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Wang HF, Liu WC, Zailani H, Yang CC, Chen TB, Chang CM, Tsai IJ, Yang CP, Su KP. A 12-week randomized double-blind clinical trial of eicosapentaenoic acid intervention in episodic migraine. Brain Behav Immun 2024; 118:459-467. [PMID: 38499208 DOI: 10.1016/j.bbi.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 03/20/2024] Open
Abstract
Omega-3 polyunsaturated fatty acids (PUFAs) may benefit migraine improvement, though prior studies are inconclusive. This study evaluated the effect of eicosapentaenoic acid (EPA) on episodic migraine (EM) prevention. Seventy individuals with EM participated in a 12-week randomized, double-blind, placebo-controlled trial from March 2020 and May 2022. They were randomly assigned to either the EPA (N = 35, 2 g fish oil with 1.8 g of EPA as a stand-alone treatment daily), or the placebo group (N = 35, 2 g soybean oil daily). Migraine frequency and headache severity were assessed using the monthly migraine days, visual analog scale (VAS), Migraine Disability Assessment (MIDAS), Hospital Anxiety and Depression Scale (HADS), Migraine-Specific Quality-of-Life Questionnaire (MSQ), and Pittsburgh Sleep Quality Index (PSQI) in comparison to baseline measurements. The EPA group significantly outperformed the placebo in reducing monthly migraine days (-4.4 ± 5.1 days vs. - 0.6 ± 3.5 days, p = 0.001), days using acute headache medication (-1.3 ± 3.0 days vs. 0.1 ± 2.3 days, p = 0.035), improving scores for headache severity (ΔVAS score: -1.3 ± 2.4 vs. 0.0 ± 2.2, p = 0.030), disability (ΔMIDAS score: -13.1 ± 16.2 vs. 2.6 ± 20.2, p = 0.001), anxiety and depression (ΔHADS score: -3.9 ± 9.4 vs. 1.1 ± 9.1, p = 0.025), and quality of life (ΔMSQ score: -11.4 ± 19.0 vs. 3.1 ± 24.6, p = 0.007). Notably, female particularly benefited from EPA, underscoring its potential in migraine management. In conclusion, high-dose EPA has significantly reduced migraine frequency and severity, improved psychological symptoms and quality of life in EM patients, and shown no major adverse events, suggesting its potential as a prophylactic for EM.
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Affiliation(s)
- Hsueh-Fang Wang
- Department of Nutrition, Hungkuang University, Taichung, Taiwan
| | - Wen-Chun Liu
- An Nan Hospital, China Medical University, Tainan, Taiwan; Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
| | - Halliru Zailani
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; Graduate Institute of Nutrition, China Medical University, Taichung, Taiwan
| | - Cheng-Chia Yang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Ting-Bin Chen
- Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ching-Mao Chang
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - I-Ju Tsai
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan; Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Chun-Pai Yang
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan; Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
| | - Kuan-Pin Su
- An Nan Hospital, China Medical University, Tainan, Taiwan; Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; Institute of Psychiatry, King's College London, London, UK; College of Medicine, China Medical University, Taichung, Taiwan.
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Aoh Y, Hou TW, Yang CC, Chang CM, Chen SP, Tsai IJ, Cheng CW, Yang CP. Update on gepants for the treatment of chronic migraine. J Chin Med Assoc 2024; 87:350-356. [PMID: 38349136 DOI: 10.1097/jcma.0000000000001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Chronic migraine (CM) is a profoundly debilitating condition that has detrimental clinical and social outcomes. Over the past two decades, novel small-molecule calcitonin gene-related peptide (CGRP) receptor antagonists, known as gepants, and CGRP monoclonal antibodies (mAbs) have been developed, ushering in a new era of migraine-specific treatment. In this review, we discuss the literature investigating the role of gepants for the treatment of CM. Numerous completed and ongoing clinical studies have conclusively demonstrated the safety, tolerability, and efficacy of several gepants for the acute treatment of migraine. However, preventive trials involving gepants have focused on patients with episodic migraine, with atogepant being the only gepant approved for CM prevention by the US Food and Drug Administration at the time of writing. Although some preliminary positive results have been reported, further research is still required to achieve additional advancements in the future. In summary, the effectiveness of gepants for treating individuals with CM are highly expected. This review highlights the development and current progress of gepants for the treatment of CM, focusing both on their role as acute abortive agents and preventive measures and on their concomitant use with other antimigraine medications, such as CGRP mAbs or triptans.
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Affiliation(s)
- Yu Aoh
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan, ROC
| | - Tsung-Wei Hou
- Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC
| | - Cheng-Chia Yang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC
| | - Ching-Mao Chang
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Pin Chen
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Brain Research Center & School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - I-Ju Tsai
- Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan, ROC
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan, ROC
| | - Chin-Wen Cheng
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan, ROC
| | - Chun-Pai Yang
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan, ROC
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
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Tsai IJ, Chou CM, Huang SY, Chen HC. Nipple apocrine hidrocystoma in a male adolescent: A rare lesion site. Asian J Surg 2023; 46:5872-5873. [PMID: 37659929 DOI: 10.1016/j.asjsur.2023.08.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/25/2023] [Indexed: 09/04/2023] Open
Affiliation(s)
- I-Ju Tsai
- Division of General Surgery, Department of Surgery, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Situn District, Taichung City, 407219, Taiwan
| | - Chia-Man Chou
- Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Situn District, Taichung City, 407219, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec.2, Linong Street, Beitou District, Taipei City, 112304, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, No. 145, Xingda Road., South District, Taichung City, 402202, Taiwan
| | - Sheng-Yang Huang
- Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Situn District, Taichung City, 407219, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, No. 155, Sec.2, Linong Street, Beitou District, Taipei City, 112304, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, No. 145, Xingda Road., South District, Taichung City, 402202, Taiwan.
| | - Hou-Chuan Chen
- Division of Pediatric Surgery, Department of Surgery, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Boulevard, Situn District, Taichung City, 407219, Taiwan
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Chen TB, Chang CM, Yang CC, Tsai IJ, Wei CY, Yang HW, Yang CP. Neuroimmunological Effect of Vitamin D on Neuropsychiatric Long COVID Syndrome: A Review. Nutrients 2023; 15:3802. [PMID: 37686834 PMCID: PMC10490318 DOI: 10.3390/nu15173802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/26/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the coronavirus disease 2019 (COVID-19). COVID-19 is now recognized as a multiorgan disease with a broad spectrum of manifestations. A substantial proportion of individuals who have recovered from COVID-19 are experiencing persistent, prolonged, and often incapacitating sequelae, collectively referred to as long COVID. To date, definitive diagnostic criteria for long COVID diagnosis remain elusive. An emerging public health threat is neuropsychiatric long COVID, encompassing a broad range of manifestations, such as sleep disturbance, anxiety, depression, brain fog, and fatigue. Although the precise mechanisms underlying the neuropsychiatric complications of long COVID are presently not fully elucidated, neural cytolytic effects, neuroinflammation, cerebral microvascular compromise, breakdown of the blood-brain barrier (BBB), thrombosis, hypoxia, neurotransmitter dysregulation, and provoked neurodegeneration are pathophysiologically linked to long-term neuropsychiatric consequences, in addition to systemic hyperinflammation and maladaptation of the renin-angiotensin-aldosterone system. Vitamin D, a fat-soluble secosteroid, is a potent immunomodulatory hormone with potential beneficial effects on anti-inflammatory responses, neuroprotection, monoamine neurotransmission, BBB integrity, vasculometabolic functions, gut microbiota, and telomere stability in different phases of SARS-CoV-2 infection, acting through both genomic and nongenomic pathways. Here, we provide an up-to-date review of the potential mechanisms and pathophysiology of neuropsychiatric long COVID syndrome and the plausible neurological contributions of vitamin D in mitigating the effects of long COVID.
