scholarly journals Pediatric Nuclear Medicine Examinations and Subsequent Risk of Neoplasm: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Mei-Kang Yuan ◽  
Shih-Chieh Chang ◽  
Mei-Chun Yuan ◽  
Ning-Ping Foo ◽  
Shan-Ho Chan ◽  
...  
Keyword(s):  
Nuclear Medicine ◽  
Data Science ◽  
Population Based ◽  
Exposed Group ◽  
Research Database ◽  
Science Center ◽  
Pediatric Nuclear Medicine ◽  
Pediatric Neoplasms ◽  
Taiwan National Health Insurance ◽  
Subsequent Risk

Objective: To evaluate the association between radiation exposure from repeated nuclear medicine (NM) examinations and the subsequent risk of neoplasm in pediatric patients.Methods: From 2000 to 2017, participants under 18 years of age who underwent NM scanning were identified using the Health and Welfare Data Science Center (HWDC) dataset, which was extracted from the Taiwan National Health Insurance Research Database (NHIRD). Both the exposed cohort and unexposed subjects were followed up with until the presence of any malignancy arose, including malignant brain, lymphoid and hematopoietic tumors and benign brain or other central nervous tumors.Results: There were 35,292 patients in the exposed cohort and 141,152 matched subjects in the non-exposed group. The exposed cohort had an overall higher IR (IR: incidence rate, per 100,000 person-years) of any malignancy and benign central nervous tumor than the non-exposed group [IR, 16.9 vs. 1.54; adjusted hazard ratio (HR), 10.9; 95% CI, 6.53–18.2]. Further stratifying the number of NM examinations into 1-2, 3-4, and 5 or more times revealed that the IR of pediatric neoplasms increased gradually with the increased frequency of NM examinations (IR, 11.5; adjusted HR, 7.5; 95% CI, 4.29–13.1; IR, 25.8; adjusted HR, 15.9; 95% CI, 7.00–36.1; IR, 93.8; adjusted HR, 56.4; 95% CI, 28.8–110.3).Conclusion: NM examination is significantly associated with a higher risk of pediatric neoplasms, according to our population-based data. Thorough radiation protection and dose reduction in pediatric NM procedures should be an issue of concern.

scholarly journals Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sze-Wen Ting ◽  
Sze-Ya Ting ◽  
Yu-Sheng Lin ◽  
Ming-Shyan Lin ◽  
George Kuo
Keyword(s):  
Cohort Study ◽  
Herpes Zoster ◽  
Population Based ◽  
Research Database ◽  
Newly Diagnosed ◽  
Increased Risk ◽  
Taiwan National Health Insurance ◽  
Reduced Risk ◽  
Systemic Therapies

AbstractThe incidence of herpes zoster in psoriasis patients is higher than in the general population. However, the association between herpes zoster risk and different systemic therapies, especially biologic agents, remains controversial. This study investigated the association between herpes zoster risk and several systemic antipsoriasis therapies. This prospective open cohort study was conducted using retrospectively collected data from the Taiwan National Health Insurance Research Database. We included 92,374 patients with newly diagnosed psoriasis between January 1, 2001, and December 31, 2013. The exposure of interest was the “on-treatment” effect of systemic antipsoriasis therapies documented by each person-quarter. The outcome was the occurrence of newly diagnosed herpes zoster. During a mean follow-up of 6.8 years, 4834 (5.2%) patients were diagnosed with herpes zoster after the index date. Among the systemic antipsoriasis therapies, etanercept (hazard ratio [HR] 4.78, 95% confidence interval [CI] 1.51–15.17), adalimumab (HR 5.52, 95% CI 1.72–17.71), and methotrexate plus azathioprine (HR 4.17, 95% CI 1.78–9.82) were significantly associated with an increased risk of herpes zoster. By contrast, phototherapy (HR 0.76, 95% CI 0.60–0.96) and acitretin (HR 0.39, 95% CI 0.24–0.64) were associated with a reduced risk of herpes zoster. Overall, this study identified an association of both etanercept and adalimumab with an increased risk of herpes zoster among psoriasis patients. Acitretin and phototherapy were associated with a reduced risk.

scholarly journals Statin for Tuberculosis and Pneumonia in Patients with Asthma–Chronic Pulmonary Disease Overlap Syndrome: A Time-Dependent Population-Based Cohort Study

