scholarly journals α-Glucosidase Inhibitor Can Effectively Inhibit the Risk of Tuberculosis in Patients with Diabetes: A Nested Case-Control Study

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Kai-Huang Lin ◽  
Ci-Wen Luo ◽  
Shih-Pin Chen ◽  
Dom-Gene Tu ◽  
Ming-Shian Lin ◽  
...  
Keyword(s):  
International Classification Of Diseases ◽  
Infection Risk ◽  
Research Database ◽  
High Concentration ◽  
Low Concentration ◽  
Glucosidase Inhibitors ◽  
Patients With Diabetes ◽  
Classification Of Diseases ◽  
Nested Case Control

Diabetes mellitus (DM) and tuberculosis (TB) are major public health and economic burdens. DM increases Mycobacterium tuberculosis (M.tb) infection rates and treatment durations. This study evaluated the relationship between five classes of oral DM medications and TB infection risk in DM patients. We used longitudinal records from the Taiwan Longitudinal Health Insurance Research Database. DM patients were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 250 and A code A181. TB patients were identified using ICD-9-CM code 010.x-017.x. Oral DM medications were divided into five classes: sulfonylureas, biguanides, meglitinides, α-glucosidase inhibitors (AGIs), and thiazolidinediones. Users were classified as nonusers, low-concentration users, and high-concentration users. The incidence rate ratio (IRR) was derived using multivariate Poisson regression to calculate the relative risk of TB infection. DM patients using low- and high-concentration AGIs had significantly lower TB infection risks compared with nonusers. The IRRs of the sulfonylureas and AGI users were [CI] 0.693–0.948) and (95% CI 0.651–0.995), respectively. The other four classes of medications exhibited no significant effect on TB infection risk in DM patients. Furthermore, DM patients using high-concentration AGIs had a significantly lower TB infection risk compared with those using low-concentration AGIs (IRR 0.918, 95% CI: 0.854–0.987). We noted a dose-response relationship in the effects of DM medications on TB risk. Accordingly, we suggest that DM patients use AGIs to benefit from their protective effect on TB infection risk.

scholarly journals Patient Outcomes following Subarachnoid Hemorrhage between the Medical Center and Regional Hospital: Whether All Patients Should Be Transferred to Medical Centers

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Tsung-Ying Lin ◽  
Chieh Hsin Wu ◽  
Wei-Che Lee ◽  
Chao-Wen Chen ◽  
Liang-Chi Kuo ◽  
...  
Keyword(s):  
Health Insurance ◽  
Subarachnoid Hemorrhage ◽  
Hospital Volume ◽  
Medical Center ◽  
International Classification Of Diseases ◽  
Research Database ◽  
Medical Centers ◽  
Classification Of Diseases ◽  
Comorbidity Index

Subarachnoid hemorrhage (SAH) is a critical illness that may result in patient mortality or morbidity. In this study, we investigated the outcomes of patients treated in medical center and nonmedical center hospitals and the relationship between such outcomes and hospital and surgeon volume. Patient data were abstracted from the National Health Insurance Research Database of Taiwan in the Longitudinal Health Insurance Database 2000, which contains all claims data of 1 million beneficiaries randomly selected in 2000. The International Classification of Diseases, Ninth Revision, subarachnoid hemorrhage (430) was used for the inclusion criteria. We identified 355 patients between 11 and 87 years of age who had subarachnoid hemorrhage. Among them, 32.4% (115/355) were men. The median Charlson comorbidity index (CCI) score was 1.3 (SD ± 0.6). Unadjusted logistic regression analysis demonstrated that low mortality was associated with high hospital volume (OR = 3.21; 95% CI: 1.18–8.77). In this study, we found no statistical significances of mortality, LOS, and total charges between medical centers and nonmedical center hospitals. Patient mortality was associated with hospital volume. Nonmedical center hospitals could achieve resource use and outcomes similar to those of medical centers with sufficient volume.

scholarly journals Progress of Diabetic Severity and Risk of Dementia

2015 ◽  
Vol 100 (8) ◽  
pp. 2899-2908 ◽  
Author(s):  
Wei-Che Chiu ◽  
Wen-Chao Ho ◽  
Ding-Lieh Liao ◽  
Meng-Hung Lin ◽  
Chih-Chiang Chiu ◽  
...  
Keyword(s):  
Severity Index ◽  
International Classification Of Diseases ◽  
Population Based ◽  
International Classification ◽  
Diabetic Patients ◽  
Research Database ◽  
Classification Of Diseases ◽  
New Onset

