Bidirectional Association between Psoriasis and Atopic Dermatitis: A Nationwide Population-Based Cohort Study

Dermatology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Ying-Xiu Dai ◽  
Ying-Hsuan Tai ◽  
Yun-Ting Chang ◽  
Tzeng-Ji Chen ◽  
Mu-Hong Chen
Keyword(s):  
Atopic Dermatitis ◽  
Cohort Study ◽  
Health Insurance ◽  
National Health Insurance ◽  
Cox Regression ◽  
Age Groups ◽  
Population Based ◽  
Research Database ◽  
Biological Mechanisms ◽  
Bidirectional Association

Background: There have been some reports on the coexistence of psoriasis and atopic dermatitis; however, the longitudinal relationship between these two diseases remains unclear. Objective: This study aimed to investigate the bidirectional association between psoriasis and atopic dermatitis. Methods: This cohort study recruited patients from the National Health Insurance Research Database in Taiwan. We included 8,206 patients with psoriasis and 32,824 matched controls to assess the risk of atopic dermatitis and 25,743 patients with atopic dermatitis and 102,972 matched controls to assess the risk of psoriasis. Cox regression model was used for the analyses. Results: After adjusting for potential confounders, patients with psoriasis had a higher risk of atopic dermatitis (adjusted hazard ratio [aHR] 13.01; 95% CI 10.23–16.56) than the controls. Patients with atopic dermatitis had a higher risk of psoriasis (aHR 10.37; 95% CI 6.85–15.69) than the controls. Stratified analyses revealed similar results in both sexes and all age groups. Conclusion: Our study demonstrated a bidirectional association between psoriasis and atopic dermatitis, suggesting that psoriasis and atopic dermatitis are not mutually exclusive and may share some biological mechanisms.

scholarly journals Thiazide diuretics and the risk of hip fracture after stroke: a population-based propensity-matched cohort study using Taiwan’s National Health Insurance Research Database

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016992 ◽  
Author(s):  
Shu-Man Lin ◽  
Shih-Hsien Yang ◽  
Hung-Yu Cheng ◽  
Chung-Chao Liang ◽  
Huei-Kai Huang
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Hip Fracture ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Research Database ◽  
Matched Cohort ◽  
Matched Cohort Study

ObjectivesThis study aimed to investigate the association between thiazide use and the risk of hip fracture after stroke.SettingA population-based, propensity-matched cohort study was conducted on the basis of Taiwan’s National Health Insurance Research Database.ParticipantsPatients with newly diagnosed ischaemic stroke between 2000 and 2011 were included. After propensity score matching, 7470 patients were included, of whom 3735 received thiazides and 3735 did not.Outcome measuresHRs for developing hip fractures within 2 years after stroke were calculated using Cox proportional hazards regression model with adjustments for sociodemographic and coexisting medical conditions.ResultsOverall, patients using thiazides after stroke had a lower risk of hip fracture than those not using thiazides (8.5 vs 13.9 per 1000 person-years, adjusted HR=0.64, 95% CI 0.46 to 0.89, p=0.007). Further sensitivity analysis based on the duration of thiazide use revealed that the risk of hip fracture tended to decrease as the duration of exposure of thiazides increased. However, the effect was significant only in patients with long-term use of thiazides (using thiazides for >365 days within 2 years after stroke), with a 59% reduction in the risk of hip fracture when compared with patients not using thiazide (adjusted HR=0.41, 95% CI 0.22 to 0.79, p=0.008).ConclusionsThe long-term use of thiazides is associated with a decreased risk of hip fracture after stroke.

Methylphenidate and mortality in children with attention-deficit hyperactivity disorder: population-based cohort study

2020 ◽  
pp. 1-9
Author(s):  
Vincent Chin-Hung Chen ◽  
Hsiang-Lin Chan ◽  
Shu-I Wu ◽  
Mong-Liang Lu ◽  
Michael E. Dewey ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Cohort Study ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Attention Deficit ◽  
Population Based ◽  
Research Database ◽  
Adhd Diagnosis ◽  
Hyperactivity Disorder

