scholarly journals Association of nasal septal deviation with the incidence of anxiety, depression, and migraine: A national population-based study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259468
Author(s):  
Ki-Il Lee ◽  
Seung Min In ◽  
Jong-Yeup Kim ◽  
Jee-Young Hong ◽  
Kyung-Do Han ◽  
...  

Background & aims Nasal obstruction caused by nasal septal deviation is very bothersome and, therefore, can affect the patient’s emotional state. However, little is known about the effect of nasal septal deviation (NSD) on the neuropsychiatric aspects of patients. Therefore, this study aims to verify the higher incidence of anxiety, depression, and migraine in patients diagnosed with NSD compared to general populations using big data. Methods This retrospective cohort study collected subjects from the Korean National Health Insurance Service (NHIS) database. Adjustments were made to minimize the confounding of variables for age, sex, residence type, income levels, hypertension, diabetes, dyslipidemia, rhinitis, and chronic rhinosinusitis between the two groups. The primary endpoint of this study was newly diagnosed anxiety, depression, and migraine between January 2009 and December 2018. Kaplan-Meier survival curves, logarithmic rank test, and Cox proportional regression test were used for statistical analysis. Results Among a total of 135,769 subjects in the NHIS database, 48,495 patients with NSD (NSD group) and 54,475 control subjects (control group) were selected. Patients with NSD had an increased risk of anxiety, depression, and migraine compared to the control group. In the NSD group, the adjusted hazard ratios (HR) were 1.236 (95% CI, 1.198–1.276) for anxiety, 1.289 (95% CI, 1.238–1.343) for depression, and 1.251 (95% CI, 1.214–1.290) for migraine. Conclusion NSD is associated with a higher incidence of anxiety, depression, and migraine. Therefore, it is suggested that physicians carefully consider psychoneurological distress and employ therapeutic strategies to minimize these conditions.

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lena Løfblad ◽  
Gunhild Garmo Hov ◽  
Arne Åsberg ◽  
Vibeke Videm

AbstractInflammatory markers have been associated with increased risk of cardiovascular mortality in general populations. We assessed whether these associations differ by diabetes status. From a population-based cohort study (n = 62,237) we included all participants with diabetes (n = 1753) and a control group without diabetes (n = 1818). Cox regression models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CI) for possible associations with cardiovascular mortality of 4 different inflammatory markers; C-reactive protein (CRP), calprotectin, neopterin and lactoferrin. During a median follow-up of 13.9 years, 728 (20.4%) died from cardiovascular disease (CVD). After adjustment for age, sex and diabetes, the associations of all inflammatory markers with risk of cardiovascular mortality were log-linear (all P ≤ 0.017 for trend) and did not differ according to diabetes status (all P ≥ 0.53 for interaction). After further adjustments for established risk factors, only CRP remained independently associated with cardiovascular mortality. HRs were 1.22 (1.12–1.32) per standard deviation higher loge CRP concentration and 1.91 (1.50–2.43) when comparing individuals in the top versus bottom quartile. The associations of CRP, calprotectin, lactoferrin and neopterin with cardiovascular mortality did not differ by diabetes, suggesting that any potential prognostic value of these markers is independent of diabetes status.


2020 ◽  
Vol 9 (9) ◽  
pp. 3005
Author(s):  
Soo-Hwan Byun ◽  
Chanyang Min ◽  
Hyo-Geun Choi ◽  
Seok-Jin Hong

