scholarly journals Association between Cervical Spondylosis and Migraine: A Nationwide Retrospective Cohort Study

Author(s):  
Wang-Sheng Lin ◽  
Tung-Fu Huang ◽  
Tien-Yow Chuang ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao

Background: Few studies have investigated the longitudinal association between cervical spondylosis (CS) and migraine by using a nationwide population-based database. Methods: We conducted a retrospective cohort study from 2000 to 2011 identifying 27,930 cases of cervical spondylosis and 111,720 control subjects (those without cervical spondylosis) from a single database. The subjects were frequency-matched on the basis of sex, age, and diagnosis date. The non- cervical spondylosis cohort was four times the size of the cervical spondylosis cohort. To quantify the effects of cervical spondylosis on the risk of migraine, univariate and multivariate Cox proportional hazard regression analyses were used to calculate the hazard ratio (HR) and 95% confidence interval (CI). Results: After a 10-year follow-up controlling for potential confounding factors, overall migraine incidence was higher in the cervical spondylosis cohort than in the non- cervical spondylosis cohort (5.16 and 2.09 per 1,000 people per year, respectively; crude hazard ratio = 2.48, 95% confidence interval = 2.28–2.69) with an adjusted hazard ratio of 2.03 (95% confidence interval = 1.86–2.22) after accounting for sex, age, comorbidities, and medication. Individuals with myelopathy in the cervical spondylosis cohort had a 2.19 times (95% confidence interval = 1.80–2.66) higher incidence of migraine compared than did those in the non- cervical spondylosis cohort. Conclusion: Individuals with cervical spondylosis exhibited a higher risk of migraine than those without cervical spondylosis. The migraine incidence rate was even higher among individuals with cervical spondylotic myelopathy.

2020 ◽  
Vol 34 (8) ◽  
pp. 1067-1077
Author(s):  
Colleen Webber ◽  
Christine L Watt ◽  
Shirley H Bush ◽  
Peter G Lawlor ◽  
Robert Talarico ◽  
...  

Background: Delirium is a distressing neurocognitive disorder that is common among terminally ill individuals, although few studies have described its occurrence in the acute care setting among this population. Aim: To describe the prevalence of delirium in patients admitted to acute care hospitals in Ontario, Canada, in their last year of life and identify factors associated with delirium. Design: Population-based retrospective cohort study using linked health administrative data. Delirium was identified through diagnosis codes on hospitalization records. Setting/participants: Ontario decedents (1 January 2014 to 31 December 2016) admitted to an acute care hospital in their last year of life, excluding individuals age of <18 years or >105 years at admission, those not eligible for the provincial health insurance plan between their hospitalization and death dates, and non-Ontario residents. Results: Delirium was recorded as a diagnosis in 8.2% of hospitalizations. The frequency of delirium-related hospitalizations increased as death approached. Delirium prevalence was higher in patients with dementia (prevalence ratio: 1.43; 95% confidence interval: 1.36–1.50), frailty (prevalence ratio: 1.67; 95% confidence interval: 1.56–1.80), or organ failure–related cause of death (prevalence ratio: 1.23; 95% confidence interval: 1.16–1.31) and an opioid prescription (prevalence ratio: 1.17; 95% confidence interval: 1.12–1.21). Prevalence also varied by age, sex, chronic conditions, antipsychotic use, receipt of long-term care or home care, and hospitalization characteristics. Conclusion: This study described the occurrence and timing of delirium in acute care hospitals in the last year of life and identified factors associated with delirium. These findings can be used to support delirium prevention and early detection in the hospital setting.


Rheumatology ◽  
2020 ◽  
Author(s):  
Yu-Hao Xue ◽  
Liang-Tian You ◽  
Hsin-Fu Ting ◽  
Yu-Wen Chen ◽  
Zi-Yun Sheng ◽  
...  

Abstract Objectives Autoimmunity may play a role in endometriosis. The association between endometriosis and RA remains unknown. This study was conducted to identify any evidence for this relationship. Methods This 13-year, nationwide, population-based, retrospective cohort study analysed the risk of RA in a cohort of individuals with endometriosis. We investigated the incidence of RA among patients with endometriosis using data from the Longitudinal Health Insurance Database 2000, which is maintained by the Taiwan National Health Research Institutes. We used propensity scores to match comorbidities in the two cohorts. Kaplan–Meier analysis and Cox proportional hazard model were employed to analyse the association between endometriosis and RA among patients with different potential risks. Results Patients with endometriosis [adjusted hazard ratio (HR) 1.75, 95% CI 1.27, 2.41], aged ≥45 years (adjusted HR 1.50, 95% CI 1.06–2.13) and with autoimmune disease (adjusted HR 6.99, 95% CI 2.84–17.21) had a significantly higher risk of RA. The analyses also showed that when stratified by age, comorbidities and medication use, the risk of RA in patients with endometriosis was also higher than in those without endometriosis. Conclusions This 14-year, nationwide, population-based retrospective cohort study revealed that patients with endometriosis have a higher risk of RA. In the clinical management of patients with RA, rheumatologists should be especially mindful of the possibility of underlying endometriosis.