Background Little is known about methylphenidate (MPH) use and mortality outcomes. Aims To investigate the association between MPH use and mortality among children with an attention-deficit hyperactivity disorder (ADHD) diagnosis. Method This population-based cohort study analysed data from Taiwan's National Health Insurance Research Database (NHIRD). A total of 68 096 children and adolescents aged 4–17 years with an ADHD diagnosis and prescribed MPH between 2000 and 2010 were compared with 68 096 without an MPH prescription, matched on age, gender and year of first ADHD diagnosis. All participants were followed to death, migration, withdrawal from the National Health Insurance programme or 31 December 2013. MPH prescriptions were measured on a yearly basis during the study period, and the association between MPH use and mortality was analysed using a repeated-measures time-dependent Cox regression model. The outcome measures included all-cause, unnatural-cause (including suicide, accident and homicide) and natural-cause mortality, obtained from linkage to the National Mortality Register in Taiwan. Results The MPH group had lower unadjusted all-cause, natural-, unnatural- and accident-cause mortality than the comparison group. After controlling for potential confounders, MPH use was associated with a significantly lower all-cause mortality (adjusted hazard ratio AHR = 0.81, 95% CI 0.67–0.98, P = 0.027), delayed use of MPH was associated with higher mortality (AHR = 1.05, 95% CI 1.01–1.09) and longer MPH use was associated with lower mortality (AHR = 0.83, 95% CI 0.70–0.98). Conclusions MPH use is associated with a reduced overall mortality in children with ADHD in this cohort study, but unmeasured confounding cannot be excluded absolutely.

scholarly journals Association between de Quervain syndrome and herpes zoster: a population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e046891
Author(s):  
Chao-Yu Hsu ◽  
Der-Shin Ke ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao
Keyword(s):  
Cohort Study ◽  
Health Insurance ◽  
Herpes Zoster ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Control Group ◽  
Research Database ◽  
Increased Risk ◽  
De Quervain

ObjectiveBoth physical diseases such as infection and chronic pain and psychological disorders such as depression have been associated with herpes zoster (HZ) reactivation. However, the relationship between de Quervain syndrome (DQS), a painful tenosynovitis and HZ remains unclear. We investigated whether DQS increases the risk of HZ reactivation.DesignA retrospective population-based cohort study.SettingTaiwan.ParticipantsWe used a subset of Taiwan’s National Health Insurance Research Database, the Longitudinal Health Insurance Database which contains the registration files and original claims data of 1 million randomly selected individuals from the National Health Insurance programme. The case group in this study comprised patients newly diagnosed with DQS between 2000 and 2012. Individuals without DQS comprised the control group. Cases and controls were 1:1 matched by age, sex and index year (defined as the year of DQS diagnosis).ResultsApproximately 55% of the participants were ≤49 years. Most participants were women (77%). The incidence rate of HZ in the DQS group was 8.39 per 1000 person years. After adjustments for age, sex and comorbidities, patients with DQS had a 1.30 times higher risk of HZ reactivation than the control group. Stratification analysis revealed taht DQS increases the HZ risk in individuals ≤64 years, women, and patients without comorbidities.ConclusionDQS is associated with an increased risk of HZ. Clinicians should be aware of this risk when dealing with patients with DQS, particularly in young adults.

Iatrogenic Vocal Fold Paralysis: A Population-Based Cohort Study in Taiwan

2021 ◽  
pp. 000348942110412
Author(s):  
Ying-Ta Lai ◽  
Pin-Zhir Chao ◽  
Yu-Kang Chang ◽  
Yu-Chun Yen ◽  
Yu-Ting Shen ◽  
...  
Keyword(s):  
Health Insurance ◽  
Cervical Spine ◽  
National Health Insurance ◽  
National Health ◽  
Vocal Fold ◽  
Population Based ◽  
Vocal Fold Paralysis ◽  
Research Database ◽  
Bilateral Vocal Fold Paralysis ◽  
Co Morbidity

Objective: Iatrogenic vocal fold paralysis is an important issue in laryngology, yet there are few population-based studies regarding the epidemiology. This study used a nationwide population-based claims database (the National Health Insurance Research Database) to investigate the epidemiology of iatrogenic unilateral and bilateral vocal fold paralysis (UVFP/BVFP) among the general adult population in Taiwan. Method: This study analyzed patients (20-90 years old) who underwent thyroid, parathyroid, thoracic, cardiac, or anterior cervical spine operations with vocal fold paralysis among adults in Taiwan from January 1, 2007 to December 31, 2013. The codes for vocal fold paralysis were defined by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). Claims data in the Taiwan National Health Insurance Research Database were used. Results: The most commonly performed operations which were related to vocal fold paralysis in Taiwan were, in descending order of frequency, thyroid, cervical spine, cardiac, thoracic (esophagectomy), and parathyroid operations. The operations that put laryngeal nerves at risk (ONRs) most commonly associated with a diagnosis of UVFP were, in descending order of frequency, thoracic, thyroid, parathyroid, cardiac, and cervical spine. For both UVFP and BVFP, the most commonly associated age group was 51 to 60. For both UVFP and BVFP, the more commonly associated sex was women. Increased length of stay was associated with a higher incidence of UVFP and BVFP. Charlson medical co-morbidity index (CCI) was not associated with UVFP but BVFP was associated with higher Charlson medical co-morbidity scores. Conclusions: Thyroid operations, age 51 to 60, longer hospital stays are associated with vocal fold paralysis. Overall women are more surgically affected than men. This is the first population-based study of iatrogenic vocal fold paralysis.