We evaluated the incidence of temporomandibular disorder (TMD) in patients with rheumatoid arthritis (RA) and examined the association between TMD and RA, through longitudinal follow-up. Population data from the Korean National Health Insurance Service-Health Screening Cohort from 2002 to 2015 was used. From 514,866 subjects, 3122 with RA were matched with 12,488 controls in a 1:4 ratio. The crude and adjusted models (for obesity, smoking, alcohol consumption, blood pressure, blood glucose, total cholesterol, and Charlson Comorbidity Index scores) were calculated. Chi-square tests, Kaplan-Meier (KM) analysis, and two-tailed analyses were used for statistical analysis. Stratified Cox proportional hazard models were used to assess the hazard ratios (HR) and 95% confidence intervals (CI) for TMD in the RA group, compared to those in the control group. The adjusted HR for TMD in RA was 2.52 (95% CI = 1.70–3.74), compared to the control group. The results were consistent with the subgroup analyses, according to age and sex, except in men older than 60 years of age. KM analysis showed similar results. Hence, we found that patients with RA have a higher risk of TMD, and should be observed for symptoms of the initial stage of TMD to prevent the risk of aggravation.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Abdollah ◽  
S B Brogly ◽  
D Payne ◽  
K Lajkosz ◽  
N S Coverdale ◽  
...  

Abstract Background Cohort studies of surgery compared with medical treatment (MT) on endocarditis mortality are conflicting. We conducted a population-based study to estimate associations between treatment and mortality. Methods 1,381 patients with substance use disorder (SUD) and 5,053 without (NSUD) hospitalized for endocarditis were included. Treatment was modeled as a time-dependent variable: patients who underwent surgery after admission were classified as MT until surgery occurred and surgically treated thereafter. Patients without surgery were classified as MT. Adjusted hazard ratios (aHR) between treatment and death (in-hospital, 30 days, one, two, five years) by SUD status were estimated. Results Among SUD patients, there was a trend towards reduction in in-hospital death with surgery vs. MT (aHR 0.61 [95% CI: 0.35–1.04]), but no difference at 30 days (aHR 0.79 [95% CI: 0.42–1.48]). Mortality was higher in SUD patients who underwent surgery compared with MT at one (aHR 1.30 [95% CI: 0.95–1.76]), two (aHR 1.27 [95% CI: 0.97–1.65]), and five years (aHR 1.37 [95% CI: 1.09–1.72]). In NSUD patients, in-hospital mortality (aHR 0.93 [95% CI 0.76–1.16]) did not differ, but 30 day mortality (aHR 1.36 [95% CI 1.04–1.77]) was higher with surgery versus MT, and lower at one (aHR 0.87 [95% CI: 0.73–1.03]), two (aHR 0.75 [95% CI: 0.64–0.88]), and five years (aHR 0.70 [95% CI: 0.61–0.81]). Kaplan-Meier Survival Curves of Patients Interpretation Surgery compared with MT conferred no long-term survival benefit in SUD patients. In NSUD patients, surgery was associated with an initial increased risk of early death followed by a lower risk after one year. Acknowledgement/Funding Grant from Department of Surgery, Queen's University


2021 ◽  
Vol 12 ◽  
Author(s):  
Zhiyong Chen ◽  
Yiwen Xu ◽  
Miao Chen ◽  
Ran Cui ◽  
Yu-Hsun Wang ◽  
...  

ObjectivePatients with psoriasis (PsO) have a high frequency of concomitant gout and increased risk of cardiovascular diseases (CVD). We aimed to estimate the synergistic impact of gout on the risk of CVD in patients with PsO.MethodsA population-based cohort of patients registered in the National Health Insurance Research Database of Taiwan between 2000 and 2013 was stratified according to the presence of PsO and gout. Propensity score analysis was used to match age and gender at a ratio of 1:4. Cox proportional hazard models and subgroup analyses were used to estimate the hazard ratios (HRs) for CVD adjusted for traditional risk factors. The Kaplan–Meier method was used to plot the cumulative incidence curves.ResultsPatients with combined PsO and gout (n = 97), PsO alone (n = 388), gout alone (matched, n = 388) and matched controls (n = 388) were identified. Compared with the patients with PsO alone, the patients with combined PsO and gout had a significantly higher risk of CVD (relative risk 2.39, 95% CI 1.56 to 3.65). After adjustment for traditional risk factors, the risk of CVD was higher in patients with gout alone (HR 2.16, 95% CI 1.54 to 3.04) and in patients with combined PsO and gout (HR 2.72, 95% CI 1.73 to 4.28).ConclusionsGout augments the risk of CVD independently of traditional risk factors in patients with PsO.


Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1625
Author(s):  
Chia-Wen Li ◽  
Yen-Chin Chen ◽  
Nan-Yao Lee ◽  
Po-Lin Chen ◽  
Ming-Chi Li ◽  
...  

(1) Background: This study aimed to determine the association between the use of efavirenz and depressive disorders among human immunodeficiency virus (HIV)-infected patients. (2) Methods: A retrospective cohort study was conducted using Taiwan’s National Health Insurance Database. We identified patients receiving anti-retroviral therapy (ART) between 2000 and 2009; these patients were followed until 2010 for diagnoses of depressive disorders using the Cox proportional hazard model to estimate hazard ratios. (3) Results: After up to 11 years of follow-up, the incidence of depressive disorders for the efavirenz-treated group was estimated at 12.2/1000 person-years (PYs), and the control group was at 12.5/1000 PY (p = 0.822). The independent risk factors for depressive disorders included an insurance premium of less than NTD 17,820 (New Taiwan Dollars—NTD) (adjusted hazard ratio (aHR) 2.59, 95% confidence interval (CI), 1.79–3.76, p < 0.001), and between NTD 17,821 and NTD 26,400 (aHR 1.55, 95% CI, 1.04–2.31, p = 0.030), living in Southern Taiwan (aHR 1.49, 95% CI, 1.21–1.84, p = 0.002), and with a psychiatric history (excluding depressive disorders) (aHR 4.59, 95% CI, 3.51–6.01, p = 0.030). (4) Conclusions: This study concluded that ART-treated patients with a past history of psychiatric disorders, lower insurance premium, and living in Southern Taiwan have an increased risk of depressive disorders, which are not associated with the use of efavirenz.


BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Han-En Wang ◽  
Yu-Chan Liao ◽  
Je-Ming Hu ◽  
Wen-Chih Wu ◽  
Wan-Yun Chou ◽  
...  

Abstract Background Kidney transplantation (KT) correlates with an increased risk of developing several malignancies; however, the risk of colorectal cancer (CRC) after KT remains debatable and has been marginally explored. Hence, in this nationwide, retrospective, population-based cohort study, we aimed to examine the correlation between KT and CRC in a large-scale population-based Chinese cohort. Methods We identified a total of 3739 regular hemodialysis patients undergoing KT (exposed cohort) and 42,324 hemodialysis patients not undergoing KT (non-exposed cohort) between 2000 and 2008 from Taiwan’s National Health Insurance Research Database (NHIRD). Both cohorts were followed up from January 1, 2000, to the date of CRC diagnosis, death, or the end of 2013. Using Kaplan–Meier method, we measured the cumulative incidence of CRC in each cohort. Furthermore, Cox proportional hazards models were used to compute hazards ratios (HRs) and 95% confidence intervals (CIs) to estimate the correlation between KT and CRC in hemodialysis patients. Results The Kaplan–Meier analysis revealed that the cumulative incidence of CRC was significantly higher in the exposed cohort than in the non-exposed cohort (log-rank test, P < 0.001). After adjusting for potential confounders, the exposed cohort exhibited a significantly increased risk of CRC compared with the non-exposed cohort (adjusted HR, 1.34; 95% CI, 1.11–1.62). Conclusions Hemodialysis patients undergoing KT have a significantly higher risk of CRC than those not undergoing KT. Cancer should continue to be a primary focus of prevention during KT.


2021 ◽  
Author(s):  
Wei-Hung Wang ◽  
Tian-Hoe Tan ◽  
Chung-Han Ho ◽  
Yi-Chen Chen ◽  
Chien-Chin Hsu ◽  
...  