2018 ◽  
Vol 7 (11) ◽  
pp. 381 ◽  
Author(s):  
Jun-Jun Yeh ◽  
Cheng-Li Lin ◽  
Chung-Y. Hsu ◽  
Zonyin Shae ◽  
Chia-Hung Kao
Keyword(s):  
Pulmonary Disease ◽  
Inhaled Corticosteroids ◽  
Population Based ◽  
Overlap Syndrome ◽  
Time Dependent ◽  
Research Database ◽  
Chronic Pulmonary Disease ◽  
Oral Steroids ◽  
Taiwan National Health Insurance ◽  
Study Participants

We investigated the effects of statins on tuberculosis (TB) and pneumonia risks in asthma–chronic pulmonary disease overlap syndrome (ACOS) patients. We extracted data of patients diagnosed as having ACOS during 2000–2010 from the Taiwan National Health Insurance Research Database and divided them into statin users and nonusers. All study participants were followed up from the index date until death, withdrawal from insurance, or TB and pneumonia occurred (31 December 2011). The cumulative TB and pneumonia incidence was analyzed using Cox proportional regression analysis with time-dependent variables. After adjustments for multiple confounding factors including age, sex, comorbidities, and use of medications [statins, inhaled corticosteroids (ICSs), or oral steroids (OSs)], statin use was associated with significantly lower TB [adjusted hazard ratio (aHR) 0.49, 95% confidence interval (CI) 0.34–0.70] and pneumonia (aHR 0.52, 95% CI 0.41–0.65) risks. Moreover, aHRs (95% CIs) for statins combined with ICSs and OSs were respectively 0.60 (0.31–1.16) and 0.58 (0.40–0.85) for TB and 0.61 (0.39–0.95) and 0.57 (0.45–0.74) for pneumonia. Thus, statin users had lower TB and pneumonia risks than did nonusers, regardless of age, sex, comorbidities, and ICS or OS use. Pneumonia risk was lower among users of statins combined with ICSs or Oss and TB risk was lower among the users of statins combined with OSs.

scholarly journals Time-dependent risks of cancer clustering among couples: a nationwide population-based cohort study in Taiwan

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018968 ◽  
Author(s):  
Jong-Yi Wang ◽  
Yia-Wen Liang ◽  
Chun-Chen Yeh ◽  
Chiu-Shong Liu ◽  
Chen-Yu Wang
Keyword(s):  
Married Couples ◽  
Population Based ◽  
Research Database ◽  
Malignant Tumours ◽  
Lifestyle Risk Factors ◽  
Risk Characteristics ◽  
Vulnerable Families ◽  
Taiwan National Health Insurance ◽  
High Age ◽  
Lifestyle Risk

ObjectivesSpousal clustering of cancer warrants attention. Whether the common environment or high-age vulnerability determines cancer clustering is unclear. The risk of clustering in couples versus non-couples is undetermined. The time to cancer clustering after the first cancer diagnosis is yet to be reported. This study investigated cancer clustering over time among couples by using nationwide data.MethodsA cohort of 5643 married couples in the 2002–2013 Taiwan National Health Insurance Research Database was identified and randomly matched with 5643 non-couple pairs through dual propensity score matching. Factors associated with clustering (both spouses with tumours) were analysed by using the Cox proportional hazard model.ResultsPropensity-matched analysis revealed that the risk of clustering of all tumours among couples (13.70%) was significantly higher than that among non-couples (11.84%) (OR=1.182, 95% CI 1.058 to 1.321, P=0.0031). The median time to clustering of all tumours and of malignant tumours was 2.92 and 2.32 years, respectively. Risk characteristics associated with clustering included high age and comorbidity.ConclusionsShared environmental factors among spouses might be linked to a high incidence of cancer clustering. Cancer incidence in one spouse may signal cancer vulnerability in the other spouse. Promoting family-oriented cancer care in vulnerable families and preventing shared lifestyle risk factors for cancer are suggested.

scholarly journals Gender and Age Differences and the Trend in the Incidence and Prevalence of Dementia and Alzheimer’s Disease in Taiwan: A 7-Year National Population-Based Study

2019 ◽  
Vol 2019 ◽  
pp. 1-12
Author(s):  
Chih-Ching Liu ◽  
Chung-Yi Li ◽  
Yu Sun ◽  
Susan C. Hu
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Age Differences ◽  
Population Based ◽  
Incidence Rates ◽  
Research Database ◽  
Gender And Age ◽  
Taiwan National Health Insurance ◽  
Gender And Age Differences ◽  
Prevalence Of Dementia