Context: Diabetes is a risk factor for dementia, but the effects of diabetic severity on dementia are unclear. Objective: The purpose of this study was to investigate the association between the severity and progress of diabetes and the risk of dementia. Design and Setting: We conducted a 12-year population-based cohort study of new-onset diabetic patients from the Taiwan National Health Insurance Research Database. The diabetic severity was evaluated by the adapted Diabetes Complications Severity Index (aDCSI) from the prediabetic period to the end of follow-up. Cox proportional hazard regressions were used to calculate the hazard ratios (HRs) of the scores and change in the aDCSI. Participants: Participants were 431,178 new-onset diabetic patients who were older than 50 years and had to receive antidiabetic medications. Main Outcome: Dementia cases were identified by International Classification of Diseases, ninth revision, code (International Classification of Diseases, ninth revision, codes 290.0, 290.1, 290.2, 290.3, 290.4, 294.1, 331.0), and the date of the initial dementia diagnosis was used as the index date. Results: The scores and change in the aDCSI were associated with the risk of dementia when adjusting for patient factors, comorbidity, antidiabetic drugs, and drug adherence. At the end of the follow-up, the risks for dementia were 1.04, 1.40, 1.54, and 1.70 (P < .001 for trend) in patients with an aDCSI score of 1, 2, 3, and greater than 3, respectively. Compared with the mildly progressive patients, the adjusted HRs increased as the aDCSI increased (2 y HRs: 1.30, 1.53, and 1.97; final HRs: 2.38, 6.95, and 24.0 with the change in the aDCSI score per year: 0.51–1.00, 1.01–2.00, and > 2.00 vs < 0.50 with P < .001 for trend). Conclusions: The diabetic severity and progression reflected the risk of dementia, and the early change in the aDCSI could predict the risk of dementia in new-onset diabetic patients.

Epidemiology and Medication Pattern Change of Psoriatic Diseases in Taiwan from 2000 to 2013: A Nationwide, Population-based Cohort Study

2018 ◽  
Vol 45 (3) ◽  
pp. 385-392 ◽  
Author(s):  
James Cheng-Chung Wei ◽  
Lin-Hong Shi ◽  
Jing-Yang Huang ◽  
Xue-Fen Wu ◽  
Rui Wu ◽  
...  
Keyword(s):  
Anatomical Therapeutic Chemical ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Incidence Rates ◽  
Research Database ◽  
Chi Square ◽  
Classification Code ◽  
Classification Of Diseases ◽  
Taiwan National Health Insurance

Objective.To analyze the trend of prevalence and incidence rates for psoriatic arthritis (PsA) and psoriasis in Taiwan, and to determine the changes in medication patterns.Methods.Data were collected from the Taiwan National Health Insurance Research Database, which covered at least 95% of the population from 2000 to 2013. International Classification of Diseases, 9th edition (ICD-9) was used to identify PsA (ICD-9 696.0) and other psoriasis (ICD-9 696.1). Medications were identified by Anatomical Therapeutic Chemical Classification code. We calculated the annual age standardized prevalence and incidence rate of PsA and psoriasis in individuals aged ≥ 16 years from 2000 to 2013, and used the Poisson regression to test the trends by Wald chi-square statistic.Results.The prevalence (per 100,000 population) of psoriatic diseases between 2000 and 2013 increased from 11.12 to 37.75 for PsA, and from 179.2 to 281.5 for psoriasis. The incidence (per 100,000 person-yrs) increased from 3.64 to 6.91 in PsA, while there was no significant change in psoriasis. Prevalence and incidence in PsA were more rapidly increased than in psoriasis. Sex ratio (men to women) of PsA decreased from 2.0 to 1.5 in 2000 and 2013, respectively. There was an increase in the use of disease-modifying antirheumatic drugs (DMARD), especially biologics, which is significantly different from topical therapies.Conclusion.The prevalence and incidence rates of psoriatic disease, especially PsA, were increasing in Taiwan. The medication pattern showed an increase in DMARD and biologics, while use of topical therapies decreased.