Abstract Background: Osteoarthritis (OA) may increase urinary tract infection (UTI) in older adults. However, this issue remains unclear.Methods: We identified 8599 older patients (≥65 years) with OA, and an equal number of older patients without OA, matched by age, sex, and index date from the Taiwan National Health Insurance Research Database between 2001 and 2005. Past histories, including UTI and underlying comorbidities, were included in the analyses. Comparisons for any UTI, ≥1 hospitalization for UTI, and ≥3 hospitalizations for UTI between the two cohorts by following up until 2015 were performed.Results: In both cohorts, the percentages of age subgroups were 65–74 years (65.7%), 75–84 years (30.1%), and ≥85 years (4.2%). The male sex was 42.4%. Patients with OA had an increased risk of any UTI compared with those without OA after adjusting for all past histories (adjusted hazard ratio [AHR]: 1.72; 95% confidence interval [CI]: 1.64–1.80). The Kaplan–Meier curve and log-rank test showed that OA increased any UTI (p <.001). Compared with patients without OA, patients with OA also had an increased risk of ≥1 hospitalization for UTI and ≥3 hospitalizations for UTI (AHR: 1.13; 95% CI: 1.06–1.19 and AHR: 1.25; 95% CI: 1.13−1.38, respectively). In addition to OA, older age, female sex, history of UTI, benign prostatic hyperplasia, indwelling urinary catheter, cerebrovascular disease, diabetes, dementia, and urolithiasis were independent predictors for any UTI.Conclusions: OA increased UTI in older adults. We suggest appropriately managing OA and controlling underlying comorbidities to prevent subsequent UTI.


PeerJ ◽  
2018 ◽  
Vol 6 ◽  
pp. e4792 ◽  
Author(s):  
Kuo-Liang Chiang ◽  
Fang-Chuan Kuo ◽  
Jen-Yu Lee ◽  
Chin-Yin Huang

Background Epidemiologic data supporting the epilepsy–asthma association are insufficient. Therefore, we examined this association in this study. Methods By using claims data from the National Health Insurance Research Database (Taiwan), we executed a retrospective cohort analysis. Analysis 1 entailed comparing 150,827 patients diagnosed as having incident asthma during 1996–2013 with disease-free controls who were selected randomly during the same period, frequency matched in terms of age and sex. Similarly, analysis 2 entailed comparing 25,274 patients newly diagnosed as having epilepsy with sex- and age-matched controls who were selected randomly. At the end of 2013, we evaluated in analysis 1 the epilepsy incidence and risk and evaluated in analysis 2 the asthma incidence and risk. We applied Kaplan–Meier analysis to derive plots of the proportion of asthma-free seizures. Results In analysis 1, the asthma group exhibited a higher epilepsy incidence than did the control group (3.05 versus 2.26 per 1,000 person-years; adjusted hazard ratio: 1.39, 95% CI [1.33–1.45]). We also noted a greater risk of subsequent epilepsy in women and girls. In analysis 2, we determined that the asthma incidence between the control and epilepsy groups did not differ significantly; however, some age subgroups including children and individuals in their 30s had an increased risk. A negative association was found in adolescents. The Kaplan–Meier analysis revealed epilepsy to be positively associated with subsequent onset of asthma within seven years of epilepsy diagnosis. Discussion Asthma may be associated with high epilepsy risk, and epilepsy may be associated with high asthma risk among children and individuals in their 30s. Nevertheless, people with epilepsy in other age subgroups should be aware of the possibility of developing asthma within seven years of epilepsy diagnosis.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1253.1-1253
Author(s):  
Y. J. Ha ◽  
E. H. Park ◽  
E. H. Kang ◽  
Y. W. Song ◽  
Y. J. Lee

