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Lai SW, Lin CL, Liao KF. Association between colorectal cancer and zolpidem use in a case-control study. Medicine (Baltimore) 2019; 98:e18127. [PMID: 31770243 PMCID: PMC6890285 DOI: 10.1097/md.0000000000018127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/04/2019] [Accepted: 10/28/2019] [Indexed: 11/27/2022] Open
Abstract
This study aimed to examine the association between colorectal cancer and zolpidem use in Taiwan.A case-control study was conducted using the database of Taiwan National Health Insurance Program from 2000 to 2013. Participants aged 20 to 84 years with newly diagnosed colorectal cancer were selected as the cases. Sex-matched and age-matched participants without colorectal cancer were randomly selected as the matched controls. The odds ratio and 95% confidence interval for colorectal cancer associated with zolpidem use were calculated by the multivariable logistic regression model.There were 4912 cases with colorectal cancer and 4912 matched controls without colorectal cancer. The mean age was 63 years and 58% were male participants. After adjustment for co-variables, the multivariable logistic regression model disclosed that there was no statistical association between colorectal cancer and zolpidem use (adjusted OR 1.05, 95% CI 0.95-1.15).No statistical association can be detected between colorectal cancer and zolpidem use in Taiwan.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University
- Department of Family Medicine
| | - Cheng-Li Lin
- College of Medicine, China Medical University
- Management Office for Health Data, China Medical University Hospital, Taichung
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien
- Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taichung, Taiwan
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Rogers JP, Pollak TA, Blackman G, David AS. Catatonia and the immune system: a review. Lancet Psychiatry 2019; 6:620-630. [PMID: 31196793 PMCID: PMC7185541 DOI: 10.1016/s2215-0366(19)30190-7] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 03/27/2019] [Accepted: 04/04/2019] [Indexed: 12/13/2022]
Abstract
Catatonia is a psychomotor disorder featuring stupor, posturing, and echophenomena. This Series paper examines the evidence for immune dysregulation in catatonia. Activation of the innate immune system is associated with mutism, withdrawal, and psychomotor retardation, which constitute the neurovegetative features of catatonia. Evidence is sparse and conflicting for acute-phase activation in catatonia, and whether this feature is secondary to immobility is unclear. Various viral, bacterial, and parasitic infections have been associated with catatonia, but it is primarily linked to CNS infections. The most common cause of autoimmune catatonia is N-methyl-D-aspartate receptor (NMDAR) encephalitis, which can account for the full spectrum of catatonic features. Autoimmunity appears to cause catatonia less by systemic inflammation than by the downstream effects of specific actions on extracellular antigens. The specific association with NMDAR encephalitis supports a hypothesis of glutamatergic hypofunction in catatonia.
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Affiliation(s)
- Jonathan P Rogers
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley National Health Service Foundation Trust, Bethlem Royal Hospital, UK.
| | - Thomas A Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley National Health Service Foundation Trust, Bethlem Royal Hospital, UK
| | - Graham Blackman
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; South London and Maudsley National Health Service Foundation Trust, Bethlem Royal Hospital, UK
| | - Anthony S David
- Institute of Mental Health, University College London, London, UK
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Liao KF, Lin CL, Lai SW. Association between colorectal cancer and thiazolidinediones administration in a case-control study. Biomedicine (Taipei) 2019; 9:4. [PMID: 30794151 PMCID: PMC6385609 DOI: 10.1051/bmdcn/2019090104] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 06/15/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES This study was designed to assess whether there was an association between colorectal cancer and thiazolidinediones use. METHODS A population-based case-control study was performed using the database of the Taiwan National Health Insurance Program. The case group consisted of 20218 type 2 diabetic subjects aged 20 to 84 years with newly diagnosed colorectal cancer between 2000 and 2011. The date of a subject being diagnosed with colorectal cancer was defined as the index date. The control group consisted of 20218 randomly selected type 2 diabetic subjects aged 20 to 84 years without colorectal cancer between 2000 and 2011. A subject who had at least a prescription of thiazolidinediones before the index date was defined as "ever used". A subject who did not have a prescription of thiazolidinediones before the index date was defined as "never used". The odds ratio (OR) and 95% confidence interval (CI) was used to estimate the association between colorectal cancer and thiazolidinediones use by the multivariable logistic regression model. RESULTS After adjustment for potential confounders, the odds of thiazolidinediones use in cases with colorectal cancer were lower than the odds of thiazolidinediones use in subjects without colorectal cancer (adjusted OR 0.94, 95% CI 0.89-0.99). CONCLUSIONS The odds of thiazolidinediones use in cases with colorectal cancer were lower than subjects without colorectal cancer. A prospective study is required to test whether thiazolidinediones use has a protective effect against colorectal cancer.
