect children against appendicitis.

scholarly journals Risk of Endometriosis and Subsequent Ovary and Breast Cancers in Nurses: A Population-Based Cohort Study in Taiwan

2019 ◽  
Vol 16 (18) ◽  
pp. 3469 ◽  
Author(s):  
Hsing-Chi Hsu ◽  
Kai-Yu Tseng ◽  
Hsiang-Chi Wang ◽  
Fung-Chan Sung ◽  
Wei-Fen Ma
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Subsequent Development ◽  
Population Based ◽  
Research Database ◽  
Breast Cancers ◽  
Hazard Ratios ◽  
Taiwan National Health Insurance ◽  
And Control ◽  
Incident Cases

Background: Endometriosis has been associated with the subsequent development of ovarian and breast cancers. This study evaluated whether nurses were at increased risks of developing endometriosis and subsequent ovarian and breast cancers. Methods: From Taiwan National Health Insurance Research Database during 2000 to 2011, we established 3 study cohorts, consisting of 23,801 nurses, 11,973 other hospital employees, and 143,096 general women free of endometriosis and cancer. Women in all cohorts were followed to the end of 2011 to measure the occurrences of endometriosis and subsequent ovarian and breast cancers. The incident endometriosis cases and related hazard ratio (HR) and 95% confidence interval (CI) were calculated. The incident cases of ovarian cancer and breast cancer and related odds ratio were calculated. Results: The incidence of endometriosis was the highest in the nurse cohort (4.23 per 100, n = 966) followed by other health professionals (3.74 per 100, n = 427) and control cohort (3.06 per 100, n = 4193), with adjusted hazard ratios of 1.28 (95% CI = 1.20–1.38) and 1.13 (95% CI = 1.02–1.25), respectively, comparing to controls. Among those who developed endometriosis, nurses had higher subsequent ovarian cancer and lower breast cancer, but not significant. Conclusions: Nurses are at a higher risk of developing endometriosis. However, the link between endometriosis and subsequent cancers is weak.

scholarly journals Decreased risk of colorectal cancer among patients with type 2 diabetes receiving Chinese herbal medicine: a population-based cohort study

2020 ◽  
Vol 8 (1) ◽  
pp. e000732
Author(s):  
Jing-Siang Jhang ◽  
Hanoch Livneh ◽  
Shu-Yi Yang ◽  
Hui-Ju Huang ◽  
Michael W Y Chan ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Type 2 Diabetes ◽  
Cohort Study ◽  
Proportional Hazards ◽  
Herbal Medicines ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Research Database ◽  
Chinese Herbal

ObjectivesPatients with type 2 diabetes have a higher risk of colorectal cancer (CRC), but whether Chinese herbal medicines (CHMs) can reduce this risk is unknown. This study investigated the effect that CHMs have on CRC risk in patients with type 2 diabetes.Research design and methodsThis cohort study used the Taiwanese National Health Insurance Research Database to identify 54 744 patients, newly diagnosed with type 2 diabetes, aged 20–70 years, who were receiving treatment between 1998 and 2007. From this sample, we randomly selected 14 940 CHMs users and 14 940 non-CHMs users, using propensity scores matching. All were followed through 2012 to record CRC incidence. Cox proportional hazards regression was used to compute the hazard ratio (HR) of CRC by CHMs use.ResultsDuring follow-up, 235 CHMs users and 375 non-CHMs users developed CRC, incidence rates of 1.73% and 2.47% per 1000 person-years, respectively. CHM users had a significantly reduced risk of CRC compared with non-CHM users (adjusted HR=0.71; 95% CI 0.60 to 0.84). The greatest effect was in those receiving CHMs for more than 1 year. Huang-Qin, Xue-Fu-Zhu-Yu-Tang, Shu-Jing-Huo-Xue-Tang, Liu-Wei-Di-Huang-Wan, Ji-Sheng-Shen-Qi-Wan, Gan-Lu-Yin, Shao-Yao-Gan-Cao-Tang and Ban-Xia-Xie-Xin-Tang were significantly associated with lower risk of CRC.ConclusionIntegrating CHMs into the clinical management of patients with type 2 diabetes may be beneficial in reducing the risk of CRC.

scholarly journals Adherence to Statins Use and Risk of Dementia among Patients with Diabetes and Comorbid Hyperlipidemia