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Affiliation(s)
- Ting-Bin Chen
- Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung 407219, Taiwan;
| | - Ching-Mao Chang
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan;
- Faculty of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
- Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
| | - Cheng-Chia Yang
- Department of Healthcare Administration, Asia University, Taichung 41354, Taiwan;
| | - I-Ju Tsai
- Department of Medical Research, Kuang Tien General Hospital, Taichung 433, Taiwan;
| | - Cheng-Yu Wei
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei 11114, Taiwan
- Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua 50544, Taiwan
| | - Hao-Wen Yang
- Department of Family Medicine, Kuang Tien General Hospital, Taichung 433, Taiwan
| | - Chun-Pai Yang
- Department of Medical Research, Kuang Tien General Hospital, Taichung 433, Taiwan;
- Department of Neurology, Kuang Tien General Hospital, Taichung 433, Taiwan
- Department of Nutrition, HungKuang University, Taichung 433, Taiwan
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung 402, Taiwan
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Tseng ST, Lee MC, Tsai YT, Lu MC, Yu SC, Tsai IJ, Lee IT, Yan YH. Risks after Gestational Diabetes Mellitus in Taiwanese Women: A Nationwide Retrospective Cohort Study. Biomedicines 2023; 11:2120. [PMID: 37626617 PMCID: PMC10452882 DOI: 10.3390/biomedicines11082120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/17/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVE An increasing trend in the prevalence of gestational diabetes mellitus (GDM) has been reported in Taiwan. GDM has been linked to various adverse maternal outcomes over a long period, including cardiovascular disease (CVD) and chronic kidney disease (CKD). However, evidence implies that the effects of GDM on the mid-term surrogate risk factors for these diseases are limited. Furthermore, data from nationwide cohort studies are limited. The primary aim of this study was to investigate the risk of developing type 2 diabetes mellitus (T2DM), arterial hypertension (aHTN), and hyperlipidemia (HL) through a 5-year follow-up post-delivery of women with GDM in a nationwide cohort study in Taiwan. The second objective was to investigate the risk of developing insulin resistance syndrome (IRS)-related diseases, including CVD, acute myocardial infarction (AMI), peripheral artery occlusive disease (PAOD), non-alcoholic fatty liver diseases (NAFLD), and CKD. METHODS This was a retrospective, population-based nationwide cohort study. The data source comprises a merge of the Birth Certificate Application Database (BCA) and the National Health Insurance Research Database in Taiwan. Women aged between 15 and 45 years who gave birth in Taiwan between 2004 and 2011 were included. Women who were enrolled and had a GDM diagnosis were assigned to the exposure group. Women who were enrolled without a GDM diagnosis were assigned to the comparison group. The relative risk of developing T2DM, aHTN, HL, and IRS-related diseases, including CVD, AMI, PAOD, NAFLD, and CKD, were analyzed and presented as hazard ratio (HR) through Cox regression and log-rank regression analyses. RESULTS A total of 1,180,477 women were identified through the BCA database between 2004 and 2011. Of those, 71,611 GDM-diagnosed women and 286,444 women without GDM were included in the final analysis. After adjusting for age, pre-existing cancer, and parity, developing T2DM, aHTN, and HL were still significantly increased in the GDM group (HR and interquartile range (IQR): 2.83 (2.59, 3.08), 1.09 (1.01, 1.06), and 1.29 (1.20, 1.38), accordingly). CVD, NAFLD, and CKD had a very low incidence and showed insignificant results. CONCLUSION Our findings provide nationwide cohort data showing that GDM increased the risk of developing T2DM, aHTN, and HL 5 years after delivery within the same group. The GDM complications and risk of CVD, AMI, PAOD, NAFLD, and CKD need further investigation.
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Affiliation(s)
- Shih-Ting Tseng
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kuang Tien General Hospital, Taichung 433, Taiwan
- Jenteh Junior College of Medicine, Nursing and Management, Miaoli 356, Taiwan
| | - Ming-Chang Lee
- Division of Nephrology, Department of Internal Medicine, Dachien General Hospital, Miaoli 360, Taiwan
| | - Yi-Ting Tsai
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
| | - Mei-Chun Lu
- Department of Medical Research, Kuang Tien General Hospital, Taichung 433, Taiwan
| | - Su-Chen Yu
- Department of Nursing, Kuang Tien General Hospital, Taichung 433, Taiwan
| | - I-Ju Tsai
- Department of Medical Research, Kuang Tien General Hospital, Taichung 433, Taiwan
- Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan
| | - I-Te Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
| | - Yuan-Horng Yan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kuang Tien General Hospital, Taichung 433, Taiwan
- Department of Medical Research, Kuang Tien General Hospital, Taichung 433, Taiwan
- Department of Nutrition, Hungkuang University, Taichung 433, Taiwan
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Yang CP, Yang CC, Tsai IJ, Lin TH, Chiou YL, Wang HF, Chang CM, Yih KH. The immediate effects of lavender-based essential oil inhalation on subsequent polysomnography in people with poor sleep quality. J Chin Med Assoc 2023; 86:665-671. [PMID: 37098173 DOI: 10.1097/jcma.0000000000000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Although aromatherapy is considered an adjuvant therapy to promote sleep quality, few objective sleep testing instruments can confirm the effects of aromatherapy on sleep physiology. The purpose of this study was to confirm and compare the immediate effects of a single lavender essential oil (SLEO) group to a complex lavender essential oil (CLEO) group by objective polysomnography (PSG) recordings. METHODS Participants were randomly divided into the SLEO group and CLEO group in this single-blind trial to explore the sleep effect of essential oil aroma. All the participants completed the sleep-related questionnaires and underwent two consecutive nights of PSG recordings, who had one night without aromatherapy and one night with one of the two aromas randomly assigned to them. RESULTS Total of 53 participants were recruited for this study, 25 participants were in the SLEO group, and 28 were in the CLEO group. Baseline characteristics and sleep-related questionnaires were similar in both groups. Both SLEO and CLEO extended the total sleep time (TST) (Δ = 43.42 and 23.75 minutes, respectively) and sleep period time (SPT) (Δ = 38.86 and 24.07 minutes, respectively). The SLEO group further improved sleep efficiency and increased the amounts of non-rapid eye movement (NREM) and rapid eye movement (REM) sleep and decreased spontaneous arousals. However, there was no significant difference in PSG parameters between the SLEO and CLEO groups. CONCLUSION Both SLEO and CLEO extended TST and SPT, with no significant differences between these two groups. These results warrant practical applications and merit future studies (Clinical trial registration: ClinicalTrials.gov : NCT03933553).
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Affiliation(s)
- Chun-Pai Yang
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan, ROC
- Department of Nutrition, HungKuang University, Taichung, Taiwan, ROC
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
- Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan, ROC
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC
- Department of Emergency Medicine, Kuang Tien General Hospital, Taichung, Taiwan, ROC
- Department of Nutrition (Master Program), Hungkuang University, Taichung, Taiwan, ROC
- General Education Center & Department of Applied Cosmetology, Hungkuang University, Taichung, Taiwan, ROC
- Department of Applied Cosmetology, Hungkuang University, Taichung, Taiwan, ROC
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Cheng-Chia Yang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC
| | - I-Ju Tsai
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan, ROC
- Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan, ROC
| | - Tsung-Hsing Lin
- Department of Emergency Medicine, Kuang Tien General Hospital, Taichung, Taiwan, ROC
| | - Ya-Ling Chiou
- Department of Nutrition (Master Program), Hungkuang University, Taichung, Taiwan, ROC
| | - Hsiao-Fen Wang
- General Education Center & Department of Applied Cosmetology, Hungkuang University, Taichung, Taiwan, ROC
- Department of Applied Cosmetology, Hungkuang University, Taichung, Taiwan, ROC
| | - Ching-Mao Chang
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan, ROC
- Department of Nutrition, HungKuang University, Taichung, Taiwan, ROC
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan, ROC
- Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan, ROC
- Department of Healthcare Administration, Asia University, Taichung, Taiwan, ROC
- Department of Emergency Medicine, Kuang Tien General Hospital, Taichung, Taiwan, ROC
- Department of Nutrition (Master Program), Hungkuang University, Taichung, Taiwan, ROC
- General Education Center & Department of Applied Cosmetology, Hungkuang University, Taichung, Taiwan, ROC
- Department of Applied Cosmetology, Hungkuang University, Taichung, Taiwan, ROC
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - Kuang-Hway Yih
- General Education Center & Department of Applied Cosmetology, Hungkuang University, Taichung, Taiwan, ROC
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Yang CP, Tseng PT, Yang CC, Tsai IJ, Su KP. Delirium prevention with age consideration-Reply to "Comment on Yang et al., 2020: Melatonergic agents in the prevention of delirium: A network meta-analysis of randomized controlled trials". Sleep Med Rev 2023; 70:101803. [PMID: 37336066 DOI: 10.1016/j.smrv.2023.101803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 05/21/2023] [Indexed: 06/21/2023]
Affiliation(s)
- Chun-Pai Yang
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan; Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Ping-Tao Tseng
- WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan; Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan; Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Cheng-Chia Yang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - I-Ju Tsai
- Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Kuan-Pin Su
- Mind-Body Interface Research Center (MBI-Lab), China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan.