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Affiliation(s)
- Kuan-Fu Liao
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College of Medicine, Tzu Chi University Hualien 970 Taiwan
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Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital Taichung 427 Taiwan
| | - Cheng-Li Lin
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College of Medicine, China Medical University Taichung 404 Taiwan
- Management Office for Health Data
| | - Shih-Wei Lai
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College of Medicine, China Medical University Taichung 404 Taiwan
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Department of Family Medicine, China Medical University Hospital Taichung 404 Taiwan
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Lai SW, Lin CL, Liao KF. Association between tamoxifen use and acute myocardial infarction in women with breast cancer. Medicine (Baltimore) 2019; 98:e13925. [PMID: 30653098 PMCID: PMC6370151 DOI: 10.1097/md.0000000000013925] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 11/20/2018] [Accepted: 12/09/2018] [Indexed: 01/01/2023] Open
Abstract
The relationship between tamoxifen use and acute myocardial infarction in women with breast cancer remains uncertain. The goal of the study was to assess whether tamoxifen use could be associated with acute myocardial infarction in women with breast cancer in Taiwan.A population-based case-control study was conducted to analyze the database of the Taiwan National Health Insurance Program. Totally, 489 women with breast cancer aged 20 to 84 years having the first episode of acute myocardial infarction from 2000 to 2011 were found as the cases. In addition, 1718 women with breast cancer aged 20 to 84 years without any type of ischemic heart disease were selected as the matched controls. Ever use of tamoxifen was classified as the studied women who had at least a prescription for tamoxifen before the index date. Never use of tamoxifen was classified as the studied women who never had a prescription for tamoxifen before the index date. We used the multivariable logistic regression model to estimate the odds ratio (OR) and 95% confidence interval (CI) for acute myocardial infarction associated with tamoxifen use.In a multivariable-adjusted analysis, women with acute myocardial infarction were 1.71 times more likely to be exposed to tamoxifen than those women without acute myocardial infarction (adjusted OR 1.71, 95% CI 1.38-2.13).The odds of tamoxifen use are 1.71 times higher in women with acute myocardial infarction versus those women without acute myocardial infarction in Taiwan.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University
- Department of Family Medicine, and
| | - Cheng-Li Lin
- College of Medicine, China Medical University
- Management Office for Health Data, China Medical University Hospital, Taichung
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien
- Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taichung, Taiwan
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Lai SW, Lin CL, Liao KF. Weight loss might be an early clinical feature of undiagnosed human immunodeficiency virus infection in Taiwan. Biomedicine (Taipei) 2018; 8:19. [PMID: 30141406 PMCID: PMC6108225 DOI: 10.1051/bmdcn/2018080319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 04/24/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND/OBJECTIVE Little research is available on the relationship between weight loss and human immunodeficiency virus (HIV) infection in Taiwan. We hope to evaluate whether weight loss could be an early clinical feature of undiagnosed HIV infection in Taiwan. METHODS We conducted a retrospective population-based cohort study using the database of the Taiwan National Health Insurance (NHI) Program. There were 4748 male subjects aged 1-84 with newly diagnosed weight loss as the weight loss group from 1998-2012 and 18982 age-matched male subjects without weight loss as the non-weight loss group. The incidence of HIV infection at the end of 2013 was measured in both groups. The multivariable Cox proportional hazards regression model was used to measure the hazard ratio (HR) and 95% confidence interval (CI) for HIV risk associated with weight loss. RESULTS The overall incidence of HIV infection was 3.79-fold higher in the weight loss group than in the non-weight loss group (6.83 vs. 1.80 per 10000 person-years, 95% CI 3.41, 4.21). The incidence was the highest during the first 6 months of follow-up in the weight loss group (39.0 per 10000 person-years). After adjusting for confounding factors, the adjusted HR of HIV infection was 3.63 (95% CI 1.77, 7.44) for the weight loss group, compared with the non-weight loss group. CONCLUSION Weight loss might be an early clinical feature of undiagnosed HIV infection in Taiwan. Male patients with weight loss who have risk factors for HIV infection should be recommended to regularly be tested for HIV infection.