2021 ◽  
Vol 58 ◽  
pp. 004695802110192
Author(s):  
Ching-Yuan Chang ◽  
Fang-Ju Lin ◽  
Jin-Liern Hong ◽  
Chung-Hsuen Wu
Keyword(s):  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Research Database ◽  
Good Adherence ◽  
Neuroprotective Effects ◽  
Dementia Prevention ◽  
User Design ◽  
Patients With Diabetes ◽  
Taiwan National Health Insurance ◽  
Study Population

The results from previous observational studies and clinical trials about the neuroprotective benefits of statins use for the prevention of dementia are contradictory. It is unclear whether the neuroprotective benefits are experienced in a specific group with a higher risk of dementia, such as patients with concurrent diabetes and hyperlipidemia. We aimed to examine the association between adherence to statins and the risk of dementia among patients with diabetes and comorbid hyperlipidemia. This was a retrospective study with a new user design. We used data from the Taiwan National Health Insurance Research Database to identify patients with diabetes and comorbid hyperlipidemia. The occurrence of dementia was the study outcome. The adherence to statins was the exposure, which was measured by the proportion of days covered (PDC) of statins. The good adherence included patients with ≥80% PDC of statins. Cox proportional hazards regression models were used to evaluate the association between adherence to statins and dementia. Among 18,125 included individuals with diabetes and comorbid hyperlipidemia, 33.5% had good adherence to statins. Compared to poor adherence to statins, good adherence to statins was not significantly associated with a reduced risk of dementia (hazard ratio = 0.94; 95%confidence interval = 0.70–1.24) among patients with diabetes and comorbid hyperlipidemia. Good adherence to statins was not found to be associated with the risk of dementia among patients with diabetes and comorbid hyperlipidemia in Taiwan. Future studies with a more diverse study population are needed to evaluate the neuroprotective effects of statins use on dementia prevention.

scholarly journals Optic neuritis at the nexus of peripheral autoimmunity and central nervous system demyelination: a nationwide cohort study

2020 ◽  
Author(s):  
Wei-Sheng Lin ◽  
Ho-Min Chen ◽  
Chih-Chao Yang ◽  
Ta-Ching Chen ◽  
Jou-Wei Lin ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Cohort Study ◽  
Optic Neuritis ◽  
Lupus Erythematosus ◽  
Proportional Hazards ◽  
Subsequent Development ◽  
Cox Proportional Hazards ◽  
Research Database ◽  
Central Nervous System Demyelination

Abstract Background Long-term course of optic neuritis is heterogeneous and varies across populations. We aim to investigate immune-related determinants that predict conversion of optic neuritis (ON) to multiple sclerosis (MS) or neuromyelitis optica (NMO) in a nationwide cohort. Methods We conducted the population-based cohort study using data from Taiwan’s National Health Insurance Research Database. Incident ON cases during 2003~2014 were followed until the end of 2015. Pediatric and adult sub-cohorts were examined separately. The associations between immune-related comorbidities or treatment and outcomes were analyzed using Cox proportional hazards models. Results A total of 11923 adult and 1365 pediatric ON patients were enrolled. The rates of conversion to MS were 2.7% for adult and 3.1% for pediatric ON with median follow-up duration of 6.3 and 7.3 years respectively, while 1.2% of pediatric and adult ON evolved to NMO. Comorbid systemic lupus erythematosus was associated with increased risks of subsequent development of MS in adult (adjusted hazard ratio [aHR], 2.80; 95% CI, 1.04-7.49) and pediatric ON patients (aHR, 21.65; 95% CI, 1.29-363.4). Adult ON patients were at increased risks of NMO if comorbid with myasthenia gravis (aHR, 9.13; 95% CI, 1.20-69.45) or Sjogren’s syndrome (aHR, 4.71; 95% CI, 1.74-12.76). Conclusion ON could be the sentinel event linking several peripheral autoimmune comorbidities to distinct forms of central nervous system demyelination. The clinical context in which ON occurs should be taken into account in the care and counseling of these patients.

