scholarly journals Population-Based Study of the Association between Urbanization and Kawasaki Disease in Taiwan

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Wei-Pin Chang ◽  
Shyh-Jong Wu ◽  
Wei-Chiao Chang ◽  
Ho-Chang Kuo

Background.It is unclear if the prevalence of Kawasaki disease (KD) correlates with the degree of urbanization. We hypothesized that the prevalence of KD is more pronounced in urban versus rural environments.Methods.The National Health Insurance (NHI) program was implemented in Taiwan in 1995 and covers most of the population (>99%). We used the NHI database to investigate the epidemiological features of KD. A total of 115 diagnosed patients with KD from 1997 to 2010 were included, together with 1,150 matched controls without KD. Chi-square analyses were performed to investigate the difference between modern city and rural environments.Results.Of the 1265 sampled subjects (claims data from 1,000,000 random subjects), the mean age of the KD study group and control group was 2.08 ± 1.66 and 2.08 ± 1.64 years, respectively. After matching for age, sex, and same index date, no statistically significant differences in urbanization level and geographical location of the patients' residence were observed.Conclusion.Urbanization did not appear to be an important effect modifier of Kawasaki disease in Taiwan.

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0033
Author(s):  
Karan Malhotra ◽  
Oliver Chan ◽  
Nicholas Cullen ◽  
Matthew Welck ◽  
Andrew Goldberg ◽  
...  

Category: Other Introduction/Purpose: Gastrocnemius tightness (GT) is thought to predispose patients to multiple musculoskeletal pathologies including back pain, plantar fasciitis, and metatarsalgia. It is thought to be especially prevalent in patients with foot and ankle pathology (FAP) and consequently there is an emerging trend to perform lengthening / release procedures in this patient group. However, it is not clear what proportion of the normal population has GT and how this differs in patients with FAP. We set out to investigate what the incidence and degree of GT in the foot and ankle population is compared to the normal population. Methods: This was a prospective study comparing GT in a cohort of patients with FAP with GT in controls matched for age, gender, and ethnicity. The control group consisted of healthy adult volunteers and the FAP group consisted of patients presenting to our Foot & Ankle unit. Patients with previous surgery, tendoachilles tightness, or ankle arthritis were excluded. GT was measured using a digital inclinometer and the lunge test. It was calculated as the difference between maximal ankle dorsiflexion with the knee extended and with the knee flexed. Data on the control group was collected first and a power calculation suggested a FAP cohort size of 91 feet was required to detect a 2° difference in GT (a= 0.05, ß = 0.05, Ratio 3:1). Results: After case-matching 97 FAP cases were paired with 291 controls for analysis. Mean GT was 8.0° ±5.7° (range: 0-21°) in FAP patients versus 6.0° ±3.5° (range: 0-16°) in controls (p<0.001). Regression analysis demonstrated demographics including BMI and activity level were not significant determinants of GT in the FAP group (r=0.141, p=0.599). Subgroup analysis of the FAP group revealed a mean GT of 10.3° ±6.0° in patients with forefoot pathology (FoP) versus 6.9° ±5.3° in the other FAP patients (NFoP) (p=0.008). When comparing the NFoP group to the controls, there was no difference in GT (p=0.188). In total 21 FAP patients (21.6%) and 12 FoP patients (37.5%) had GT greater than 2 standard deviations of the control group (Figure 1). Conclusion: This population based study demonstrates increased GT in the FAP population versus the normal population; however, in patients without forefoot pathology, this difference may not be clinically relevant. Over a third of patients with forefoot pathology have GT which is greater than the normal population range. We conclude that not all patients with foot and ankle pathology have inherently increased GT, compared with the normal population, but it is reasonably common in patients with forefoot pathology. Further work is required to define what degree of GT may be considered significant, to determine which patients will benefit from surgical treatment.