2021 ◽  
Author(s):  
Mu-Ming Chien ◽  
Hsiu-Chen Lin ◽  
Li-Fen Lee ◽  
Joseph Jordan Keller ◽  
Li-Hsuan Wang

Abstract Silymarin is a bioflavonoid compound mostly used in patients with chronic hepatic diseases (CHDs). It has been shown to inhibit retinal angiogenesis in in vitro and in vivo animal studies. Age-related macular degeneration (AMD) is a leading cause of vision impairment worldwide, and no definite preventive measures for AMD exist at present. Through this study, we aimed to investigate whether the use of silymarin affects the risk of AMD in patients with CHDs. Cox proportional hazard models were used to assess the hazard ratio (HR) of AMD in this population-based retrospective cohort study. The CHDs was associated with a higher risk of AMD (adjusted hazard ratio (aHR): 1.33, 95% CI 1.22–1.46), and the use of silymarin reduced the risk of AMD among patients with CHDs (aHR: 0.76, 95% CI: 0.67–0.87). A higher accumulative dose (defined daily dose [DDD] < 631 mg) of silymarin was associated with a lower risk of AMD, but the difference was nonsignificant. In conclusion, CHDs were associated with a higher incidence of AMD, and the use of silymarin was associated with a reduced risk of AMD in patients with CHDs. However, a higher accumulative DDD of silymarin did not reduce the risk of AMD.


BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e022865 ◽  
Author(s):  
Ying-Yi Lu ◽  
Chun-Ching Lu ◽  
Wei-Wen Yu ◽  
Li Zhang ◽  
Qing-Rui Wang ◽  
...  

ObjectiveThe pathogenesis of keloid is largely unknown. Because keloid and atopic dermatitis have overlapping pathophysiological mechanisms, we aimed to evaluate keloid risk in patients with atopic dermatitis.Study designPopulation-based retrospective cohort study.SettingThe Taiwan National Health Insurance Research Database was used to analyse data for people who had been diagnosed with atopic dermatitis.ParticipantsWe identified 8371 patients with newly diagnosed atopic dermatitis during 1996–2010. An additional 33 484 controls without atopic dermatitis were randomly identified and frequency matched at a one-to-four ratio.Primary and secondary outcome measureThe association between atopic dermatitis and keloid risk was estimated using Cox proportional hazard regression models.ResultsAfter adjustment for covariates, the atopic dermatitis patients have a 3.19-fold greater risk of developing keloid compared with the non-atopic dermatitis group (3.19vs1.07 per 1000 person-years, respectively). During the study period, 163 patients with atopic dermatitis and 532 patients without atopic dermatitis developed keloid. Notably, keloid risk increased with severity of atopic dermatitis, particularly in patients with moderate to severe atopic dermatitis.ConclusionsOur results indicate that patients with atopic dermatitis had a higher than normal risk of developing keloid and suggest that atopic dermatitis may be an independent risk factor for keloid.


2020 ◽  
Author(s):  
Hsin-Yi Hsieh ◽  
Lin-Chi Huang ◽  
Hong-Ren Yu ◽  
Kuang-Che Kuo ◽  
Yi-Chen Lee ◽  
...  

Abstract Background: Few studies have studied the association between asthma and pediatric transfusion naïve thalassemia. Methods: A nationwide population-based retrospective cohort study was conducted using medical records of selected children from the 2010 Registry for Beneficiaries of the Taiwan National Health Insurance Research Database, with a follow-up period extending to the end of 2013. One thalassemia patient was matched with four control patients without thalassemia according to year of birth, sex, and the propensity score model based on comorbidities. Results: In this study, 794 patients with thalassemia and 3176 controls were included. Transfusion-naïve thalassemia children had higher rates to develop asthma (41.03 vs 36.69 per 1000 person-y; P = 0.032) than the non-thalassemia controls with an adjusted hazard ratio of 1.16 (95% confidence interval (CI) = 1.01–1.33). Boys in the thalassemia cohort had a significantly higher adjusted hazard ratio of asthma than those in the non-thalassemia cohort (adjusted hazard ratio = 1.20, 95% CI = 1.02–1.42). In thalassemic patients without atopic dermatitis, the risk of asthma was 1.25-fold higher than in the non-thalassemic ones (95% CI=1.07–1.47). Conclusions: Transfusion-naïve thalassemia children are more likely to have asthma. We need to pay more attention to it in order to diagnosis asthma earlier and to prevent asthma attacked earlier.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Na Zeng ◽  
Erica Erwin ◽  
Wendy Wen ◽  
Daniel J. Corsi ◽  
Shi Wu Wen ◽  
...  

Abstract Background Racial disparities in adverse perinatal outcomes have been studied in other countries, but little has been done for the Canadian population. In this study, we sought to examine the disparities in adverse perinatal outcomes between Asians and Caucasians in Ontario, Canada. Methods We conducted a population-based retrospective cohort study that included all Asian and Caucasian women who attended a prenatal screening and resulted in a singleton birth in an Ontario hospital (April 1st, 2015-March 31st, 2017). Generalized estimating equation models were used to estimate the independent adjusted relative risks and adjusted risk difference of adverse perinatal outcomes for Asians compared with Caucasians. Results Among 237,293 eligible women, 31% were Asian and 69% were Caucasian. Asians were at an increased risk of gestational diabetes mellitus, placental previa, early preterm birth (< 32 weeks), preterm birth, emergency cesarean section, 3rd and 4th degree perineal tears, low birth weight (< 2500 g, < 1500 g), small-for-gestational-age (<10th percentile, <3rd percentile), neonatal intensive care unit admission, and hyperbilirubinemia requiring treatment, but had lower risks of preeclampsia, macrosomia (birth weight > 4000 g), large-for-gestational-age neonates, 5-min Apgar score < 7, and arterial cord pH ≤7.1, as compared with Caucasians. No difference in risk of elective cesarean section was observed between Asians and Caucasians. Conclusion There are significant differences in several adverse perinatal outcomes between Asians and Caucasians. These differences should be taken into consideration for clinical practices due to the large Asian population in Canada.


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