The Epidemiology of Benign Voice Disorders in Taiwan: A Nationwide Population-Based Study

2019 ◽  
Vol 128 (5) ◽  
pp. 406-412 ◽  
Author(s):  
Ying-Ta Lai ◽  
Yuan-Hung Wang ◽  
Yu-Chun Yen ◽  
Tzu-Yun Yu ◽  
Pin-Zhir Chao ◽  
...  
Keyword(s):  
Adult Population ◽  
Voice Disorders ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Research Database ◽  
Age Group ◽  
Classification Of Diseases ◽  
General Adult Population ◽  
Study Participants

Objective: Because there are few population-based studies regarding the epidemiology of benign voice diseases, the present study used a nationwide population-based claims database (the National Health Insurance Research Database) to investigate the epidemiology of benign voice diseases among the general adult population in Taiwan. Methods: Study participants were retrieved for those patients who were 20 to 90 years old with a diagnosis of benign voice diseases that were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes from 2006 to 2014. Patient visits were grouped into infectious (ICD-9-CM: 012.3, 032.3, 034.0, 090.5, 095.8,101, 464.0, 464.20, 464.21, 465.x, 476.0, 476.1) and noninfectious (ICD-9-CM: 306.1, 478.3x, 478.4, 478.5, 748.3, 784.4x) dysphonia groups. Results: Benign voice disorders have a prevalence of approximately 3.6% in Taiwan as of 2014. The year-to-year prevalence decreased gradually in the query period. Infectious dysphonia diagnoses were higher than noninfectious ones. Dysphonia caused by noninfectious diagnoses was most prevalent in the 60 to 79 years age group. Dysphonia caused by infectious diagnoses was highest in 20 to 39 years group. Noninfectious dysphonia diagnoses were more common in women. Conclusion: The prevalence of voice disorders among the adult population in Taiwan was 3.6% in 2014. Voice disorders are more common in women and occur primarily in the 20 to 39 years age group. Infectious dysphonia is more common than noninfectious dysphonia. The results may be underestimated due to limitation of the database. This is the first population-based epidemiology study of adult voice disorders.

scholarly journals Vegetarian Diet Is Associated with Lower Risk of Depression in Taiwan

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1059
Author(s):  
Yu-Chih Shen ◽  
Chiao-Erh Chang ◽  
Ming-Nan Lin ◽  
Chin-Lon Lin
Keyword(s):  
Lower Risk ◽  
Depressive Disorders ◽  
Proportional Hazards ◽  
International Classification Of Diseases ◽  
Vegetarian Diet ◽  
Cox Proportional Hazards ◽  
Research Database ◽  
Hazard Ratios ◽  
Classification Of Diseases

In order to determine whether Taiwanese vegetarian diets reduce the risks of depression, we analyzed data from the Tzu Chi Vegetarian Study (TCVS), which is a prospective cohort study following 12,062 participants from the Buddhist Tzu Chi Foundation of Taiwan since 2005. The cohort was prospectively followed by linking to the National Health Institute Research Database (NHIRD) of Taiwan and hazard ratios of depression between vegetarian and non-vegetarian groups were calculated by Cox proportional hazards regression. We assessed dietary intake using a detailed food frequency questionnaire (FFQ). Incident depression was ascertained through linkage to NHIRD which had claim records with the International Classification of Diseases, and a total of 3,571 vegetarians and 7,006 non-vegetarians were included in this analysis. Compared with non-vegetarians, the vegetarian group had a lower incidence of depressive disorders (2.37 vs. 3.21 per 10,000 person-years; adjusted hazard ratio (aHR): 0.70; 95% confidence interval (95% CI): 0.52–0.93). Thus, Taiwanese vegetarians had a lower risk of developing subsequent depressive disorders compared with non-vegetarians. This indicated that diet may be an important measure for the prevention of depression. However, to generalize to the global population requires further study.

scholarly journals Association of Tramadol and Hypoglycemia in Diabetic Asians

2018 ◽  
Vol 7 (11) ◽  
pp. 380 ◽  
Author(s):  
Shang-Yi Li ◽  
Hsin-Hung Chen ◽  
Cheng-Li Lin ◽  
Su-Yin Yeh ◽  
Chia-Hung Kao
Keyword(s):  
Claims Data ◽  
International Classification Of Diseases ◽  
Diabetic Patients ◽  
Research Database ◽  
Control Frequency ◽  
Classification Of Diseases ◽  
Multivariable Analyses ◽  
Baseline Characteristics