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Affiliation(s)
- Shih-Wei Lai
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College of Medicine, China Medical University Taichung
404 Taiwan
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Department of Family Medicine, China Medical University Hospital Taichung
404 Taiwan
| | - Cheng-Li Lin
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College of Medicine, China Medical University Taichung
404 Taiwan
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Management Office for Health Data, China Medical University Hospital Taichung
404 Taiwan
| | - Kuan-Fu Liao
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College of Medicine, Tzu Chi University Hualien
970 Taiwan
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Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi General Hospital Taichung
427 Taiwan
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Lai SW, Lin CL, Liao KF. Synergistic effect of oral corticosteroids use on risk of hepatocellular carcinoma in high risk populations. Eur J Intern Med 2018; 52:73-77. [PMID: 29555406 DOI: 10.1016/j.ejim.2018.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 02/26/2018] [Accepted: 03/10/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Little evidence is available on the relationship between oral corticosteroids use and hepatocellular carcinoma. The objective of this study was to investigate whether oral corticosteroids use correlates with the risk of hepatocellular carcinoma in high risk populations in Taiwan. METHODS Using representative claims database established from the Taiwan National Health Insurance Program with a population coverage rate of 99.6%, we identified 102,182 subjects aged 20-84 years with newly diagnosed hepatocellular carcinoma in 2000-2011 as the cases and 102,182 randomly selected subjects aged 20-84 years without hepatocellular carcinoma as the matched controls. RESULTS In subjects with any one of comorbidities including alcohol-related disease, chronic liver disease, and diabetes mellitus, the adjusted OR of hepatocellular carcinoma was 29.9 (95% CI 28.7, 31.1) for subjects with never use of oral corticosteroids, and the adjusted OR would increase to 33.7 (95% CI 32.3, 35.3) for those with ever use of oral corticosteroids. The adjusted OR of hepatocellular carcinoma was 1.03 for subjects with increasing cumulative duration of oral corticosteroids use for every one year (95% CI 1.01, 1.06), with a duration-dependent effect. The largest OR occurred in subjects with ever use of oral corticosteroids and concurrently comorbid with alcohol-related disease, chronic liver disease, and diabetes mellitus (adjusted OR 122.7, 95% CI 108.5, 138.8). CONCLUSION There is a synergistic effect between oral corticosteroids use and the traditional risk factors on the risk of hepatocellular carcinoma. People with risk factors for hepatocellular carcinoma should receive regular ultrasound surveillance, particularly when they currently use oral corticosteroids.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.
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Lai SW, Lin CL, Liao KF. Association between oral corticosteroid use and pyogenic liver abscesses in a case-control study. Biomedicine (Taipei) 2018; 8:5. [PMID: 29480800 PMCID: PMC5825916 DOI: 10.1051/bmdcn/2018080105] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 11/05/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND AIM There are no epidemiological studies focusing on the association between oral corticosteroid use and pyogenic liver abscesses. The aim of the study was to assess whether oral corticosteroid use is associated with increased odds of pyogenic liver abscesses in adults in Taiwan. METHODS This retrospective population-based case-control study was conducted to analyze the database of the Taiwan National Health Insurance Program from 2000 to 2013. Subjects aged 20 to 84 years with their first episode of pyogenic liver abscesses were assigned as the cases (n = 881). Randomly selected subjects without pyogenic liver abscesses aged 20 to 84 years were selected as the controls (n = 3207). A multivariable logistic regression model was used to assess the odds ratio and 95% confidence interval for the correlation of oral corticosteroid use with pyogenic liver abscesses. RESULTS After regulating for confounders, the adjusted odds ratio of pyogenic liver abscesses was 1.40 for subjects currently using oral corticosteroids (95% confidence interval 1.14, 1.70), compared with subjects who never used them. Upon further analysis, the adjusted odds ratio of pyogenic liver abscesses was 1.03 for subjects with current use of oral corticosteroids when increasing dosage for every one mg (95% CI 1.01, 1.06). CONCLUSION Although the findings are not unexpected, they are important because they suggest that current use of oral corticosteroids is significantly associated with increased odds of developing pyogenic liver abscesses in adults in Taiwan, with a dose-dependent effect.