Background. Very few nationwide studies have focused on the variations in the incidence and prevalence of dementia and Alzheimer’s disease (AD) in Asian countries. This study aims to describe the gender and age differences in the incidence and prevalence of dementia and AD in Taiwan. Methods. The data on dementia and AD were acquired from the Taiwan National Health Insurance Research Database from 2004 to 2010. The sex and age-specific rates were standardized, and the differences of gender and age on dementia or AD were assessed using Poisson regression analysis. Results. Over seven years, the prevalence of dementia and AD significantly increased from 4.7 to 7.6 per hundred people (β = 0.0784, p<0.0001) and 2.3 to 3.5 per hundred people (β = 0.0696, p<0.0001), respectively. However, the incidence of both dementia and AD decreased but not significantly from 10.9 to 10.7 and 4.9 to 4.6 per thousand person-years, respectively. Noticeably, both incidence and prevalence increased with age and were higher in women than in men. Conclusions. The standardized incidence rates of dementia and AD are much lower than the data reported in some studies from Europe, the US, and Japan. Further studies are warranted to explore which factors are associated with the differences in the incidence of dementia and AD in Taiwan.

Chronic Pain Increases the Risk for Major Adverse Cardiac and Cerebrovascular Events: A Nationwide Population-Based Study in Asia

Pain Medicine ◽  
2020 ◽  
Vol 21 (9) ◽  
pp. 1985-1990 ◽  
Author(s):  
Kun-Ming Chung ◽  
Chung-Han Ho ◽  
Yi-Chen Chen ◽  
Chien-Chin Hsu ◽  
Chong-Chi Chiu ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Asian Population ◽  
Population Based ◽  
Renal Diseases ◽  
Chronic Obstructive ◽  
Research Database ◽  
Obstructive Pulmonary Disease ◽  
Cerebrovascular Events ◽  
Increased Risk ◽  
Taiwan National Health Insurance

Abstract Objective Chronic pain (CP) may increase the risk for major adverse cardiac and cerebrovascular events (MACCEs); however, this issue is still unclear in the Asian population. We conducted this study to delineate it. Design From the Taiwan National Health Insurance Research Database, we identified 17,614 participants (&lt;65 years) with CP and matched them by age and sex at a 1:2 ratio to participants without CP, who made up the comparison cohort. Several causes of CP and its underlying comorbidities were also analyzed. Outcome Measure A comparison of MACCE occurring in the two cohorts was performed via follow-up until 2015. Results The mean age (SD) was 50.2 (11.5) years and 50.4 (11.7) years in participants with and without CP, respectively. In both cohorts, the percentage of female participants was 55.5%. Common causes of CP were spinal disorders (23.9%), osteoarthritis (12.4%), headaches (11.0%), gout (10.2%), malignancy (6.2%), and osteoporosis (4.5%). After adjusting for hypertension, diabetes, chronic obstructive pulmonary disease, renal diseases, hyperlipidemia, liver diseases, dementia, and depression, participants with CP had a higher risk for MACCE than those without CP (adjusted hazard ratio [AHR] = 1.3, 95% confidence interval [CI] = 1.3 − 1.4). After conducting subgroup analyses, an increased risk was also found for all-cause mortality (AHR = 1.4, 95% CI = 1.1 − 1.8), acute myocardial infarction (AHR = 1.2, 95% CI = 1.0 − 1.4), and stroke (AHR = 1.3, 95% CI = 1.3 − 1.4). Conclusions CP is associated with increased occurrence of MACCE. Early detection and interventions for CP are suggested.

In-hospital mortality among electroconvulsive therapy recipients: A 17-year nationwide population-based retrospective study

2017 ◽  
Vol 42 ◽  
pp. 29-35 ◽  
Author(s):  
C.-S. Liang ◽  
C.-H. Chung ◽  
C.-K. Tsai ◽  
W.-C. Chien
Keyword(s):  
Hospital Mortality ◽  
Electroconvulsive Therapy ◽  
Scientific Evidence ◽  
Population Based ◽  
National Database ◽  
Research Database ◽  
Taiwan National Health Insurance ◽  
Hospital Stays ◽  
Psychiatric Conditions ◽  
Using Data