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Huang CL, Tsai IJ, Lin WC, Lin CL, Ho IK, Wang RY, Lee CWS. Reduced mortality in patients with extended duration of methadone maintenance treatment: a five-year retrospective nationwide study. Psychol Med 2023; 53:722-730. [PMID: 34011426 DOI: 10.1017/s0033291721002051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The retention of patients under methadone maintenance treatment (MMT) is an indication for the effectiveness of the therapy. We aimed to explore the relation between mortality and the cumulative MMT duration. METHODS A retrospective cohort analysis was performed using Taiwan Illicit Drug Issue Database (TIDID) and National Health Insurance Research Database (NHIRD) during 2012-2016. We included 9149 and 11 112 MMT patients as the short and long groups according to the length of their cumulative MMT duration, 1-364 and ⩾365 days, respectively. The risk of mortality was calculated by Cox proportional hazards regression model with time-dependent exposure to MMT, and the survival probability was plotted with the Kaplan-Meier curve. RESULTS The mortality rates were 2.51 and 1.51 per 100 person-years in the short and long cumulative MMT duration groups, respectively. After adjusting for on or off MMT, age, sex, marital status, education level, maximum methadone dose, and comorbidities (human immunodeficiency virus, depression, hepatitis C virus, hepatitis B virus, alcoholic liver disease, and cardiovascular disease), the long group had a lower risk of death (hazard ratio = 0.67; 95% confidence interval 0.60-0.75) than the short group. Increased risk was observed in patients with advanced age, being male, unmarried, infected by HIV, HCV, and HBV, and diagnosed with depression, ALD, and CVD. Causes of death were frequently related to drug and injury. CONCLUSIONS Longer cumulative MMT duration is associated with lower all-cause and drug-related mortality rate.
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Affiliation(s)
- Chieh-Liang Huang
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou County, Taiwan
| | - I-Ju Tsai
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Wen-Chi Lin
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Ing-Kang Ho
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Ruey-Yun Wang
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Cynthia Wei-Sheng Lee
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
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Lin TH, Yang CC, Lee SY, Chang CM, Tsai IJ, Wei CY, Yang CP. The effect of bright light therapy in migraine patients with sleep disturbance: A prospective, observational cohort study protocol. Front Aging Neurosci 2023; 14:1041076. [PMID: 36742203 PMCID: PMC9892937 DOI: 10.3389/fnagi.2022.1041076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 12/23/2022] [Indexed: 01/20/2023] Open
Abstract
Background Migraine is a common disabling disorder, and its substantial burden is associated with a considerable negative impact on the patients' quality of life. Moreover, aging patients with migraine have more cognitive complaints. Additionally, the elderly are more likely to have sleep disturbances, which may also predict the risk of incident dementia. Migraines are reported to be closely associated with sleep and circadian rhythms. Sleep disturbance is a well-known trigger for migraine episodes; moreover, shift work or jet lag reportedly triggers some migraines. The hypothalamus is thought to be the migraine generator; sleep and circadian activity rhythm are also controlled by the hypothalamus. Evidence suggests an influence of both sleep and circadian system on migraine. Previously, light therapy has been show to stabilize sleep architecture and further improve insomnia related to circadian rhythm disorders. However, the beneficial effect of light therapy on migraine with sleep disturbance has not yet been determined. We aim to explore the effects of light therapy for migraine combined with sleep disturbance. Methods and analysis This project is a 2-year, randomized, double-blind, placebo-controlled clinical trial. The study design includes a 4-week monitoring period (baseline and pretest), a 4-week treatment period, and a posttest. The study participants will undergo assessments on headache frequency and severity and subjective and objective (wrist actigraphy and polysomnography) sleep disturbances, and quality of life and a series of blood tests for serum biomarkers. Discussion This study will establish evidence-based alternative medicine for the preventive effect of bright light therapy in migraine patients with sleep disturbances. Moreover, our data will be useful to comprehend the biochemical mechanism of light therapy in migraine prevention.Clinical Trial Registration: ClinicalTrials.gov, identifier NCT04890691.
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Affiliation(s)
- Tsung-Hsing Lin
- Department of Emergency Medicine, Kuang Tien General Hospital, Taichung, Taiwan
| | - Cheng-Chia Yang
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - Shih-Yu Lee
- Biotechnology Health and Innovation Research Center, Hungkuang University, Taichung, Taiwan,College of Nursing, Hungkuang University, Taichung, Taiwan
| | - Ching-Mao Chang
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan,Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan,Institute of Traditional Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - I-Ju Tsai
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan
| | - Cheng-Yu Wei
- Department of Exercise and Health Promotion, College of Kinesiology and Health, Chinese Culture University, Taipei, Taiwan,Department of Neurology, Chang Bing Show Chwan Memorial Hospital, Changhua, Taiwan,Cheng-Yu Wei,
| | - Chun-Pai Yang
- Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan,Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan,*Correspondence: Chun-Pai Yang,
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10
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Huang CL, Tsai IJ, Lee CWS. Risk of psychosis in illicit amphetamine users: a 10 year retrospective cohort study. Evid Based Ment Health 2022; 25:163-168. [PMID: 35165118 PMCID: PMC10231478 DOI: 10.1136/ebmental-2021-300300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 12/18/2021] [Indexed: 11/04/2022]
Abstract
QUESTION Amphetamine use is a risk factor for psychosis, which imposes a substantial burden on society. We aimed to investigate the incidence of psychosis associated with illicit amphetamine use and whether rehabilitation treatments could influence the psychosis risk. STUDY SELECTION AND ANALYSIS A retrospective cohort study was conducted using the population based Taiwan Illicit Drug Issue Database (TIDID) and the National Health Insurance Research Database (NHIRD), from 2007 to 2016. We identified 74 601 illicit amphetamine users as the amphetamine cohort and 2 98 404 subjects as the non-amphetamine cohort. The incidence rate of newly diagnosed psychosis was the main outcome. Cox proportional hazards models were applied to assess the effects of amphetamine, and the Kaplan-Meier method was used to estimate the cumulative psychosis incidence curves. FINDINGS Illicit amphetamine users were 5.28 times more likely to experience psychosis than those without illicit drug use records. The risk was higher for subjects with multiple arrests for amphetamine use. A greater hazard ratio (HR) magnitude was observed in female patients. We also observed a significant decrease in the risk of psychosis in patients receiving rehabilitation treatments during deferred prosecution (adjusted HR 0.74, 95% CI 0.61 to 0.89). CONCLUSIONS Illicit amphetamine use was associated with an increased incidence of psychosis. The risk was identified across all age groups, particularly in women and in those arrested multiple times, and was inversely correlated with rehabilitation treatments for amphetamine misuse.
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Affiliation(s)
- Chieh-Liang Huang
- Tsaotun Psychiatric Centre Ministry of Health and Welfare, Nan-Tou County, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
| | - Cynthia Wei-Sheng Lee
- Centre for Drug Abuse and Addiction, China Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
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11
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Yan YH, Chen TB, Yang CP, Tsai IJ, Yu HL, Wu YS, Huang WJ, Tseng ST, Peng TY, Chou EP. Long-term exposure to particulate matter was associated with increased dementia risk using both traditional approaches and novel machine learning methods. Sci Rep 2022; 12:17130. [PMID: 36224306 PMCID: PMC9556552 DOI: 10.1038/s41598-022-22100-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 10/10/2022] [Indexed: 02/05/2023] Open
Abstract
Air pollution exposure has been linked to various diseases, including dementia. However, a novel method for investigating the associations between air pollution exposure and disease is lacking. The objective of this study was to investigate whether long-term exposure to ambient particulate air pollution increases dementia risk using both the traditional Cox model approach and a novel machine learning (ML) with random forest (RF) method. We used health data from a national population-based cohort in Taiwan from 2000 to 2017. We collected the following ambient air pollution data from the Taiwan Environmental Protection Administration (EPA): fine particulate matter (PM2.5) and gaseous pollutants, including sulfur dioxide (SO2), carbon monoxide (CO), ozone (O3), nitrogen oxide (NOx), nitric oxide (NO), and nitrogen dioxide (NO2). Spatiotemporal-estimated air quality data calculated based on a geostatistical approach, namely, the Bayesian maximum entropy method, were collected. Each subject's residential county and township were reviewed monthly and linked to air quality data based on the corresponding township and month of the year for each subject. The Cox model approach and the ML with RF method were used. Increasing the concentration of PM2.5 by one interquartile range (IQR) increased the risk of dementia by approximately 5% (HR = 1.05 with 95% CI = 1.04-1.05). The comparison of the performance of the extended Cox model approach with the RF method showed that the prediction accuracy was approximately 0.7 by the RF method, but the AUC was lower than that of the Cox model approach. This national cohort study over an 18-year period provides supporting evidence that long-term particulate air pollution exposure is associated with increased dementia risk in Taiwan. The ML with RF method appears to be an acceptable approach for exploring associations between air pollutant exposure and disease.