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Affiliation(s)
- Shih-Wei Lai
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College of Medicine, China Medical University Taichung 404 Taiwan
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Department of Family Medicine, China Medical University Hospital Taichung 404 Taiwan
| | - Cheng-Li Lin
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College of Medicine, China Medical University Taichung 404 Taiwan
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Management Office for Health Data, China Medical University Hospital Taichung 404 Taiwan
| | - Kuan-Fu Liao
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College of Medicine, Tzu Chi University Hualien 970 Taiwan
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Department of Internal Medicine, Taichung Tzu Chi General Hospital Taichung 427 Taiwan
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Proton pump inhibitors therapy and the risk of hip fracture in older people in Taiwan. Eur Geriatr Med 2018; 9:169-174. [DOI: 10.1007/s41999-017-0022-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 12/18/2017] [Indexed: 12/12/2022]
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Lai SW, Lin CL, Liao KF. Head and neck cancer associated with increased rate of pulmonary tuberculosis in a population-based cohort study. Medicine (Baltimore) 2017; 96:e8366. [PMID: 29069025 PMCID: PMC5671858 DOI: 10.1097/md.0000000000008366] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The objective of this study was to examine the incidence and hazard ratio (HR) of pulmonary tuberculosis in patients with head and neck cancer in Taiwan.This population-based retrospective cohort study was conducted to analyze the database of the Taiwan National Health Insurance Program. There were 2522 subjects aged 20 to 84 years with newly diagnosed head and neck cancer as the head and neck cancer group between 2000 and 2012, and 10,064 randomly selected sex- and age-matched subjects without any cancer as the noncancer group. The incidence of pulmonary tuberculosis at the end of 2013 was estimated in both groups. A multivariable Cox proportional hazards regression model was used to estimate the HR and 95% confidence interval (CI) for pulmonary tuberculosis being associated with head and neck cancer.The overall incidence of pulmonary tuberculosis was 2.86-fold greater in the head and neck cancer group than that in the noncancer group (4.70 vs 1.64 per 1000 person-years, 95% CI, 2.53-3.24). After adjusting for confounding factors, the adjusted HR of pulmonary tuberculosis became 2.90 for the head and neck cancer group (95% CI, 2.11-3.99), compared with the noncancer group. In addition, male (adjusted HR 2.27, 95% CI, 1.29-4.00) and age (increase for 1 year, adjusted HR 1.06, 95% CI, 1.05-1.08) were associated with pulmonary tuberculosis.Head and neck cancer is significantly associated with 2.90-fold increased hazard of pulmonary tuberculosis in Taiwan, compared with the general population.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University, Taichung
- Department of Family Medicine, China Medical University Hospital, Taichung
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung
- Management Office for Health Data, China Medical University Hospital, Taichung
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan
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Lai SW, Lin CL, Liao KF. Risk of contracting pneumonia among patients with predialysis chronic kidney disease: a population-based cohort study in Taiwan. Biomedicine (Taipei) 2017; 7:20. [PMID: 28840834 PMCID: PMC5571660 DOI: 10.1051/bmdcn/2017070320] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 06/09/2017] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The objective of the study was to investigate the association between predialysis chronic kidney disease and contracting pneumonia in Taiwan. METHODS We employed a population-based, retrospective cohort design using the database of the Taiwan National Health Insurance (NHI) Program. There were 18807 subjects aged 20-84 years who were newly diagnosed with predialysis chronic kidney disease between 2000 to 2012 as the predialysis chronic kidney disease group and 18807 randomly selected subjects without chronic kidney disease as the non-chronic kidney disease group. The predialysis chronic kidney disease and non-chronic kidney disease groups were matched according to sex, age, comorbidities, and the year of index date. The incidence of contracting pneumonia among both groups at the end of 2013 was calculated. The multivariable Cox proportional hazards regression model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for contracting pneumonia being associated with predialysis chronic kidney disease. RESULTS The overall incidence of contracting pneumonia was 1.47-fold higher in the predialysis chronic kidney disease group than that in the non-chronic kidney disease group (24.6 vs. 16.7 per 1, 000 person-years, 95% CI 1.40, 1.55). After adjusting for co-variables, the HR of contracting pneumonia became 1.52 for subjects with predialysis chronic kidney disease (95% CI 1.43, 1.60) compared to subjects without chronic kidney disease. With even further analysis, in the absence of any comorbidity, the adjusted HR of contracting pneumonia was 1.53 for subjects with predialysis chronic kidney disease alone (95% CI 1.32, 1.76). CONCLUSIONS Patients with predialysis chronic kidney disease have a 1.52-fold increased risk of contracting pneumonia as compared to those with non-chronic kidney disease. Even in the absence of any comorbidity, a greater than average risk of contracting pneumonia remains present.