To evaluate the association between tramadol and hypoglycemia in diabetic Asians. The data adopted in this study were derived from a subset of the National Health Insurance (NHI) Research Database, which comprises data on one million randomly sampled beneficiaries enrolled in the NHI program. Patients diagnosed with diabetes (according to the International Classification of Diseases, Ninth Revision, Clinical Modification code 250) were identified from claims data between 1998 and 2011. Diabetic patients aged 20 years or older and prescribed tramadol constituted the tramadol group and other diabetic patients without tramadol use constituted the non-tramadol group. For each tramadol case, one non-tramadol control frequency matched according to age (every 5 years), sex and the year of tramadol use was identified. The tramadol group comprised 12,446 patients and non-tramadol group comprised 11,982 patients. During a mean follow-up of 2 years for the patients in the tramadol group and 2.79 years for those in the non-tramadol group, the overall incidences of hypoglycemia (per 1000 person-years) were 7.37 and 3.77, respectively. According to the multivariable analyses, after baseline characteristics were controlled, the tramadol group exhibited a significantly greater risk of hypoglycemia (hazard ratio (HR) = 1.34, 95% confidence interval (CI) = 1.05–1.71) compared with the non-tramadol group. Tramadol use increases hypoglycemia in diabetic Asians. Greater attention must be paid to diabetic Asians with tramadol use.

scholarly journals The Evaluation of Professional Divisions of Traditional Chinese Medicine in Taiwan through Patient Visit Records of 2012

2018 ◽  
Vol 15 (9) ◽  
pp. 1992 ◽  
Author(s):  
Ta-Peng Wu ◽  
Cheng-Hung Tsai ◽  
Yu-Ting Su ◽  
Chu-Chiao Wang ◽  
Tzeng-Ji Chen ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
International Classification Of Diseases ◽  
Current Status ◽  
Research Database ◽  
Classification Of Diseases ◽  
And Gender ◽  
Using Data ◽  
Total Visit

For decades, professional divisions have been represented as the main structural divisions in Western medicine throughout the world. In Taiwan, medical policymakers are also interested in designing professional divisions of traditional Chinese medicine (TCM). Therefore, this study evaluated the current status and potentiality of professional divisions of TCM in Taiwan using data from the year 2012 obtained from the National Health Insurance Research Database; the database provides information regarding age and gender of TCM physicians (TCMPs); total visit counts; contracted medical institution codes; groupings of diseases classified under International Classification of Diseases, Ninth Revision, Clinical Modification codes; numbers of children and female patients seeking treatment; and claim disposition codes used by each TCMP. The results indicated that there were 5522 TCMPs in 2012, and 4876 (90.3%) TCMPs practiced in primary clinics. The proportions of pediatric visits to these TCMPs were mostly below 0.2, and acupuncture or traumatology-related visit proportions were below 0.5. Only a few of the studied Taiwan-based TCMPs practiced gynecology and pediatrics, but most of them performed “internal medicine”, or “acupuncture” or “traumatology” treatments. Thus, the number of TCM specialists practicing gynecology or pediatrics is insufficient, indicating that a policy that forms professional divisions of TCM practitioners in Taiwan should be reconsidered.

scholarly journals Intensive Periodontal Treatment Reduces Risks of Hospitalization for Cardiovascular Disease and All-Cause Mortality in the Hemodialysis Population

2018 ◽  
Vol 7 (10) ◽  
pp. 344 ◽  
Author(s):  
Shih-Ting Huang ◽  
Tung-Min Yu ◽  
Tai-Yuan Ke ◽  
Ming-Ju Wu ◽  
Ya-Wen Chuang ◽  
...  
Keyword(s):  
International Classification Of Diseases ◽  
International Classification ◽  
Rank Test ◽  
Research Database ◽  
Atherosclerotic Vascular Disease ◽  
Relative Risks ◽  
Log Rank Test ◽  
Comparison Cohort ◽  
Classification Of Diseases

Periodontal disease (POD) is associated with the risk of atherosclerotic vascular disease in patients on hemodialysis (HD). The association between POD treatment and cardiovascular diseases (CVDs) is still unknown. A total of 3613 patients who received HD and intensive POD treatment between 1 January 1998, and 31 December 2011 were identified from the National Health Insurance Research Database as the treatment cohort. The comparison cohort comprised patients without POD treatment who were matched to the patients in the treatment cohort at a 1:1 ratio by the propensity score. All CVDs defined by International Classification of Diseases, Ninth Revision (International Classification of Diseases, Ninth Revision (ICD-9)) codes were ascertained by hospital records for nonfatal events. The first CVD was used to define incidence. Relative risks were estimated by hazard ratios from the Cox proportional hazard model with adjustment for demographic variables and cardiovascular risk factors. Compared with the comparison cohort, the adjusted hazard ratio of hospitalization for CVDs was 0.78 (95% confidence interval = 0.73–0.84, p < 0.001) in the treatment cohort The treatment cohort exhibited significantly lower cumulative incidences of CVDs (log-rank test p < 0.001) and mortality (log-rank test p < 0.001). Intensive POD treatment was associated with reduced risks of CVDs and overall mortality in patients on HD.