2007 ◽  
Vol 122 (1) ◽  
pp. 61-64 ◽  
Author(s):  
İ Aladag ◽  
Y Bulut ◽  
M Guven ◽  
A Eyibilen ◽  
K Yelken

AbstractBackground and objectives:Chronic nonspecific pharyngitis is a chronic inflammation of the pharynx. It is found worldwide, and treatment is difficult. The underlying aetiopathogenesis is still controversial. The aim of this study was to investigate Helicobacter pylori seroprevalence in chronic nonspecific pharyngitis patients without other possible causative factors for chronic pharyngeal irritation and without H pylori gastric mucosal infection.Materials and methods:Forty-one patients with symptoms of chronic nonspecific pharyngitis and 30 healthy control subjects were enrolled in this prospective, controlled, clinical study. In both study and control groups, selected patients were shown to have gastric mucosa uninfected by H pylori, as demonstrated by the 14C-urea breath test. Comprehensive otorhinolaryngological examination did not elicit any factor contributing to the chronic pharyngeal complaint. Serum H pylori immunoglobulin G antibody titres were assayed using serum enzyme-linked immunosorbent assay. The difference between the study and control groups was analysed by the chi-square test (the likelihood ratio was used).Results:Thirty-two of the 41 patients (78 per cent) and 14 of the 30 control subjects (46.7 per cent) were found to be H pylori positive. Patients with chronic nonspecific pharyngitis were found to have a significantly higher rate of H pylori seropositivity than the control group (p = 0.016).Conclusion:These data may be important in developing future treatment strategies for chronic nonspecific pharyngitis.


2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sheng-Wen Hou ◽  
Yi-Kung Lee ◽  
Chen-Yang Hsu ◽  
Ching-Chih Lee ◽  
Yung-Cheng Su

Study Objective. Antibiotics prescriptions for upper respiratory infections (URI) are not uncommon, but the benefits for these groups had seldom been evaluated. We aimed to utilize a sampled National Health Insurance (NHI) claims data containing one million beneficiaries to explore if the use of antibiotics could reduce the possibility of unscheduled returns. Methods. We identified patients presented to ambulatory clinics with the discharged diagnoses of URI. The prescriptions of antibiotics were identified. We further matched each patient in the antibiotic group to the patient in the control group by selected covariates using a standard propensity score greedy-matching algorithm. The risks of unscheduled revisits were compared between the two groups. Results. A total of 6915140 visits were identified between 2005 and 2010. The proportions of antibiotics prescriptions are similar among these years, ranging from 9.99% to 13.38 %. In the propensity score assignment, 9190 patients (4595 in each group) were further selected. The odds ratio of unscheduled revisits among antibiotics group and control group was 0.92 (95% CI, 0.70–1.22) with P value equal to 0.569. Conclusions. Overall, antibiotics prescriptions did not seem to decrease the unscheduled revisits in patients presented to the ED with URI. Emergency physicians should reduce the unnecessary prescriptions and save antibiotics to patients with real benefits.


2020 ◽  
Vol 26 (3) ◽  
pp. 311-321
Author(s):  
Jeong-Hui Nam ◽  
Hyun-Sook Park

Purpose: This study examined the effects of a loving-kindness and compassion meditation program on the empathy, emotion, and stress of nursing college students.Methods: A pre-posttest experimental design with a non-equivalent control group was applied. The participants were 39 nursing college students (experimental group: 19, control group: 20). The loving-kindness and compassion meditation program for nursing college students took 8 weeks. Data was collected from February 2016 to March 2016, and was analyzed by Chi-square test and independent t-test using IBM SPSS/WIN 19.0.Results: The difference between the experiment group and control group was statistically significant in empathy, negative affect, and perceived stress.Conclusion: The results indicate that the loving-kindness and compassion meditation program was effective for empathy improvement and stress management of nursing college students.


BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e018714 ◽  
Author(s):  
Yu-Chieh Lin ◽  
Chih-Cheng Lai ◽  
Chih-Chiang Chien ◽  
Chin-Ming Chen ◽  
Shyh-Ren Chiang ◽  
...  