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Affiliation(s)
- Shih-Wei Lai
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College of Medicine, China Medical University Taichung
404 Taiwan
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Department of Family Medicine, China Medical University Hospital Taichung
404 Taiwan
| | - Cheng-Li Lin
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College of Medicine, China Medical University Taichung
404 Taiwan
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Management Office for Health Data, China Medical University Hospital Taichung
404 Taiwan
| | - Kuan-Fu Liao
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Graduate Institute of Integrated Medicine, China Medical University Taichung
404 Taiwan
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College of Medicine, Tzu Chi University Hualien
970 Taiwan
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Department of Internal Medicine, Taichung Tzu Chi General Hospital Taichung
427 Taiwan
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Lai SW, Lin CL, Liao KF. Population-based cohort study investigating the correlation of diabetes mellitus with pleural empyema in adults in Taiwan. Medicine (Baltimore) 2017; 96:e7763. [PMID: 28885331 PMCID: PMC6392655 DOI: 10.1097/md.0000000000007763] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/23/2017] [Accepted: 07/24/2017] [Indexed: 12/13/2022] Open
Abstract
We assessed the association between diabetes mellitus and the risk of pleural empyema in Taiwan.A population-based retrospective cohort study was conducted using the database of the Taiwan National Health Insurance Program. There were 28,802 subjects aged 20 to 84 years who were newly diagnosed with diabetes mellitus from 2000 to 2010 as the diabetes group and 114,916 randomly selected subjects without diabetes mellitus as the non-diabetes group. The diabetes group and the non-diabetes group were matched by sex, age, comorbidities, and the year of index date. The incidence of pleural empyema at the end of 2011 was estimated. A multivariable Cox proportional hazards regression model was used to estimate the hazard ratio (HR) and 95% confidence interval (95% CI) for pleural empyema associated with diabetes mellitus.The overall incidence of pleural empyema was 1.65-fold higher in the diabetes group than that in the non-diabetes group (1.58 vs 0.96 per 10,000 person-years, 95% CI 1.57-1.72). After adjusting for confounders, a multivariable Cox proportional hazards regression model revealed that the adjusted HR of pleural empyema was 1.71 in subjects with diabetes mellitus (95% CI 1.16-2.51), compared with those without diabetes mellitus. In further analysis, even in the absence of any comorbidity, the adjusted HR was 1.99 for subjects with diabetes mellitus alone (95% CI 1.18-3.38).Diabetic patients confer a 1.71-fold increased hazard of developing pleural empyema. Even in the absence of any comorbidity, the risk remains existent.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine
- Department of Family Medicine
| | - Cheng-Li Lin
- College of Medicine
- Management Office for Health Data, China Medical University Hospital, Taichung
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien
- Department of Internal Medicine, Taichung Tzu Chi General Hospital
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
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Lai SW, Lin CL, Liao KF. Nation-based case-control study investigating the relationship between oral corticosteroids use and pulmonary tuberculosis. Eur J Intern Med 2017; 43:53-57. [PMID: 28554781 DOI: 10.1016/j.ejim.2017.05.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 05/20/2017] [Accepted: 05/22/2017] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVE No published formal study focuses on the relationship between oral corticosteroids use and pulmonary tuberculosis in Taiwan. The aim of the study was to investigate whether oral corticosteroids use was associated with increased odds of pulmonary tuberculosis. METHODS The retrospective, nation-based, case-control study was conducted to analyze the database of the Taiwan National Health Insurance Program between 2000 and 2013. Subjects aged 20 to 84years with newly diagnosed pulmonary tuberculosis were defined as the cases (n=6021). Randomly selected subjects without pulmonary tuberculosis aged 20 to 84years were defined as the controls (n=6021). Subjects who never had a prescription for oral corticosteroids were defined as never use. Subjects who ever had a prescription for oral corticosteroids were defined as ever use. RESULTS After adjustment for confounders, the adjusted odds ratio of pulmonary tuberculosis was 1.91 for subjects with even use of oral corticosteroids (95% confidence interval 1.73, 2.11), comparing with never use. The adjusted odds ratio of pulmonary tuberculosis was 1.03 for subjects with increasing cumulative dose of oral corticosteroids for per milligram (95% confidence interval 1.02, 1.03), comparing with never use. In addition, the adjusted odds ratios of pulmonary tuberculosis were 1.83 (95% CI 1.65, 2.02) for subjects with cumulative duration of oral corticosteroids<3months, and 2.12 (95% CI 1.87, 2.40) for subjects with cumulative duration≥3months, comparing with never use. CONCLUSION Though the finding is not unexpected, use of oral corticosteroids is significantly associated with 1.9-fold increased odds of pulmonary tuberculosis, independent of other risk comorbidities. There are dose-dependent and duration-dependent effects of oral corticosteroids use on the risk of pulmonary tuberculosis.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan; Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan; College of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.