scholarly journals Do Children With Constipation Have Increased Risk of Asthma? Real-World Data From a Nationwide Population-Based Cohort Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Yen-Chu Huang ◽  
Meng-Che Wu ◽  
Yu-Hsun Wang ◽  
James Cheng-Chung Wei
Keyword(s):  
Cohort Study ◽  
Cox Regression ◽  
Population Based ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
Research Database ◽  
Real World Data ◽  
Childhood Disorders ◽  
Cox Regression Analysis ◽  
Increased Risk

Background: Asthma is one of the most burdensome childhood disorders. Growing evidence disclose intestinal dysbiosis may contribute to asthma via the gut-lung axis. Constipation can lead to alteration of the gut microbiota. The clinical impact of constipation on asthma has not been researched. Therefore, we aim to assess whether pediatric constipation influence the risk of developing asthma by a nationwide population-based cohort study.Methods: We analyzed 10,363 constipated patients and 10,363 individuals without constipation between 1999 and 2013 from Taiwan's National Health Insurance Research Database. Analysis of propensity score was utilized to match age, sex, comorbidities, and medications at a ratio of 1:1. In addition, multiple Cox regression analysis was performed to evaluate the adjusted hazard ratio of asthma. Furthermore, sensitivity tests and a stratified analysis were performed.Results: After adjustment for age, sex, comorbidities, and medications, constipated patients had a 2.36-fold greater risk of asthma compared to those without constipation [adjusted hazard ratio (aHR): 2.36, 95% C.I. 2.04–2.73, p < 0.001]. Furthermore, the severity of constipation is associated with an increased risk of asthma; the adjusted hazard ratio was 2.25, 2.85, and 3.44 within < 3, 3–12, and ≥12 times of laxatives prescription within 1 year, respectively (p < 0.001).Conclusion: Constipation was correlated with a significantly increased risk of asthma. Pediatricians should be aware of the possibility of asthma in constipated patients. Further research is warranted to investigate the possible pathological mechanisms of this association.

scholarly journals Association Between Subconjunctival Hemorrhage and Acute Coronary Syndrome: A 14-Year Nationwide Population-Based Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Ping-Hao Chiang ◽  
Jung-Nien Lai ◽  
Yun-Chi Chiang ◽  
Kai-Chieh Hu ◽  
Min-Yen Hsu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Coronary Syndrome ◽  
Cohort Study ◽  
Age Groups ◽  
Population Based ◽  
Research Database ◽  
Coronary Syndrome ◽  
Subconjunctival Hemorrhage ◽  
Related Risk ◽  
Patients With Diabetes

Purpose: Subconjunctival hemorrhage (SCH) is usually a benign ocular disorder that causes painless, redness under the conjunctiva. However, since SCH and acute coronary syndrome (ACS) share many vascular risk factors, studies have suggested that these two disorders may be significantly associated with each other, and evaluate the concomitance of ACS in patients with SCH.Methods: This population-based cohort study, enrolled 35,260 Taiwanese patients, and used the Taiwan National Health Insurance Research Database to identify patients with ACS and SCH. Outcomes were compared between the with and without SCH groups. The study population was followed until the date of ACS onset, the date of withdrawal, death, or December 31st 2013, whichever came first.Results: Of the 85,925 patients identified with SCH between 1996 and 2013, 68,295 were excluded based on the study's exclusion criteria, and a total of 17,630 patients with SCH who were diagnosed by ophthalmologists between 2000 and 2012 were eligible for analysis. After 1:1 propensity score matching for 5-year age groups, gender, and the index year, the results showed that SCH was more common in the 40–59 age group (53.82%) and females (58.66%). As for the ACS-related risk factors, patients with diabetes mellitus (aHR = 1.58, 95% CI = [1.38, 1.81]), hypertension (aHR = 1.71, 95% CI = [1.49, 1.96]) and patients taking aspirin (aHR = 1.67, 95% CI = [1.47, 1.90]) had a notably higher risk of ACS. However, it was found that there were no significant differences in the occurrence of ACS between the non-SCH and SCH patients.Conclusion: This results of this study regarding the risk factors and epidemiology of SCH and ACS were in keeping with previously reported findings. However, the results revealed no significant association between SCH and ACS.