Abstract 90: Race, Ethnic, and Sex Disparities in Stroke Incidence in the Northern Manhattan Study

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Hannah Gardener ◽  
Ralph L Sacco ◽  
Tatjana Rundek ◽  
Consuelo Mora-McLaughlin ◽  
Ying Kuen Cheung ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Low Socioeconomic Status ◽  
Stroke Risk ◽  
Proportional Hazards ◽  
Population Based ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Stroke Incidence ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios

Background: An excess incidence of strokes among blacks vs whites has been shown previously, but data on disparities related to Hispanic ethnicity remains limited. This study examines race, ethnic, and sex differences in stroke incidence in the multi-ethnic, yet largely Caribbean Hispanic, Northern Manhattan Study (NOMAS). Methods: The study population included participants in the prospective population-based NOMAS, followed for a mean of 13±7 years. Cox proportional hazards models were constructed to estimate the hazard ratios and 95% confidence intervals (HR, 95%CI) for the association between race/ethnicity and sex with confirmed incident stroke of any subtype and ischemic stroke, stratified by age and adjusting for sociodemographics and vascular risk factors. Results: Among 3,298 participants (mean baseline age 69±10, 37% men, 24% black, 21% white, 52% Hispanic), 477 incident strokes accrued (394 ischemic, 43 ICH, 9 SAH). The most common ischemic subtype was cardioembolic, followed by lacunar infarcts, then cryptogenic. The greatest incidence rate was observed in blacks (13/1000 person-years [PY]), followed by Hispanics (11/1000 PY), and lowest in whites (8/1000 PY), and this order was observed for crude incidence rates until age 75. By age 85 the greatest incidence rate was in Hispanics. Blacks had an increased stroke risk vs whites overall in fully adjusted models (HR=1.37, 95% CI=1.02-1.84), and stratified analyses showed that this disparity was driven by women age ≥70 (HR=1.69, 1.05-2.73). The increased rate of stroke observed for Hispanics (age/sex-adjusted HR=1.50, 1.15-1.94) was largely explained by education and insurance status (a proxy for socieoeconomic status; HR after further adjusting for these variables=1.15, 0.84-1.58), but remained significant for women age ≥70. Men had an increased rate of stroke compared to women (fully adjusted HR=1.48, 1.21-1.81). Conclusions: This study provides novel data regarding the increased stroke risk among Caribbean Hispanics. Results highlight the need to create culturally-tailored campaigns to reach blacks and Hispanic populations to reduce race/ethnic stroke disparities, and support the important role of low socioeconomic status in driving an elevated risk among Caribbean Hispanics.

Increased risk of trigeminal neuralgia in patients with migraine: A nationwide population-based study

Cephalalgia ◽  
2016 ◽  
Vol 36 (13) ◽  
pp. 1218-1227 ◽  
Author(s):  
Kuan-Hsiang Lin ◽  
Yung-Tai Chen ◽  
Jong-Ling Fuh ◽  
Shuu-Jiun Wang
Keyword(s):  
Trigeminal Neuralgia ◽  
Proportional Hazards ◽  
Underlying Mechanism ◽  
Population Based ◽  
Incidence Rates ◽  
Cox Proportional Hazards ◽  
Sensitivity Analyses ◽  
Research Database ◽  
Increased Risk ◽  
Using Data

Objectives The objectives of this article are to evaluate the association between migraine and trigeminal neuralgia and to investigate the effects of age, sex, migraine subtype, and comorbid risk factors on trigeminal neuralgia development. Methods This population-based cohort study was conducted using data from Taiwan’s National Health Insurance Research Database. Individuals aged ≥ 20 years with neurologist-diagnosed migraine between 2005 and 2009 were included. A non-headache age-, sex-, and propensity score-matched control cohort was selected for comparison. All participants were followed until the end of 2010, death, or the occurrence of trigeminal neuralgia. Cox proportional hazards regression was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for comparison of the risk of trigeminal neuralgia between groups. Results Both cohorts ( n = 137,529 each) were followed for a mean of 3.1 years. During the follow-up period, 575 patients (421,581 person-years) in the migraine cohort and 88 matched controls (438,712 person-years) were newly diagnosed with trigeminal neuralgia (incidence rates, 136.39 and 20.06/100,000 person-years, respectively). The HR for trigeminal neuralgia was 6.72 (95% CI, 5.37–8.41; p < 0.001). The association between migraine and trigeminal neuralgia remained significant in sensitivity analyses. Among migraine subtypes, patients with migraine with aura were at greater risk of trigeminal neuralgia development. No other significant interaction was identified in subgroup analyses. Conclusions Migraine is a previously unidentified risk factor for trigeminal neuralgia. The association between these conditions suggests a linked underlying mechanism, which is worthy of further exploration.

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