ObjectivesTo determine whether insomnia at baseline is a risk factor for new-onset asthma.MethodsWe recruited 48 871 patients with insomnia (insomnia group) newly diagnosed between 2002 and 2007, and 97 742 matched controls without insomnia (control group) from Taiwan’s Longitudinal Health Insurance Database 2000. All of the patients were followed up for 4 years to see whether new-onset asthma developed. Patients with previous asthma or insomnia were excluded. The Poisson regression was used to estimate the incidence rate ratios (IRRs) and 95% CIs of asthma. Cox proportional hazard regression was used to calculate the risk of asthma between the two groups.ResultsAfter a 4-year follow-up, 424 patients in the insomnia group and 409 in the control group developed asthma. The incidence rate of asthma was significantly higher in the insomnia group (22.01vs10.57 per 10 000 person-years). Patients with insomnia have a higher risk of developing new-onset asthma during the 4-year follow-up (HR: 2.08, 95% CI 1.82 to 2.39). The difference remained significant after adjustment (adjusted HR: 1.89, 95% CI 1.64 to 2.17).ConclusionsThis large population-based study suggests that insomnia at baseline is a risk factor for developing asthma.


2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Peng Yeong Woon ◽  
Wei Chiao Chang ◽  
Chi-Cheng Liang ◽  
Chun Hung Hsu ◽  
Sukhontip Klahan ◽  
...  

Kawasaki disease (KD) is an acute febrile systemic vasculitis and has been reported to be associated with allergic disease. The risk of atopic dermatitis (AD) in preschool children with KD has not been investigated. The study was to determine the longitudinal risk of the development of AD in preschool children with KD. A nationwide 5-year population-based study was performed using data from the National Health Insurance Database in Taiwan between 1999 and 2003. The risk factors for AD were compared between the 2 study groups during the follow-up period using the Cox proportional hazards model. In addition, plasma interleukin (IL)-5 levels were analyzed in normal subjects and KD patients. Among the 1440 subjects included, 21.6% developed AD during the 5-year follow-up period, of which 30.3% and 18.7% belonged to the study cohort and the comparison group, respectively. Children with KD were 1.25 times more likely to have AD than those in controls (P=0.04). Levels of IL-5 and IgE were significantly higher in KD patients. Children with KD had a higher risk of developing AD during the 5-year follow-up period than the control group. Increased IL-5 and IgE levels may be key factors contributing to the risk of AD.


Author(s):  
Yi-Wei Kao ◽  
Ben-Chang Shia ◽  
Huei-Chen Chiang ◽  
Mingchih Chen ◽  
Szu-Yuan Wu

Accumulating evidence has shown a significant correlation between periodontal diseases and systemic diseases. In this study, we investigated the association between the frequency of tooth scaling and acute myocardial infarction (AMI). Here, a group of 7164 participants who underwent tooth scaling was compared with another group of 7164 participants without tooth scaling through propensity score matching to assess AMI risk by Cox’s proportional hazard regression. The results show that the hazard ratio of AMI from the tooth scaling group was 0.543 (0.441, 0.670) and the average expenses of AMI in the follow up period was USD 265.76, while the average expenses of AMI in follow up period for control group was USD 292.47. The tooth scaling group was further divided into two subgroups, namely A and B, to check the influence of tooth scaling frequency on AMI risk. We observed that (1) the incidence rate of AMI in the group without any tooth scaling was 3.5%, which is significantly higher than the incidence of 1.9% in the group with tooth scaling; (2) the tooth scaling group had lower total medical expenditures than those of the other group because of the high medical expenditure associated with AMI; and (3) participants who underwent tooth scaling had a lower AMI risk than those who never underwent tooth scaling had. Therefore, the results of this study demonstrate the importance of preventive medicine.


Author(s):  
Ellahe Mohyadin ◽  
Zohreh Ghorashi ◽  
Zahra Molamomanaei

AbstractBackgroundAnxiety and fear of labor pain has led to elevated cesarean section rate in some countries. This study was conducted to investigate the effect of yoga in pregnancy on anxiety, labor pain and length of labor stages.MethodsThis clinical trial study was performed on 84 nulliparous women who were at least 18 years old and were randomly divided into two groups of yoga and control groups. Pregnancy Yoga Program consisting of 6 60-min training sessions was started every 2 weeks from week 26 of pregnancy and continued until 37 weeks of gestation. Anxiety severity at maternal admission to labor was measured by the Spielbergers State-Trait Anxiety Inventory, and labor pain was measured by Visual Analogue Scale (VAS) at dilatation (4–5 cm) and 2 h after the first measurement. Data were analyzed using Chi-Square and t-test.ResultsIntervention group reported less pain at dilatation (4–5 cm) (p=0.001) and 2 h after the first measurement (p=0.001) than the control group. Stat anxiety was also lower in intervention group than the control group (p=0.003) at the entrance to labor room. Subjects in the control group required more induction compared to intervention group (p=0.003). Women in intervention group experienced shorter duration of the first phase of the labor than the control group (p=0.002). Also, the total duration of two stages of labor was shorter in intervention group than the control group (p=0.003).ConclusionsPracticing yoga during pregnancy may reduce women’s anxiety during labor; shorten labor stages, and lower labor pain.