scholarly journals Utilization of emergency ophthalmology services in Taiwan: a nationwide population study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Min-Huei Hsu ◽  
Chia-An Hsu ◽  
Sheng-Huang Hsiao ◽  
Dachen Chu ◽  
Ju-Chuan Yen
Keyword(s):  
Nationwide Survey ◽  
Corneal Opacity ◽  
International Classification Of Diseases ◽  
Research Database ◽  
Eye Injuries ◽  
Eye Care ◽  
Care Services ◽  
Diagnosis Codes ◽  
Classification Of Diseases

Abstract The aim of this study was to conduct a nationwide survey of the use of emergency ophthalmology services using a sub-dataset of one million beneficiaries sampled from Taiwan’s National Health Insurance Research Database (NHIRD) for the years 2008 through 2012. By analyzing this population dataset, the study illustrates the disease landscape of emergency eye care services. The five-year, one-million-person NHIRD sub-dataset for 2008 through 2012 was used to explore emergency visits and ophthalmology specialty visits and to analyze the associated demographics and diagnosis codes based on the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM). Diagnoses were categorized into three groups: urgent, non-urgent, and intermediate. A total of 2454 emergency eye care visits were identified. The mean age of the patients who made these visits was 34.6 years old, and their sex ratio was 1.36 men to women. The percentages of urgent, non-urgent, and intermediate eye care visits in this study were 48.2%, 30.9%, and 20.9%, respectively. The leading diagnoses in the urgent category were corneal abrasions, foreign bodies in the eyes, eye burns, and blunt eye injuries. The leading diagnoses for the non-urgent visits were conjunctivitis, subconjunctival hemorrhages, trichiasis, and dry eye disease. Those for the intermediate category were superficial punctate keratitis, corneal opacity and degeneration, and lid, orbital, and lacrimal drainage infections. The urgent visit category accounted for nearly half of all the visits identified in this study. Compared to outpatient department visitors, the emergency ophthalmology service patients were younger and more predominantly male. These results were consistent with those of previous reports. Low copays have made emergency ophthalmology services highly accessible in Taiwan. However, future policies can be designed to more effectively allocate resources to urgent cases.

scholarly journals Association Between Antibiotic Treatment of Chlamydia pneumoniae and Reduced Risk of Alzheimer Dementia: A Nationwide Cohort Study in Taiwan

2021 ◽  
Vol 13 ◽  
Author(s):  
Hsun Ou ◽  
Wu-Chien Chien ◽  
Chi-Hsiang Chung ◽  
Hsin-An Chang ◽  
Yu-Chen Kao ◽  
...  
Keyword(s):  
Cohort Study ◽  
Chlamydia Pneumoniae ◽  
International Classification Of Diseases ◽  
Population Based ◽  
Community Acquired Pneumonia ◽  
Research Database ◽  
Alzheimer Dementia ◽  
Hazard Ratios ◽  
Classification Of Diseases

Background:Chlamydia pneumoniae (CPn) is a common community-acquired pneumonia. In the literature, CPn infection is demonstrated to exhibit an association with Alzheimer dementia (AD). We executed the present nationwide, population-based research with the goal of probing the association of CPn infection and antibiotic therapy with AD risk.Methods: We conducted a cohort study using a database extracted from Taiwan's National Health Insurance Research Database (NHIRD). All medical conditions for each enrolled individuals were categorized using the International Classification of Diseases, ninth Revision classifications. Hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between CPn pneumonia-associated hospitalizations and AD were estimated using Fine and Gray's survival analysis and adjusted for comorbidities. The effects of the antibiotics on the HRs for AD in the patients with CPn pneumonia-associated hospitalization were also analyzed.Results: Our analyses included 6,628 individuals, including 1,657 CPn-infected patients, as well as 4,971 controls matched by age, index date, and sex (1:3). In this study, patients hospitalized for CPn pneumonia exhibited a significantly higher AD risk (adjusted HR = 1.599, 95% CI = 1.284–1.971, p &lt; 0.001). We also noted an association of macrolide use (≥15 days) and fluoroquinolone use (≥15 days) with decreased AD risk.Conclusions: We determined CPn pneumonia to be associated with a relatively high AD risk. The result in this study confirmed the findings from previous literatures, by using a large, nationwide, population-based database. Appropriate macrolide and fluoroquinolone treatment may attenuate this risk.

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