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Lai SW, Lin CL, Liao KF. Glaucoma correlates with increased risk of Parkinson's disease in the elderly: a national-based cohort study in Taiwan. Curr Med Res Opin 2017; 33:1511-1516. [PMID: 28436278 DOI: 10.1080/03007995.2017.1322570] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND/OBJECTIVE Very little is known about the association between glaucoma and Parkinson's disease in the elderly. The objective of this study was to determine whether glaucoma is associated with Parkinson's disease in older people in Taiwan. METHODS A retrospective cohort study was conducted to analyze the Taiwan National Health Insurance Program database from 2000 to 2010. We included 4330 subjects aged 65 years or older with newly diagnosed glaucoma as the glaucoma group, and 17,000 randomly selected subjects without a glaucoma diagnosis as the non-glaucoma group. Both groups were matched for sex, age, other comorbidities, and index year of glaucoma diagnosis. The incidence of Parkinson's disease at the end of 2011 was measured. A multivariable Cox proportional hazard regression model was used to measure the hazard ratio and 95% confidence intervals for Parkinson's disease associated with glaucoma. RESULTS The overall incidence of Parkinson's disease was 1.28-fold higher in the glaucoma group than that in the non-glaucoma group (7.73 vs. 6.02 per 1000 person-years; 95% confidence interval 1.18, 1.40). After controlling for potential confounding factors, the adjusted hazard ratio of Parkinson's disease was 1.23 for the glaucoma group (95% confidence interval 1.05, 1.46), compared with the non-glaucoma group. CONCLUSIONS Older people with glaucoma correlate with a small but statistically significant increase in the risk for Parkinson's disease. Whether glaucoma may be a non-motor feature of Parkinson's disease in older people requires further research to confirm.
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Affiliation(s)
- Shih-Wei Lai
- a College of Medicine , China Medical University , Taichung , Taiwan
- b Department of Family Medicine , China Medical University Hospital , Taichung , Taiwan
| | - Cheng-Li Lin
- a College of Medicine , China Medical University , Taichung , Taiwan
- c Management Office for Health Data , China Medical University Hospital , Taichung , Taiwan
| | - Kuan-Fu Liao
- d Graduate Institute of Integrated Medicine , China Medical University , Taichung , Taiwan
- e College of Medicine , Tzu Chi University , Hualien , Taiwan
- f Department of Internal Medicine , Taichung Tzu Chi General Hospital , Taichung , Taiwan
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Cheng KC, Liao KF, Lin CL, Lai SW. Correlation of Proton Pump Inhibitors with Pulmonary Tuberculosis: A Case-Control Study in Taiwan. Front Pharmacol 2017; 8:481. [PMID: 28769810 PMCID: PMC5515903 DOI: 10.3389/fphar.2017.00481] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Accepted: 07/04/2017] [Indexed: 12/15/2022] Open
Abstract
Background and Objectives: Although the relationship between the use of proton pump inhibitors (PPIs) and pulmonary tuberculosis (TB) in Taiwan published in 2014. Due to just only one article and not enough comprehensively, we explore this issue. Methods: We conducted a population-based case-control study to identify 9,422 subjects aged 20 years or older with newly diagnosed pulmonary TB in 2000–2013 as test cases. We then randomly selected 9,422 subjects aged 20 years or older without pulmonary TB as controls. Both cases and controls were matched in terms of sex, age, and comorbidities. Use of PPIs were defined as subjects who had had at least one prescription for these medications before the index date. No use was defined as subjects who had never had a prescription for PPIs before the index date. The odds ratio (OR) and 95% confidence interval (CI) for pulmonary TB associated with PPI use was estimated using the logistic regression model. Results: The OR of pulmonary TB was 1.31 for subjects who had used PPIs (95% CI 1.22, 1.41) compared with those with no use of the medications. Sub-analysis revealed the OR of pulmonary TB in subjects using PPI per increasing microgram was 1.25 (95% CI 1.19, 1.30). Conclusions: PPI use is associated with a 1.3-fold increase in odds of developing pulmonary TB in Taiwan. There is a dose-related response between PPI use and pulmonary TB.