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Affiliation(s)
- Yuan-Horng Yan
- grid.415517.30000 0004 0572 8068Department of Endocrinology and Metabolism, Kuang Tien General Hospital, Taichung, Taiwan ,grid.415517.30000 0004 0572 8068Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan ,grid.411432.10000 0004 1770 3722Institute of Biomedical Nutrition, Hungkuang University, Taichung, Taiwan
| | - Ting-Bin Chen
- grid.410764.00000 0004 0573 0731Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan ,grid.411432.10000 0004 1770 3722Department of Applied Cosmetology, Hungkuang University, Taichung, Taiwan
| | - Chun-Pai Yang
- grid.415517.30000 0004 0572 8068Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan ,grid.411432.10000 0004 1770 3722Institute of Biomedical Nutrition, Hungkuang University, Taichung, Taiwan ,grid.415517.30000 0004 0572 8068Department of Neurology, Kuang Tien General Hospital, Taichung, Taiwan
| | - I-Ju Tsai
- grid.415517.30000 0004 0572 8068Department of Medical Research, Kuang Tien General Hospital, Taichung, Taiwan
| | - Hwa-Lung Yu
- grid.19188.390000 0004 0546 0241Department of Bioenvironmental Systems Engineering, National Taiwan University, Taipei, Taiwan
| | - Yuh-Shen Wu
- grid.411432.10000 0004 1770 3722Department of Safety, Health, and Environmental Engineering, Hungkuang University, Taichung, Taiwan
| | - Winn-Jung Huang
- grid.411432.10000 0004 1770 3722Department of Safety, Health, and Environmental Engineering, Hungkuang University, Taichung, Taiwan
| | - Shih-Ting Tseng
- grid.415517.30000 0004 0572 8068Division of Endocrinology and Metabolism, Department of Internal Medicine, Kuang Tien General Hospital, Taichung, Taiwan ,Jenteh Junior College of Medicine, Nursing and Management, Miaoli County, Taiwan
| | - Tzu-Yu Peng
- grid.412042.10000 0001 2106 6277Department of Statistics, National Chengchi University, No. 64, Sec. 2, Zhinan Rd., Wenshan Dist., Taipei City, 116 Taiwan
| | - Elizabeth P. Chou
- grid.412042.10000 0001 2106 6277Department of Statistics, National Chengchi University, No. 64, Sec. 2, Zhinan Rd., Wenshan Dist., Taipei City, 116 Taiwan
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12
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Huang CL, Tsai IJ, Lin WC, Ho IK, Wang RY, Lee CWS. Augmentation in Healthcare Utilization of Patients with Opioid Use Disorder After Methadone Maintenance Treatment: A Retrospective Nationwide Study. Adv Ther 2021; 38:2908-2919. [PMID: 33559050 DOI: 10.1007/s12325-021-01633-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 01/19/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The health benefits of entering methadone maintenance treatment (MMT) for opioid-dependent persons may not be merely limited to therapy of opioid use disorder. We aimed to compare the healthcare utilization of MMT patients before and after MMT. METHODS A retrospective analysis was performed using the Taiwan Illicit Drug Issue Database and the National Health Insurance Research Database (NHIRD) between 2014 and 2016. We included 1255 newly enrolled MMT patients in 2015 and randomly selected 5020 patients from NHIRD matched by age and gender as the comparison group. Changes in healthcare utilization 1 year before and 1 year after the date of the index date (MMT initiation) were compared within and between MMT and comparison groups. RESULTS During the 1-year period following MMT, the hospitalization length was considerably decreased, while the number of outpatient visits, emergency department (ED) visits, and ED expenditure significantly increased in MMT patients. Multivariable linear regression with the difference-in-difference approach revealed that all the categories of healthcare utilization increased, except for a minor increase of outpatient expenditure and a slight decrease of hospitalization length for the MMT group relative to the comparison group. Increases in utilization of the departments of psychiatry and infectious diseases of the MMT patients were considerable. CONCLUSION MMT is associated with increased healthcare utilization, and departments of psychiatry and infectious diseases play substantial roles. Policy-makers should warrant access for all who need healthcare by ensuring the availability of the treatment for drug dependence.
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Affiliation(s)
- Chieh-Liang Huang
- School of Medicine, China Medical University, Taichung, Taiwan
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung, Taiwan
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou County, Taiwan
| | - I-Ju Tsai
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Wen-Chi Lin
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Ing-Kang Ho
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung, Taiwan
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Ruey-Yun Wang
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Cynthia Wei-Sheng Lee
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan.
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.
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Huang CL, Tsai IJ, Lin WC, Ho IK, Wang RY, Lee CWS. Correction to: Augmentation in Healthcare Utilization of Patients with Opioid Use Disorder After Methadone Maintenance Treatment: A Retrospective Nationwide Study. Adv Ther 2021; 38:2920. [PMID: 33950376 DOI: 10.1007/s12325-021-01712-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Chieh-Liang Huang
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou County, Taiwan
| | - I-Ju Tsai
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Management Office for Health Data, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Wen-Chi Lin
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Ing-Kang Ho
- Ph.D. Program for Aging, College of Medicine, China Medical University, Taichung, Taiwan
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Ruey-Yun Wang
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Cynthia Wei-Sheng Lee
- Center for Drug Abuse and Addiction, China Medical University Hospital, China Medical University, Taichung, Taiwan.
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.
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14
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Su CL, Chang GH, Tsai IJ, Hsu CY, Wang IK, Chang CC. Factors Impacting Survival in Patients With Major Burn-Induced Acute Kidney Injury Postrenal Replacement Therapy: A Nationwide Study With 15 Years Follow-Up in Taiwan. Ann Plast Surg 2021; 86:S23-S29. [PMID: 33346544 DOI: 10.1097/sap.0000000000002649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Major burn-induced acute kidney injury (AKI) causes extremely high mortality, even though renal replacement therapy (RRT) was thought of as the most efficient treatment. There was scanty research for investigating the characteristic of burn-AKI-RRT patients during intensive care. This study aims to investigate the factors impacting the survival outcomes in those burn-AKI-RRT cases. METHODS Using the Taiwan National Health Insurance Research Database and its affiliated database, the Registry for Catastrophic Illness Patients, we defined a cohort composed of 171 patients encountering major burn-induced AKI and receiving RRT during burn care for a 15-year observation period. Demographic characteristic, comorbidities, total body surface area (TBSA), major procedures, and complications were analyzed to explore the factors affecting the survival outcomes during acute burn care and 1 year after discharge. RESULTS Patients who underwent tracheostomy and skin grafting had higher survival rates during acute burn care (tracheostomy: mortality vs survival, 15.7% vs 30.2%; P = 0.0257; skin grafting: mortality vs survival, 57.4% vs 76.2%; P = 0.0134). Multivariate regression analysis showed that tracheostomy group significantly presented with lower mortality risk by 65% (odds ratio [OR], 0.35; P = 0.0372), and subgroup analysis of delaminating follow-up duration showed that patients with tracheostomy had higher overall survival by 22% (90-day postburn mortality: nontracheostomy vs tracheostomy, 58.3% vs 36.3%; adjusted hazards ratio, 0.39; 95% confidence interval, 0.22-0.69; P = 0.0011), especially during postburn first 30 days (adjusted hazards ratio, 0.15; 95% confidence interval, 0.05-0.49; P = 0.0016). Total body surface area did not significantly affect survival; however, mortality risk was significantly higher in those with a larger TBSA (TBSA, ≥80%; OR, 6.48; P = 0.0022; TBSA, 60-79%; OR, 3.12; P = 0.0518; TBSA, 40-59%; OR, 1.88; P = 0.2402; TBSA, 30-39% as reference). CONCLUSIONS For patients with major burn-induced AKI receiving RRT, tracheostomy and skin grafting may improve survival in the cases living through acute burn stage.