AbstractBackgroundElectroconvulsive therapy (ECT) remains irreplaceable in the treatment of several psychiatric conditions. However, evidence derived using data from a national database to support its safety is limited. The aim of this study was to investigate in-hospital mortality among patients with psychiatric conditions treated with and without ECT.MethodsUsing data from the Taiwan National Health Insurance Research Database from 1997 to 2013, we identified 828,899 inpatients with psychiatric conditions, among whom 0.19% (n = 1571) were treated with ECT.ResultsWe found that ECT recipients were more frequently women, were younger and physically healthier, lived in more urbanized areas, were treated in medical centers, and had longer hospital stays. ECT recipients had lower odds of in-hospital mortality than did those who did not receive ECT. Moreover, no factor was identified as being able to predict mortality in patients who underwent ECT. Among all patients, ECT was not associated with in-hospital mortality after controlling for potential confounders.ConclusionECT was indicated to be safe and did not increase the odds of in-hospital mortality. However, ECT appeared to be administered only on physically healthy but psychiatrically compromised patients, a pattern that is in opposition with the scientific evidence supporting its safety. Moreover, our data suggest that ECT is still used as a treatment of last resort in the era of modern psychiatry.

scholarly journals Risk of Endometriosis and Subsequent Ovary and Breast Cancers in Nurses: A Population-Based Cohort Study in Taiwan

2019 ◽  
Vol 16 (18) ◽  
pp. 3469 ◽  
Author(s):  
Hsing-Chi Hsu ◽  
Kai-Yu Tseng ◽  
Hsiang-Chi Wang ◽  
Fung-Chan Sung ◽  
Wei-Fen Ma
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Subsequent Development ◽  
Population Based ◽  
Research Database ◽  
Breast Cancers ◽  
Hazard Ratios ◽  
Taiwan National Health Insurance ◽  
And Control ◽  
Incident Cases

Background: Endometriosis has been associated with the subsequent development of ovarian and breast cancers. This study evaluated whether nurses were at increased risks of developing endometriosis and subsequent ovarian and breast cancers. Methods: From Taiwan National Health Insurance Research Database during 2000 to 2011, we established 3 study cohorts, consisting of 23,801 nurses, 11,973 other hospital employees, and 143,096 general women free of endometriosis and cancer. Women in all cohorts were followed to the end of 2011 to measure the occurrences of endometriosis and subsequent ovarian and breast cancers. The incident endometriosis cases and related hazard ratio (HR) and 95% confidence interval (CI) were calculated. The incident cases of ovarian cancer and breast cancer and related odds ratio were calculated. Results: The incidence of endometriosis was the highest in the nurse cohort (4.23 per 100, n = 966) followed by other health professionals (3.74 per 100, n = 427) and control cohort (3.06 per 100, n = 4193), with adjusted hazard ratios of 1.28 (95% CI = 1.20–1.38) and 1.13 (95% CI = 1.02–1.25), respectively, comparing to controls. Among those who developed endometriosis, nurses had higher subsequent ovarian cancer and lower breast cancer, but not significant. Conclusions: Nurses are at a higher risk of developing endometriosis. However, the link between endometriosis and subsequent cancers is weak.

Outcomes of chronic subdural hematoma in patients with liver cirrhosis

2018 ◽  
Vol 130 (1) ◽  
pp. 302-311 ◽  
Author(s):  
Ching-Chang Chen ◽  
Shao-Wei Chen ◽  
Po-Hsun Tu ◽  
Yin-Cheng Huang ◽  
Zhuo-Hao Liu ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Subdural Hematoma ◽  
Simple Procedure ◽  
Chronic Subdural Hematoma ◽  
Population Based ◽  
Research Database ◽  
Long Term Follow Up ◽  
Taiwan National Health Insurance ◽  
Using Data

OBJECTIVEBurr hole craniostomy is an effective and simple procedure for treating chronic subdural hematoma (CSDH). However, the surgical outcomes and recurrence of CSDH in patients with liver cirrhosis (LC) remain unknown.METHODSA nationwide population-based cohort study was retrospectively conducted using data from the Taiwan National Health Insurance Research Database. The study included 29,163 patients who underwent first-time craniostomy for CSDH removal between January 1, 2001, and December 31, 2013. In total, 1223 patients with LC and 2446 matched non-LC control patients were eligible for analysis. All-cause mortality, surgical complications, repeat craniostomy, extended craniotomy, and long-term medical costs were analyzed.RESULTSThe in-hospital mortality rate (8.7% vs 3.1% for patients with LC and non-LC patients, respectively), frequency of hospital admission, length of ICU stay, number of blood transfusions, and medical expenditures of patients with LC who underwent craniostomy for CSDH were considerably higher than those of non-LC control patients. Patients with LC tended to require an extended craniotomy to remove subdural hematomas in the hospital or during long-term follow-up. The surgical outcome worsened with an increase in the severity of LC.CONCLUSIONSEven for simple procedures following minor head trauma, LC remains a serious comorbidity with a poor prognosis.