Background:Due to the shared mechanism of nontraumatic avascular necrosis (AVN) and endothelial dysfunction, the associations of AVN with increased cardiovascular and cerebrovascular events have been suggested in the several population-based studies.Objectives:This study aimed to estimate the prevalence and incidence of nontraumatic AVN in South Korea from the Korean National Health Insurance Service Sample Cohort Database 2.0 (2006-2015) and to evaluate the risk of major cardiovascular and cerebrovascular events among patients with nontraumatic AVN.Methods:We defined an incident case as a newly diagnosed and registered patient in the registry in that year, with a 2-year washout period. Prevalent cases were defined as all patients with nontraumatic AVN in the corresponding year. To evaluate the cardiovascular and cerebrovascular risks in patients with AVN, we set AVN group composed of patients with an initial diagnosis of non-traumatic AVN between 2008 and 2010 (n=1,150). The comparison group was composed of randomly selected subject (5 per patient with AVN; n = 5,750) who were matched to the AVN group according to age, sex, resident area, and year of AVN diagnosis. The development of major cardiovascular and cerebrovascular events was tracked in each sampled patient until 2015. Cox proportional hazard regressions were used to calculate the overall risks for the development of major cardiovascular and cerebrovascular events.Results:From 2008 to 2015, the prevalence of nontraumatic AVN increased gradually, but its incidence did not change, with an annual average incidence of 413 per 1 million population and the male-to-female ratio of 1.2:1. The peak incidence occurred in the 50-59 year age group. The incident AVN was more prevalent in male than in female under 70, but there was female predominance after the age of 70 (Figure 1). The patients with AVN had a higher cumulative incidence of major adverse cardiovascular and cerebrovascular events than controls (19.5% versus 14.9%; p = 0.017). Upon univariate Kaplan-Meier method with the log-rank test, there was a significant difference in major cardiovascular and cerebrovascular events-free survival rates between AVN group and control group (p <0.001). However, after adjusting for potential confounders including hypertension, diabetes, dyslipidemia, and use of steroid or statin, the association between AVN group and major adverse cardiovascular and cerebrovascular events was insignificant (adjusted HR 1.114, 95% CI 0.959-1.295, p=0.158)Conclusion:In this population-based cohort study, we provided the updated epidemiologic data of Korean patients with nontraumatic AVN. The increased risk for major cardiovascular and cerebrovascular events among AVN patients was not observed in the representative Korean population.References:[1]Kang JH, Lin HC. Increased risk for coronary heart disease after avascular necrosis of femoral head: a 3-year follow-up study. Am Heart J. 2010;159:803-8.[2]Sung PH, Yang YH, Chiang HJ, Chiang JY, Chen CJ, Yip HK, et al Cardiovascular and cerebrovascular events are associated with nontraumatic osteonecrosis of the femoral head. Clin Orthop Relat Res 2018;476:865-74.Figure 1.Age- and sex-distributed incidence of patients with nontraumatic avascular necrosis in Korea, 2008-2015Disclosure of Interests:None declared


2020 ◽  
Author(s):  
Jin Zhang ◽  
Xin Wang ◽  
Feng Lin ◽  
Guijun Xu ◽  
Haixiao Wu ◽  
...  

Abstract Background: The characteristics and survival of patients with malignant giant cell tumour of bone (GCTB) have not been investigated thoroughly due to the rarity of the disease. We evaluated these factors in a large cohort in the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) database.Methods: Data from patients who were diagnosed with malignant GCTB from 1975 to 2016 were extracted from the SEER database. The overall survival was calculated by Kaplan–Meier analysis, and intergroup differences were tested by the log-rank test. Univariate and multivariate Cox proportional hazard regression analyses were conducted to identify the independent survival factors.Results: A total of 325 patients with malignant GCTB were included. The overall 1-, 5-, and 10-year survival rates were 94.3% (95% CI: 91.7-96.8), 82.3% (95% CI: 77.9-86.6), and 80.1% (95% CI: 75.4-84.7), respectively. A potential non-linear J-shaped dose–response relationship between the age or diagnosis year and survival were found. Multivariate Cox regression showed poor survival in patients with age from 35 to 60 years (HR=9.99, 95% CI: 1.34-74.80, P=0.025), age older than 60 years (HR=62.03, 95% CI: 7.94-484.38, P<0.001), with stage T2 disease (HR=4.85, 95% CI: 1.52-15.47, P=0.008), with stage T3 disease (HR=6.09, 95% CI: 1.03-36.23, P=0.047), and with distant tumours (HR=2.76, 95% CI: 1.14-6.65, P=0.024), and extraskeletal sites (HR=3.33, 95% CI: 1.02-10.85, P=0.046).Conclusions: This large population-based series described the clinical characteristics of malignant GCTB. Patients with stage T2/3 disease, distant disease and extra-skeletal sites had more odds to be with worse survival. The elder age than 34 years had a gradually increased risk for survival.


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