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Affiliation(s)
- Chun-Lin Su
- From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Chang Gung Memorial Hospital, Linkou
| | - Geng-He Chang
- Department of Otolaryngology, Chang Gung Memorial Hospital at Chiayi
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15
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Chiang CH, Chen W, Tsai IJ, Hsu CY, Wang JH, Lin SZ, Ding DC. Diabetes mellitus risk after hysterectomy: A population-based retrospective cohort study. Medicine (Baltimore) 2021; 100:e24468. [PMID: 33530258 PMCID: PMC7850756 DOI: 10.1097/md.0000000000024468] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 01/05/2021] [Indexed: 01/05/2023] Open
Abstract
We explored whether hysterectomy with or without bilateral oophorectomy was associated with the increasing incidence of diabetes mellitus (DM) in an East Asian population. This was a retrospective population-based cohort study that analyzed DM risk in Taiwanese women, using a health insurance research database of 1998 to 2013 containing nearly 1 million people. We identified 7088 women aged 30 to 49 years who had undergone hysterectomy with or without oophorectomy. The comparison group included 27,845 women without a hysterectomy who were randomly selected from the population and matched to women in the hysterectomy group by age (exact year) and year of the surgery. DM comorbidities were identified. The incidence and hazard ratios for DM were calculated with Cox proportional hazard regression models. The median ages of patients in the hysterectomy and comparison groups were both approximately 44 years. After a median 7.1 years of follow-up, the incidence of DM was 40% higher in the hysterectomized women as compared with the comparisons (9.12 vs 6.78/1000 person-years, P < .001), with an adjusted hazard ratio (aHR) of 1.37 (95% confidence interval [CI] = 1.23 -1.52). However, the DM risk was not increased in the women with hysterectomy plus oophorectomy (aHR=1.28, 95% CI = 0.93-1.76). Furthermore, among women aged 30 to 39 years, 40 to 49 years, the risk in hysterectomized women was higher than the comparisons (aHR = 1.75, 95% CI = 1.27-2.41; aHR = 1.33, 95% CI = 1.19-1.49, respectively). Our study provides essential and novel evidence for the association between hysterectomy and DM risk in women aged 30 to 49 years, which is relevant to these women and their physicians. Physicians should be aware of the increased DM risk associated with hysterectomy and take this into consideration when evaluating a patient for a hysterectomy. The current results might help gynecologists prevent DM and encourage diagnostic and preventive interventions in appropriate patients.
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Affiliation(s)
- Ching-Hsiang Chiang
- Department of Urology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, and Tzu Chi University, Hualien
| | - Weishan Chen
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University, Taichung
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University, Taichung
| | - Chung Y. Hsu
- College of Medicine, China Medical University, Taichung
| | | | - Shinn-Zong Lin
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation
| | - Dah-Ching Ding
- Institute of Medical Sciences
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Foundation, and Tzu Chi University, Hualien, Taiwan
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Hsu YR, Tsai IJ, Chen WK, Lin KH. Association between the frequency of admission for pneumonia and the incidence of in-hospital cardiac arrest: A population-based case–control study. HONG KONG J EMERG ME 2020. [DOI: 10.1177/1024907920964091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To examine the association between the frequency of admission for pneumonia and the incidence of in-hospital cardiac arrest. Methods: We enrolled 1739 patients with in-hospital cardiac arrest and 6956 randomly selected age- and sex-matched control patients using a longitudinal claims sub-dataset from 1996 to 2011 for 1 million people randomly selected from the population covered by the Taiwan National Health Insurance program. The odds ratio of in-hospital cardiac arrest associated with the number of hospital admissions for pneumonia was calculated. Results: During the 15-year study period, the in-hospital cardiac arrest group had a higher frequency (28.4% vs 8.1%, p < 0.0001) of admission for pneumonia compared to the control group. The comorbidities of heart failure, chronic pulmonary disease, diabetes, renal failure, liver disease, lymphoma, alcohol abuse, and drug abuse were higher in the in-hospital cardiac arrest group than in the control group. In addition, the risk of in-hospital cardiac arrest was 3.37 for the patients admitted for pneumonia, and the risk of in-hospital cardiac arrest increased for patients with multiple admissions for pneumonia (once, 3.03; two times, 3.44; and three times, 4.42). In cross-analysis, the more admissions for pneumonia and the greater the number of comorbidities, the higher the risk of in-hospital cardiac arrest (odds ratio = 21.37, 95% confidence interval = 13.6–33.9 for patients with more than three admissions for pneumonia and more than three comorbidities). Conclusion: Higher admission frequency for pneumonia was associated with a higher risk of in-hospital cardiac arrest. Awareness of this risk factor may help clinicians provide early prevention or detection for patients with potential in-hospital cardiac arrest risks immediately after admission.
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Affiliation(s)
- Yu-Rung Hsu
- Department of Emergency Medicine, China Medical University Hospital, Taichung
| | - I-Ju Tsai
- College of Medicine, China Medical University, Taichung
- Management Office for Health Data, China Medical University Hospital, Taichung
| | - Wei-Kung Chen
- Department of Emergency Medicine, China Medical University Hospital, Taichung
| | - Kuan-Ho Lin
- Department of Emergency Medicine, China Medical University Hospital, Taichung
- College of Medicine, China Medical University, Taichung
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Harnod T, Tsai IJ, Wang JH, Lin SZ, Ding DDC. Women with polycystic ovary syndrome associated with increased anxiety risk: A population-based cohort study in Taiwan. J Affect Disord 2020; 273:532-537. [PMID: 32560950 DOI: 10.1016/j.jad.2020.04.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 04/02/2020] [Accepted: 04/21/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Polycystic ovary syndrome (PCOS) has been associated with developing mental disorders in Western populations, but this association is poorly studied in Asians. Hence, using insurance claims data, this study evaluated the anxiety risk in women with PCOS. METHODS Using Taiwan's National Health Insurance Research Database, we identified 7026 women aged 15-49 years with newly diagnosed PCOS without anxiety in 1998-2013 as the PCOS cohort. We also randomly selected 28,104 women without PCOS and anxiety as the comparison cohort, which was frequency-matched to cases by age and index year. Determined by incidence and Cox method, the hazard ratio (HR) of anxiety and the 95% confidence interval (CI) for the association with PCOS were estimated after a 16-year follow-up. RESULTS The incidence of anxiety was 19.5% higher in the PCOS cohort than in the comparison cohort (15.3 vs. 12.8 per 1000 person-years), with an adjusted HR of 1.18 (95% CI=1.07-1.30). For women with both PCOS and comorbid depression, it was 32.1 per 1000 person-years, with an adjusted HR of 2.24 (95% CI=1.24-4.06), compared with those without PCOS or depression. Moreover, it was 48.0 per 1000 person-years for women with depression alone (adjusted HR=3.46; 95% CI=2.58-4.64). LIMITATIONS We used a diagnostic code to identify PCOS cases without reference to pathology records. Miscoding might have occurred in the database. CONCLUSIONS PCOS is associated with an increased risk of developing anxiety independently. Comorbid depression could increase the risk further. Our findings provide vital information for Asian women to cope with anxiety.
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Affiliation(s)
- Tomor Harnod
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; College of Medicine, China Medical University, Taichung, Taiwan
| | - Jen-Hung Wang
- Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan
| | - Shinn-Zon Lin
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan
| | - Dr Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien, Taiwan; Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
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18
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Ou YC, Chang KH, Tung MC, Tsai IJ, Huang LH, Weng WC, Hsu CY, Lin YS, Tsao TY. Building a Nomogram for Prediction of Prostate Cancer in Patients With Preoperatively Suspected Prostate Cancer. Anticancer Res 2020; 40:2995-3002. [PMID: 32366454 DOI: 10.21873/anticanres.14280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/10/2020] [Accepted: 04/16/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Expanded indications for patients with preoperatively suspected prostate cancer (PC) undergoing theranostic robotic-assisted laparoscopic radical prostatectomy (T-RARP) are reported. We aimed to build a nomogram of T-RARP to predict final pathologically proven PC. This study reviewed data of 153 patients that underwent T-RARP for suspected PC performed by the same surgeon. PATIENTS AND METHODS Patients' preoperative demographic and clinical characteristics included age, prostate-specific antigen (PSA) level, PSA density (PSAD), history of acute urinary retention (AUR), abnormal digital rectal examination (DRE) of the prostate, and Prostate Imaging Reporting and Data System (PI-RADS) classification at 3-T multiparametric magnetic resonance imaging (MRI). Logistic regression with backward elimination was used to select potential risk factors. RESULTS Based on Harrell's guidelines, we chose seven variables for our final model: Age, DRE corresponding with MRI, AUR, PSAD, prostate-specific antigen velocity (PSAV), PI-RADS, and biopsy pathology. A nomogram for prediction of adenocarcinoma was developed. The original C-index for the nomogram was 0.80 (95% confidence interval=0.74-0.89). The cut-off of the nomogram score for predicting PC was 50 (sensitivity=55.4%; specificity=91.9%). The receiver operating characteristic curve of the model analysis showed an area under the curve of 0.801. CONCLUSION A nomogram was produced using age, DRE-corresponding MRI, AUR, PSAD, PSAV, PI-RADS, and biopsy pathology. A preoperative nomogram prediction of prostate adenocarcinoma can help the patient and his family understand the possibility of PC and assist them in their decision-making.