scholarly journals Risk of lung cancer in patients with gastro-esophageal reflux disease: a population-based cohort study

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2753 ◽  
Author(s):  
Chi-Kuei Hsu ◽  
Chih-Cheng Lai ◽  
Kun Wang ◽  
Likwang Chen
Keyword(s):  
Lung Cancer ◽  
Cohort Study ◽  
Reflux Disease ◽  
Cox Regression ◽  
Large Population ◽  
Population Based ◽  
Chronic Obstructive ◽  
Research Database ◽  
Esophageal Reflux

This large-scale, controlled cohort study estimated the risks of lung cancer in patients with gastro-esophageal reflux disease (GERD) in Taiwan. We conducted this population-based study using data from the National Health Insurance Research Database of Taiwan during the period from 1997 to 2010. Patients with GERD were diagnosed using endoscopy, and controls were matched to patients with GERD at a ratio of 1:4. We identified 15,412 patients with GERD and 60,957 controls. Compared with the controls, the patients with GERD had higher rates of osteoporosis, diabetes mellitus, asthma, chronic obstructive pulmonary disease, pneumonia, bronchiectasis, depression, anxiety, hypertension, dyslipidemia, chronic liver disease, congestive heart failure, atrial fibrillation, stroke, chronic kidney disease, and coronary artery disease (all P < .05). A total of 85 patients had lung cancer among patients with GERD during the follow-up of 42,555 person-years, and the rate of lung cancer was 0.0020 per person-year. By contrast, 232 patients had lung cancer among patients without GERD during the follow-up of 175,319 person-years, and the rate of lung cancer was 0.0013 per person-year. By using stepwise Cox regression model, the overall incidence of lung cancer remained significantly higher in the patients with GERD than in the controls (hazard ratio, 1.53; 95% CI [1.19–1.98]). The cumulative incidence of lung cancer was higher in the patients with GERD than in the controls (P = .0012). In conclusion, our large population-based cohort study provides evidence that GERD may increase the risk of lung cancer in Asians.

scholarly journals Association of gout and colorectal cancer in Taiwan: a nationwide population-based cohort study

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e028892
Author(s):  
Jen-Pin Chuang ◽  
Jenq-Chang Lee ◽  
Tzeng-Horng Leu ◽  
Atik Choirul Hidajah ◽  
Ya-Hui Chang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Health Insurance ◽  
Incidence Rate ◽  
National Health Insurance ◽  
National Health ◽  
Population Based ◽  
Secondary Outcome ◽  
Research Database ◽  
Increased Risk

ObjectivesThis study aimed to determine colorectal cancer (CRC) risks among patients with gout through a follow-up study on a nationwide population-based cohort that included patients with gout and the general population in Taiwan.ParticipantFrom the Taiwan National Health Insurance Research Database, we identified 28 061 patients who were newly diagnosed with gout between 2000 and 2010 as the study cohort. We randomly selected 84 248 subjects matching in gender, age and baseline year as comparison cohort. The cohorts were followed up until CRC occurrence, withdrawal from the system of National Health Insurance, or Dec. 31, 2013.Primary and secondary outcome measuresCumulative incidences and incidence rate ratios (IRRs) of CRC between two cohorts were examined. The Cox proportional hazards model was used to evaluate risk factors associated with CRC development.ResultsDuring the 13-year follow-up, the incidence rate of CRC development in the gout cohort reached 2.44 per 1000 person-years, which was higher than the 2.13 per 1000 person-years in the control cohort (IRR=1.15; 95% CI 1.04 to 1.26). After adjusting for age, gender, urbanisation status and comorbidities, including hypertension, diabetes and hyperlipidaemia, gout showed no significant association with increased risk of CRC occurrence (adjusted HR=1.03; 95% CI 0.93 to 1.14).ConclusionsSimilar risks of CRC incidence were observed in patients with and without gout in Taiwan. Allopurinol and colchicine are commonly used as urate-lowering drug and anti-inflammation medication in Taiwan and had been shown to reduce the risk of CRC incidence. Thus, further pharmaco-epidemiological studies should be carried out to specifically assess the role of allopurinol in the relationship between gout and CRC.

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