scholarly journals The Temporal Relationship between Selected Mental Disorders and Substance-Related Disorders: A Nationwide Population-Based Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Mu-Lin Chiu ◽  
Chi-Fung Cheng ◽  
Wen-Miin Liang ◽  
Pen-Tang Lin ◽  
Trong-Neng Wu ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Personality Disorders ◽  
Large Scale ◽  
Later Life ◽  
Population Based ◽  
Research Database ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Taiwan National Health Insurance ◽  
Substance Related Disorders

Introduction. Previous studies have examined the association between specific mental disorders, particularly mood and anxiety disorders, and substance-related disorders; but the temporal link between them remains unclear. This study aimed to examine whether individuals with specific mental disorders, including affective psychoses, neurotic disorders, schizophrenia, personality disorders, and adjustment reaction, have higher risks for subsequently developing substance-related disorders compared to those without. Methods. A large-scale study with longitudinal data was conducted using the Taiwan National Health Insurance Research Database (NHIRD) consisting of 2,000,118 patients’ medical records from 2000 to 2009. A total of 124,423 people diagnosed with selected mental disorders and the same number of people without the diagnoses of the selected disorders were identified between January 1, 2001, and December 31, 2006, and followed up for the diagnoses of substance-related disorders till the end of 2009. We estimated the risk for subsequently developing substance-related disorders among patients with the selected mental disorders compared to those without by using Cox proportional hazard models. The cumulative incidence of substance-related disorders was calculated using the Kaplan-Meier method. Results. The risk for developing substance-related disorders in patients with selected mental disorders is about 5 times (HR=5.09, 95% CI: 4.74-5.48) higher than those without after adjusting for potential confounding variables. From the multivariate analyses of subsamples stratified by age, sex, and urban and income levels, we found all adjusted hazard ratios were significantly higher than 1.0, ranging from 2.12 (95% CI: 1.72-2.62) to 14.55 (95% CI: 7.89-26.83). For children and adolescents aged 10-19 years, those with specific mental disorders had 14.55-fold higher risk for developing substance-related disorders in later life compared to their counterparts. Furthermore, patients with personality disorders had the highest risk (HR=25.05). Conclusions. The earlier onset of the selected mental disorders is a potential risk for developing substance-related disorders in later life, particularly for personality disorders. Health professionals should pay more attention to this at-risk population, especially to adolescents with mental disorders.

The implications of catheter ablation for solitary atrial flutter in preventing stroke risk: a nationwide population-based cohort study

EP Europace ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. 1558-1566
Author(s):  
Yu-Sheng Lin ◽  
Victor Chien-Chia Wu ◽  
Hui-Ting Wang ◽  
Huang-Chung Chen ◽  
Mien-Cheng Chen ◽  
...  
Keyword(s):  
Atrial Flutter ◽  
Primary Outcome ◽  
Stroke Risk ◽  
Population Based ◽  
Research Database ◽  
Confounding Factors ◽  
Subdistribution Hazard ◽  
Taiwan National Health Insurance ◽  
History Of

Abstract Aims The implications of ablation for atrial fibrillation in preventing stroke are controversial, and no studies have investigated whether ablation prevents ischaemic stroke (IS) in atrial flutter (AFL). Methods and results This study analysed data contained in the Taiwan National Health Insurance Research Database for 16 765 patients with a first diagnosis of solitary AFL during 2001–2013. Eligible patients were divided into two groups according to whether or not they had received ablation. Propensity score matching (PSM) was performed to mitigate the effects of potential confounding factors. The primary outcome was occurrence of IS during follow-up. After 1:2 PSM, the analysis included 1037 patients in the ablation group and 2074 patients in the non-ablation group. The incidence of IS was lower in the ablation group compared to the non-ablation group [subdistribution hazard ratio (SHR) 0.61, 95% confidence interval (CI) 0.41–0.90] during the 2-year follow-up period but not thereafter (SHR 1.03, 95% CI 0.72–1.48). When grouping by stroke history, it revealed that ablation affected the incidence of stroke in patients without history of stroke (SHR 0.59, 95% CI 0.38–0.91) but not in patients with history of stroke. When each group was stratified by CHA2DS2-VASc score, ablation lowered the incidence of stroke in patients with CHA2DS2-VASc ≤3 (SHR 0.31, 95% CI 0.16–0.60) but not in patients with CHA2DS2-VASc ≥4 in the initial 2-year follow-up. Conclusion The different incidence of IS in patients with/without ablation indicates that ablation reduces the risk of IS in AFL patients.

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