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Affiliation(s)
- Yen Chuan Ou
- Division of Urology, Department of Surgery, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C. .,Department of Research, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C
| | - Kuangh-Hsi Chang
- Department of Research, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C.,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan, R.O.C.,General Education Center, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli, Taiwan, R.O.C
| | - Min-Che Tung
- Division of Urology, Department of Surgery, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C
| | - I-Ju Tsai
- Management Office for Health Data, College of Medicine, China Medical University, Taichung, Taiwan, R.O.C
| | - Li-Hua Huang
- Division of Urology, Department of Surgery, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C
| | - Wei-Chun Weng
- Division of Urology, Department of Surgery, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C
| | - Chao-Yu Hsu
- Division of Urology, Department of Surgery, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C
| | - Yi-Sheng Lin
- Division of Urology, Department of Surgery, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C
| | - Tang-Yi Tsao
- Department of Anatomical Pathology, Tungs' Taichung Metro Harbor Hospital, Taichung, Taiwan, R.O.C
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Wang HK, Huang CY, Sun YT, Li JY, Chen CH, Sun Y, Liu CH, Lin CH, Chang WL, Lee JT, Sung SF, Yeh PY, Lai TC, Tsai IJ, Lin MC, Lin CL, Wen CP, Hsu CY. Smoking Paradox in Stroke Survivors?: Uncovering the Truth by Interpreting 2 Sets of Data. Stroke 2020; 51:1248-1256. [PMID: 32151234 DOI: 10.1161/strokeaha.119.027012] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background and Purpose- The observation that smokers with stroke could have better outcome than nonsmokers led to the term "smoking paradox." The controversy of such a complex claim has not been fully settled, even though different case mix was noted. Analyses were conducted on 2 independent data sets to evaluate and determine whether such a paradox truly exists. Methods- Taiwan Stroke Registry with 88 925 stroke cases, and MJ cohort with 541 047 adults participating in a medical screening program with 1630 stroke deaths developed during 15 years of follow-up (1994-2008). Primary outcome for stroke registry was functional independence at 3 months by modified Rankin Scale score ≤2, for individuals classified by National Institutes of Health Stroke Scale score at admission. For MJ cohort, mortality risk by smoking status or by stroke history was assessed by hazard ratio. Results- A >11-year age difference in stroke incidence was found between smokers and nonsmokers, with a median age of 60.2 years for current smokers and 71.6 years for nonsmokers. For smokers, favorable outcome in mortality and in functional assessment in 3 months with modified Rankin Scale score ≤2 stratified by the National Institutes of Health Stroke Scale score was present but disappeared when age and sex were matched. Smokers without stroke history had a ≈2-fold increase in stroke deaths (2.05 for ischemic stroke and 1.53 for hemorrhagic stroke) but smokers with stroke history, 7.83-fold increase, overshadowing smoking risk. Quitting smoking at earlier age reversed or improved outcome. Conclusions- "The more you smoke, the earlier you stroke, and the longer sufferings you have to cope." Smokers had 2-fold mortality from stroke but endured stroke disability 11 years longer. Quitting early reduced or reversed the harms.
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Affiliation(s)
- Hao-Kuang Wang
- From the School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan (H.-K. W., J.-Y. L.).,Department of Neurosurgery, E-Da Hospital, Kaohsiung, Taiwan (H.-K. W.)
| | - Chih-Yuan Huang
- Neurosurgical Service, Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan (C.-Y. H.)
| | - Yuan-Ting Sun
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Y.-T. S. C.-H. C.).,Stroke Center, National Cheng Kung University Hospital, Tainan, Taiwan (Y.-T. S. C.-H. C.)
| | - Jie-Yuan Li
- From the School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan (H.-K. W., J.-Y. L.).,Department of Neurology, E-Da Hospital/ I-Shou University, Kaohsiung, Taiwan (J.-Y. L.)
| | - Chih-Hung Chen
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan (Y.-T. S. C.-H. C.).,Stroke Center, National Cheng Kung University Hospital, Tainan, Taiwan (Y.-T. S. C.-H. C.)
| | - Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan (Y. S.)
| | - Chung-Hsiang Liu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H. L., C.Y. Hsu)
| | - Ching-Huang Lin
- Department of Neurology, Kaohsiung Veterans General Hospital, Taiwan (C.-H. L.)
| | - Wei-Lun Chang
- Department of Neurology, Show-Chwan Memorial Hospital, Changhua, Taiwan (W.-L. C.)
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan (J.-T. L.)
| | - Sheng-Feng Sung
- Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City, Taiwan (S.-F. S.)
| | - Po-Yen Yeh
- Department of Neurology, St. Martin De Porres Hospital, Chiayi, Taiwan (P.-Y. Y.)
| | - Ta-Chang Lai
- Division of Neurology, Department of Internal Medicine, Cheng Hsin General Hospital, Taipei, Taiwan (T.-C. L.)
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital, College of Medicine, China Medical University, Taichung, Taiwan (I-J. T., M.-C. L., C.-L. L.)
| | - Mei-Chen Lin
- Management Office for Health Data, China Medical University Hospital, College of Medicine, China Medical University, Taichung, Taiwan (I-J. T., M.-C. L., C.-L. L.)
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, College of Medicine, China Medical University, Taichung, Taiwan (I-J. T., M.-C. L., C.-L. L.)
| | - Chi-Pang Wen
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan (C.-P. W.).,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan (C.-P. W.).,Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan (C.-P. W.)
| | - Chung Y Hsu
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan (C.-H. L., C.Y. Hsu)
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Nishimura T, Tsai IJ, Yamauchi H, Nakatani E, Fukushima M, Hsu CY. Association of Geomagnetic Disturbances and Suicide Attempts in Taiwan, 1997-2013: A Cross-Sectional Study. Int J Environ Res Public Health 2020; 17:ijerph17041154. [PMID: 32059562 PMCID: PMC7068248 DOI: 10.3390/ijerph17041154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 01/27/2020] [Accepted: 02/03/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND A previous study in Japan found that monthly mean K index values were related to the monthly number of male, but not female, suicides. Correlations between geomagnetic disturbances and suicide/depression have also been reported in countries such as Canada, South Africa, Finland, Australia, Russia, and Japan. We have previously shown that stronger geomagnetism is linked to a higher standardized mortality ratio for suicide. To date, however, no published studies have reported the correlation between geomagnetic disturbances and suicide attempts in Taiwan. METHODS Data on the monthly number of suicide attempts in Taiwan from January 1997 to December 2013 were obtained. We performed a multivariable analysis, with the number of suicide attempts as the response variable and monthly Kp10 index, F10.7 index, sulfur dioxide, carbon monoxide, ozone, fine particulate matter (PM2.5), temperature, humidity, unemployment rate, and cosmic rays as the explanatory variables. RESULTS The multivariable analysis showed that Kp10 index, temperature, humidity, unemployment rate, and cosmic rays were associated with the number of male suicide attempts and that Kp10 index, F10.7 index, carbon monoxide, temperature, humidity, and unemployment rate were associated with the number of female suicide attempts. CONCLUSION This is the first article reporting statistically significant relationships between the monthly number of male and female suicide attempts and the monthly mean Kp10 value in Taiwan.
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Affiliation(s)
- Tsutomu Nishimura
- Translational Research Center for Medical Innovation, Kobe 650-0047, Japan; (E.N.); (M.F.)