2021 ◽  
Vol 10 (7) ◽  
pp. 1381
Author(s):  
Hun-Ju Yu ◽  
Meng-Ni Chuang ◽  
Chiao-Lun Chu ◽  
Pei-Lin Wu ◽  
Shu-Chen Ho ◽  
...  

Kawasaki disease (KD) is a systemic vasculitis that primarily affects children under the age of 5 years old. The most significant complication is coronary artery lesions, but several ocular manifestations have also been reported. Recently, one study revealed an increasing incidence of myopia among KD patients. Therefore, the aim of this study was to assess the difference in myopic incidence between Kawasaki disease (KD) patients treated with aspirin and intravenous immunoglobulin (IVIG). Materials and methods: We carried out a nationwide retrospective cohort study by analyzing the data of KD patients (ICD-9-CM code 4461) from Taiwan’s National Health Insurance Research Database (NHIRD) during the period of 1996–2013. Results: A total of 14,102 diagnosed KD were found in Taiwan during the study period. After excluded missing data, treatment strategy and age distribution, a total of 1446 KD patients were enrolled for analysis including 53 of which received aspirin (without IVIG) and 1393 of which were treated with IVIG. Patients who had myopia, astigmatism, glaucoma, cataract, etc. prior to their KD diagnosis were excluded. The age range was 0 to 6 years old. According to the cumulative curves, our results demonstrated that the myopic incidence in the IVIG group was significantly lower than the aspirin group (hazard ratio: 0.59, 95% confidence intervals: 0.36~0.96, p = 0.02). Treatment with IVIG for KD patients may have benefit for myopia control. Conclusion: Compared to aspirin, IVIG may decrease the myopic risk in KD patients. However, it needs further investigation including clinical vision survey of myopia due to the limitations of this population-based study.


1998 ◽  
Vol 16 (2) ◽  
pp. 397-404 ◽  
Author(s):  
O T Jóhannsson ◽  
J Ranstam ◽  
A Borg ◽  
H Olsson

PURPOSE Recent studies indicate that BRCA1 breast and ovarian tumors may have an advantageous survival. In this population-based study, the survival of carriers of a mutated BRCA1 gene was investigated. PATIENTS AND METHODS The survival of 71 BRCA1-associated cancer patients (33 breast cancer, seven breast and ovarian cancer, and 31 ovarian cancer patients from 21 families with BRCA1 germline mutations) diagnosed after 1958 was compared with that of a population-based comparison group that consisted of all other invasive breast (n = 28,281) and ovarian (n = 7,011) cancers diagnosed during 1958 to 1995, as well as an age- and stage-matched control group. RESULTS No apparent survival advantage was found for BRCA1-associated breast cancers upon direct comparison. After adjustment for age and calendar year of diagnosis, survival was equal to or worse than that of the comparison group (hazards ratio [HR], 1.5; 95% confidence interval [CI], 0.9 to 2.4). In comparison with an age- and stage-matched control group, survival again appeared equal or worse (HR, 1.5; 95% CI, 0.6 to 3.7). For BRCA1-associated ovarian cancers, an initial survival advantage was noted that disappeared with time. Due to this time dependency, multivariate analyses cannot adequately be analyzed. Compared with the age- and stage-matched control group, survival again appeared equal or worse (HR, 1.2; 95% CI, 0.5 to 2.8). CONCLUSION The results suggest that survival for carriers of a BRCA1 mutation may be similar, or worse than, that for breast and ovarian cancer in general. This finding is in accordance with the adverse histopathologic features observed in BRCA1 tumors and underlines the need for surveillance in families that carry a BRCA1 mutation.


Sign in / Sign up

Export Citation Format

Share Document