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Affiliation(s)
- Kao-Chi Cheng
- College of Medicine, China Medical UniversityTaichung, Taiwan.,Department of Family Medicine, China Medical University HospitalTaichung, Taiwan
| | - Kuan-Fu Liao
- Department of Internal Medicine, Taichung Tzu Chi General HospitalTaichung, Taiwan.,College of Medicine, Tzu Chi UniversityHualien, Taiwan.,Graduate Institute of Integrated Medicine, China Medical UniversityTaichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical UniversityTaichung, Taiwan.,Management Office for Health Data, China Medical University HospitalTaichung, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical UniversityTaichung, Taiwan.,Department of Family Medicine, China Medical University HospitalTaichung, Taiwan
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15
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Lai SW, Cheng KC, Lin CL, Liao KF. Furosemide use and acute risk of hip fracture in older people: A nationwide case-control study in Taiwan. Geriatr Gerontol Int 2017; 17:2552-2558. [PMID: 28707364 DOI: 10.1111/ggi.13087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/27/2017] [Accepted: 03/28/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Shih-Wei Lai
- College of Medicine; China Medical University; Taichung Taiwan
- Department of Family Medicine; China Medical University Hospital; Taichung Taiwan
| | - Kao-Chi Cheng
- College of Medicine; China Medical University; Taichung Taiwan
- Department of Family Medicine; China Medical University Hospital; Taichung Taiwan
| | - Cheng-Li Lin
- College of Medicine; China Medical University; Taichung Taiwan
- Management Office for Health Data; China Medical University Hospital; Taichung Taiwan
| | - Kuan-Fu Liao
- College of Medicine; Tzu Chi University; Hualien Taiwan
- Graduate Institute of Integrated Medicine; China Medical University; Taichung Taiwan
- Department of Internal Medicine; Taichung Tzu Chi General Hospital; Taichung Taiwan
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16
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Abstract
BACKGROUND The purpose of this paper was to examine whether glaucoma could be a non-memory manifestation of Alzheimer's disease in older people. METHODS We conducted a population-based, retrospective, case-control study to analyze the database of the Taiwan National Health Insurance Program. There were 1,351 subjects ≥65 years old with newly diagnosed Alzheimer's disease as the cases, and 5,329 subjects without any type of dementias as the controls during 2000-2011. The odds ratio (OR) and 95% confidence interval (CI) for the risk of Alzheimer's disease associated with glaucoma was estimated by the multivariable unconditional logistic regression model. RESULTS After controlling for confounders, the multivariable logistic regression model demonstrated that the adjusted OR of Alzheimer's disease was 1.50 in subjects with glaucoma (95% CI 1.19, 1.89), compared to subjects without glaucoma. CONCLUSIONS Older people with glaucoma are associated with 1.5-fold increased odds of Alzheimer's disease in Taiwan. Glaucoma may be a non-memory manifestation of Alzheimer's disease in older people. Further research is needed to confirm this issue.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine,China Medical University,Taichung,Taiwan
| | - Cheng-Li Lin
- College of Medicine,China Medical University,Taichung,Taiwan
| | - Kuan-Fu Liao
- College of Medicine,Tzu Chi University,Hualien,Taiwan
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17
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Cheng KC, Liao KF, Lin CL, Lai SW. Increased Risk of Pulmonary Tuberculosis in Patients with Depression: A Cohort Study in Taiwan. Front Psychiatry 2017; 8:235. [PMID: 29180971 PMCID: PMC5694036 DOI: 10.3389/fpsyt.2017.00235] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2017] [Accepted: 10/31/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND/OBJECTIVE Tuberculosis (TB) and depression were major public health issues worldwide and the mutual causative relationships between them were not exhaustive. This study was performed to explore the association between depression, comorbidities, and the risk of pulmonary TB in Taiwan. METHODS The cohort study used the database of the Taiwan National Health Insurance Program. The depression group included 34,765 subjects aged 20-84 years with newly diagnosed depression from 2000 to 2012, and the non-depression group included 138,187 randomly selected subjects without depression. Both depression and non-depression groups were matched with respect to sex, age, and comorbidities. We explored the incidence of pulmonary TB at the end of 2013 in both the groups and used multivariable Cox proportional hazards regression model to explore the hazard ratio (HR) and 95% confidence interval (CI) for the risk of pulmonary TB associated with depression. RESULTS The overall incidence of pulmonary TB was 1.16-fold greater in the depression group than that in the non-depression group (1.52 vs. 1.31 per 1,000 person-years, 95% CI 1.12, 1.21). The multivariable Cox proportional hazards regression analysis revealed that the adjusted HR of pulmonary TB was 1.15 for the depression group (95% CI 1.03, 1.28), compared with the non-depression group. CONCLUSION Depression is associated with 1.15-fold increased hazard of pulmonary TB in Taiwan.