- Institute for Advancement of Clinical and Translational Science (iACT), Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan
- Correspondence:
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital, Taichung 404, Taiwan;
- College of Medicine, China Medical University, Taichung 404, Taiwan
| | | | - Eiji Nakatani
- Translational Research Center for Medical Innovation, Kobe 650-0047, Japan; (E.N.); (M.F.)
- Division of Statistical Analysis, Research Support Center, Shizuoka General Hospital, Shizuoka 420-8527, Japan
| | - Masanori Fukushima
- Translational Research Center for Medical Innovation, Kobe 650-0047, Japan; (E.N.); (M.F.)
| | - Chung Y. Hsu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung 404, Taiwan;
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Harnod T, Tsai IJ, Chen W, Wang JH, Lin SZ, Sung FC, Ding DC. Hysterectomy and unilateral salpingectomy associate with a higher risk of subsequent ovarian cancer: A population-based cohort study in Taiwan. Medicine (Baltimore) 2019; 98:e18058. [PMID: 31770221 PMCID: PMC6890306 DOI: 10.1097/md.0000000000018058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Studies on the relationship between gynecologic surgery and subsequent ovarian cancer have been carried out in limited Western ethnic groups. We aim to evaluate whether receiving hysterectomy and/or salpingectomy associated with ovarian cancer risk in Taiwan.From the Taiwan National Health Insurance Research Database, we identified a gynecologic surgery cohort consisting of women who had newly received hysterectomy (N = 181,151), salpingectomy (N = 45,410) or both hysterectomy and salpingectomy (N = 11,875) in 2000 to 2013. A comparison cohort of 953,744 women was randomly selected from women without the surgeries, frequency-matched by age and index date of the surgery case. They were followed up to identify subsequent ovarian cancer by the end of 2013.The overall ovarian cancer incidence was 4.4-fold greater in the gynecologic surgery cohort than in the comparison cohort (41.5 vs 9.43 per 10 person-years) with an adjusted hazard ratio of 3.86 (95% confidence interval = 2.56-5.84). Women with both hysterectomy and salpingectomy had the highest incidence and followed by women with hysterectomy or salpingectomy (52.5, 45.5, or 23.3 per 10 person-years, respectively). No ovarian cancer was noted in the subgroup with bilateral salpingectomies.We conclude that women with gynecologic surgery of hysterectomy and/or salpingectomy are at an increased risk of developing ovarian cancer, particularly among women who have had other gynecologic comorbidity. Women with gynecologic surgery and comorbidity deserve greater attention to prevent and screen for ovarian cancer.
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Affiliation(s)
- Tomor Harnod
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University, Taichung
| | - Weishan Chen
- Management Office for Health Data, China Medical University Hospital
- College of Medicine, China Medical University, Taichung
| | - Jen-Hung Wang
- Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien
| | - Shinn-Zong Lin
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, and Tzu Chi University, Hualien
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital
- Department of Health Services Administration, China Medical University College of Public Health, Taichung
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
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22
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Chou CH, Lee JT, Tsai CK, Lien LM, Yin JH, Lin CC, Tsai IJ, Sung YF, Yang FC, Tsai CL, Wang IK, Tseng CH, Hsu CY. Increased risk of non-multiple sclerosis demyelinating syndromes in patients with preexisting septicaemia: a nationwide retrospective cohort study. Postgrad Med J 2019; 95:307-313. [PMID: 31209183 PMCID: PMC6613738 DOI: 10.1136/postgradmedj-2019-136667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/15/2019] [Accepted: 05/30/2019] [Indexed: 12/25/2022]
Abstract
Background Growing evidence shows links between septicaemia and non-multiple sclerosis demyelinating syndromes (NMSDS); nevertheless, epidemiological data are still very limited. This study aimed to explore the relationship between septicaemia and NMSDS in a general population. Methods The study included 482 781 individuals diagnosed with septicaemia and 1 892 825 age/sex-matched non-septicaemia patients for the comparison. Data were drawn from a population-based nationwide National Health Insurance Research Database Taiwan, from 1 January 2002 to 31 December 2011. The two cohorts of patients with and without septicaemia were followed up for the occurrence of NMSDS. The Cox-proportional hazard regression model was performed to estimate adjusted HR after multivariate adjustment. Results Individuals with septicaemia had a 4.17-fold (95% CI 3.21 to 5.4, p < 0.001) higher risk to develop NMSDS compared with those without septicaemia. Patients aged <65 years had a greater NMSDS risk (<45 years: HR = 6.41, 95% CI 3.65 to 11.3, p < 0.001; 45–64 years: HR = 6.66, 95% CI 3.98 to 11.2, p < 0.001). Furthermore, females with septicaemia and individuals with higher severity of septicaemia were associated with increased risks of developing NMSDS. Conclusions Our results indicated that patients with septicaemia were likely to develop NMSDS. A possible contributing role of septicaemia in increasing the hazard of NMSDS is proposed, based on the outcome that individuals with higher severity of septicaemia carried elevated threat of encountering NMSDS.
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Affiliation(s)
- Chung-Hsing Chou
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republicof China.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republicof China .,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republicof China.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Li-Ming Lien
- Department of Neurology, Shin-Kong WHS Memorial Hospital, Taipei, Taiwan, Republic of China.,School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, Republic of China
| | - Jiu-Haw Yin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republicof China.,Division of Neurology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan, Republic of China
| | - Chun-Chieh Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republicof China
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital, College of Medicine, China Medical University, Taichung, Taiwan, Republic of China
| | - Yueh-Feng Sung
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republicof China
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republicof China
| | - Chia-Lin Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republicof China
| | - I-Kuan Wang
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, Republic of China.,Department of Internal Medicine, College of Medicine, China Medical University, Taichung, Taiwan, Republic of China.,Division of Kidney Disease, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Chun-Hung Tseng
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan, Republic of China
| | - Chung-Y Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan, Republic of China
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Shen YC, Chen W, Tsai IJ, Wang JH, Lin SZ, Ding DC. Association of hysterectomy with bipolar disorder risk: A population-based cohort study. Depress Anxiety 2019; 36:543-551. [PMID: 31025812 DOI: 10.1002/da.22904] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/17/2019] [Accepted: 04/10/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hormonal fluctuations may trigger the onset of bipolar disorder. We designed a longitudinal follow-up study to evaluate the association between hysterectomies and bipolar disorder risk. METHODS We conducted a large retrospective cohort study using Taiwan's National Health Insurance Research Database. A total of 4,337 women aged 30 to 50 years who underwent the hysterectomy during 2000-2013 were selected and 17,348 patients without hysterectomy were selected for comparison (1:4 match). Poisson regression analysis was used to calculate the incidence rate ratio (IRR) and 95% confidence interval (CI). RESULTS During the follow-up of 7.93 years, 20 participants with hysterectomy and 28 without hysterectomy developed bipolar disorder. Receiving hysterectomy was associated with the risk of developing bipolar disorder (adjusted IRR = 2.80; 95% CI = 2.54-3.09). Women with hysterectomy had a higher risk of bipolar disorder in follow-up durations of <1 year (adjusted IRR = 2.18 with 95% CI = 1.94-1.45) and ≥1 year (adjusted IRR = 2.85 with 95% CI = 2.58-3.15). Endometriosis and Premarin use increased bipolar disorder incidence in the hysterectomy group (adjusted IRR = 3.17 [95% CI = 2.83-3.56] and 4.22 [95% CI = 3.71-4.80], respectively). CONCLUSION This study concluded that women with hysterectomy have an increased risk of bipolar disorder. Endometriosis and hormone therapy may add to the risk of bipolar disorder after hysterectomy. Knowledge about how surgical or natural hormonal withdrawal influences mood is fundamental and emphasizes the importance of coordinated psychiatric and gynecological care.