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Affiliation(s)
- Kao-Chi Cheng
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- Department of Internal Medicine, Taichung Tzu Chi General Hospital, Taichung, Taiwan.,College of Medicine, Tzu Chi University, Hualien, Taiwan.,Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- College of Medicine, China Medical University, Taichung, Taiwan.,Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
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18
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Kripke DF. Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit. F1000Res 2016; 5:918. [PMID: 27303633 PMCID: PMC4890308 DOI: 10.12688/f1000research.8729.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/09/2017] [Indexed: 09/02/2023] Open
Abstract
This is a review of hypnotic drug risks and benefits, reassessing and updating advice presented to the Commissioner of the Food and Drug Administration (United States FDA). Almost every month, new information appears about the risks of hypnotics (sleeping pills). The most important risks of hypnotics include excess mortality, especially overdose deaths, quiet deaths at night, infections, cancer, depression and suicide, automobile crashes, falls, and other accidents, and hypnotic-withdrawal insomnia. Short-term use of one-two prescriptions is associated with greater risk per dose than long-term use. Hypnotics have usually been prescribed without approved indication, most often with specific contraindications, but even when indicated, there is little or no benefit. The recommended doses objectively increase sleep little if at all, daytime performance is often made worse, not better, and the lack of general health benefits is commonly misrepresented in advertising. Treatments such as the cognitive behavioral treatment of insomnia and bright light treatment of circadian rhythm disorders offer safer and more effective alternative approaches to insomnia.
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Affiliation(s)
- Daniel F. Kripke
- University of California, San Diego, La Jolla, CA, 92037-2226, USA
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Kripke DF. Hypnotic drug risks of mortality, infection, depression, and cancer: but lack of benefit. F1000Res 2016; 5:918. [PMID: 27303633 PMCID: PMC4890308 DOI: 10.12688/f1000research.8729.1] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/11/2016] [Indexed: 12/14/2022] Open
Abstract
This is a review of hypnotic drug risks and benefits, reassessing and updating advice presented to the Commissioner of the Food and Drug Administration (United States FDA). Almost every month, new information appears about the risks of hypnotics (sleeping pills). This review includes new information on the growing USA overdose epidemic, eight new epidemiologic studies of hypnotics' mortality not available for previous compilations, and new emphasis on risks of short-term hypnotic prescription. The most important risks of hypnotics include excess mortality, especially overdose deaths, quiet deaths at night, infections, cancer, depression and suicide, automobile crashes, falls, and other accidents, and hypnotic-withdrawal insomnia. The short-term use of one-two prescriptions is associated with greater risk per dose than long-term use. Hypnotics are usually prescribed without approved indication, most often with specific contraindications, but even when indicated, there is little or no benefit. The recommended doses objectively increase sleep little if at all, daytime performance is often made worse, not better, and the lack of general health benefits is commonly misrepresented in advertising. Treatments such as the cognitive behavioral treatment of insomnia and bright light treatment of circadian rhythm disorders might offer safer and more effective alternative approaches to insomnia.
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Affiliation(s)
- Daniel F. Kripke
- University of California, San Diego, La Jolla, CA, 92037-2226, USA
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Abstract
This is a review of hypnotic drug risks and benefits. Almost every month, new information appears about the risks of hypnotics (sleeping pills). The most important risks of hypnotics include excess mortality (especially overdose deaths, quiet deaths at night, and suicides), infections, cancer, depression, automobile crashes, falls, other accidents, and hypnotic-withdrawal insomnia. Short-term use of one-two prescriptions is associated with even greater risk per dose than long-term use. Hypnotics have usually been prescribed without approved indication, most often with specific contraindications, but even when indicated, there is little or no benefit. The recommended doses objectively increase sleep little if at all, daytime performance is often made worse (not better) and the lack of general health benefits is commonly misrepresented in advertising. Treatments such as the cognitive behavioral treatment of insomnia and bright light treatment of circadian rhythm disorders offer safer and more effective alternative approaches to insomnia.
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Affiliation(s)
- Daniel F. Kripke
- University of California, San Diego, La Jolla, CA, 92037-2226, USA
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