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Affiliation(s)
- Yu-Chih Shen
- Department of Psychiatry, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Weishan Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Jen-Hung Wang
- Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Shinn-Zong Lin
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan.,Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
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Su CC, Tsai CY, Tsai TH, Tsai IJ. Incidence and risk of attention-deficit hyperactivity disorder in children with amblyopia: A nationwide cohort study. Clin Exp Ophthalmol 2019; 47:259-264. [PMID: 30663207 PMCID: PMC6594075 DOI: 10.1111/ceo.13465] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Revised: 12/11/2018] [Accepted: 12/28/2018] [Indexed: 12/03/2022]
Abstract
Importance The association between visual deficits and attention disorders has been reported but remains unproven. Background The objective of this study was to evaluate the risk of attention‐deficit hyperactivity disorder (ADHD) in children with amblyopia. Design Population‐based, cohort study. Participants The dataset from the Taiwan National Health Insurance Research Database in 2000 to 2010. Methods A total of 6817 patients aged <18 years with newly diagnosed amblyopia were identified. Four age‐ and sex‐matched controls without amblyopia were included for each patient, that is, 27268 controls. Main Outcome Measures The primary outcome was the risk of ADHD. The secondary outcomes were age at ADHD onset and use of ADHD medication. Results During a mean observation period of 7.18 years, the incidence of ADHD per 1000 person‐years was 7.02 in the amblyopia group and 4.61 in the control group (P < 0.0001). The ADHD risk in the amblyopia group was 1.81 times that in the control group (hazard ratio 1.81; 95% confidence interval 1.59‐2.06). After stratification by amblyopia subtype, the greatest risk was in the deprivation type (hazard ratio 2.14; 95% confidence interval 1.56‐2.92) followed by the strabismic (hazard ratio 2.09; 95% confidence interval 1.15‐3.79) and refractive (hazard ratio 1.76; 95% confidence interval 1.54‐2.02) types. Age at ADHD onset was younger in the amblyopia group (median 8.14 vs 8.45 years; P = 0.0096). The average duration of neuropsychiatric medication use was comparable between groups (P = 0.98). Conclusions and Relevance The ADHD risk is higher in children with amblyopia.
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Affiliation(s)
- Chien-Chia Su
- Department of Ophthalmology, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chia-Ying Tsai
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Ophthalmology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan
| | - Tzu-Hsun Tsai
- Department of Ophthalmology, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - I-Ju Tsai
- Department of Ophthalmology, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
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Fan CY, Lin CS, Huang WY, Lin KT, Chao HL, Tsao CC, Liu MY, Tsai IJ, Kao CH. Association Between Migraine and Breast Cancer Risk: A Population-Based Cohort Study and Literature Review. J Womens Health (Larchmt) 2018; 27:1499-1507. [PMID: 30183462 DOI: 10.1089/jwh.2018.6929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Objective: Previous case-control studies have suggested that women with migraine have lower risk of developing breast cancer, but conflicting results were noted in cohort studies. We investigated the association between migraine and breast cancer incidence in a nationwide population-based cohort study. Methods: We identified 25,606 women with migraine between 2000 and 2013 from the National Health Insurance Research Database in Taiwan. Each migraineur was randomly frequency matched with four women without migraine by age and index year of migraine diagnosis. Cox's proportional hazard regression analysis was performed to estimate the association between migraine on the risk of developing breast cancer. Results: With a mean follow-up of 7.3 years, 234 and 978 breast malignancies occurred in the migraine cohort and matched cohort, respectively. Migraine was not associated with the risk of breast cancer (adjusted hazard ratio = 1.03, 95% confidence interval = 0.89-1.21). Among women with migraine, independent risk factors for breast cancer included older age, alcohol-related illness, and receipt of a greater number of breast cancer screening examinations, and independent protective factors included the use of antihypertensive agents, statins, and nonsteroidal anti-inflammatory drugs. Further analyses indicated that women with ≥4 medical visits for migraine per year had a significantly greater risk of breast cancer than the matched cohort. Conclusions: Migraine was not associated with a decreased risk of developing breast cancer among Taiwanese women. Further prospective studies on other geographic populations or on the association between migraine frequency and the risk of developing breast cancer are warranted to validate our findings.
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Affiliation(s)
- Chao-Yueh Fan
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chun-Shu Lin
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Wen-Yen Huang
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kuen-Tze Lin
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsing-Lung Chao
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Cheng Tsao
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ming-Yueh Liu
- Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan
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Abstract
Hysterectomy is a common procedure for benign pathologies of the uterus. Reduced production of estrogen following hysterectomy has been reported. Yet the association between hysterectomy and coronary artery disease (CAD) risk remains controversial. The aim of this study was to investigate the effect of hysterectomy on the risk of CAD; calculations were adjusted for traditional risk factors.This study used a 1 million patient cohort of the Taiwan National Health Insurance database and included a total of 7331 women who received hysterectomy from 2000 to 2013. We randomly selected a control group composed of 29,324 women without hysterectomy by 1:4 matching the age (exact year) with the hysterectomy group.The mean (standard deviation) age was 43.5 ± 4.0 in the hysterectomy and 43.6 ± 4.0 in the control group. A total of 1986 CAD cases developed in both groups during a median follow-up of 7 years. Significant differences were observed in CAD incidence in the hysterectomy versus control group (9.82 vs. 7.17/1000 person-years, P < .001, adjusted hazard ratio = 1.31 [95% confidence interval: 1.18-1.45]).We found a significant association between hysterectomy and CAD, even after adjustment for baseline CAD risk factors.
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Affiliation(s)
- Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
- Institute of Medical Sciences, Tzu Chi University, Hualien
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital
| | - Chung Y. Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung
| | - Jen-Hung Wang
- Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
| | - Shinn-Zong Lin
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
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Wang IK, Liu CH, Yen TH, Jeng JS, Sung SF, Huang PH, Li JY, Sun Y, Wei CY, Lien LM, Tsai IJ, Sung FC, Hsu CY, Liu CH, Tsai CH, Huang WS, Lu CT, Tsai TC, Tseng CH, Lin KH, Shyu WC, Yang YW, Liu YL, Cho DY, Chen CC, Jeng JS, Tang SC, Tsai LK, Yeh SJ, Chen CH, Tsai HH, Li JY, Chen HJ, Lu K, Hsu SP, Kuo HC, Tsou JC, Wang YT, Tai YC, Hsieh MT, Liliang PC, Liang CL, Wang HK, Tsai YT, Wang KW, Chen JS, Chen PY, Wang YC, Chen CH, Sung PS, Hsieh HC, Su HC, Chiu HC, Lien LM, Chen WH, Bai CH, Huang TH, Lau CI, Wu YY, Yeh HL, Chang A, Lin CH, Yen CC, Lin RT, Chen CH, Khor GT, Chao AC, Lin HF, Huang P, Lin HJ, Ke DS, Chang CY, Yeh PS, Lin KC, Cheng TJ, Chou CH, Yang CM, Shen HC, Chen AC, Tsai SJ, Lu TM, Kung SL, Lee MJ, Chou HH, Chang WL, Chiu PY, Hsu MH, Chan PC, Pan CH, Shoung HM, Lo YC, Wang FH, Chang WC, Lai TC, Yin JH, Wang CJ, Wang KC, Chen LM, Denq JC, Sun Y, Lu CJ, Lin CH, Huang CC, Liu CH, Chan HF, Lee SP, Sun MH, Ke LY, Chen PL, Lee YS, Sung SF, Ong CT, Wu CS, Hsu YC, Su YH, Hung LC, Lee JT, Lin JC, Hsu YD, Denq JC, Peng GS, Hsu CH, Lin CC, Yen CH, Cheng CA, Sung YF, Chen YL, Lien MT, Chou CH, Liu CC, Yang FC, Wu YC, Tso AC, Lai YH, Chiang CI, Tsai CK, Liu MT, Lin YC, Hsu YC, Chiang TR, Huang PH, Liao PW, Lee MC, Chen JT, Lie SK, Sun MC, Hsiao PJ, Chen WL, Chen TC, Chang CS, Lai CH, Chuang CS, Chen YY, Lin SK, Su YC, Shiao JL, Yang FY, Liu CY, Chiang HL, Chen GC, Hsu PJ, Chang CY, Lin IS, Chien CH, Chang YC, Chen PK, Chiu PY, Hsiao YJ, Fang CW, Chen YW, Lee KY, Lin YY, Li CH, Tsai HF, Hsieh CF, Yang CD, Liaw SJ, Liao HC, Yeh SJ, Wu LL, Hsieh LP, Lee YH, Chen CW, Hsu CS, Jhih YJ, Zhuang HY, Pan YH, Shih SA, Chen CI, Sung JY, Weng HY, Teng HW, Lee JE, Huang CS, Chao SP, Yuan RY, Sheu JJ, Yu JM, Ho CS, Lin TC, Yu SC, Chen JR, Tsai SY, Wei CY, Hung CH, Lee CF, Yang SK, Chen CL, Lin W, Tseng HP, Liu CH, Lin CL, Lin HC, Chen PT, Hu CJ, Chan L, Chi NF, Chern CM, Lin CJ, Wang SJ, Hsu LC, Wong WJ, Lee IH, Yen DJ, Tsai CP, Kwan SY, Soong BW, Chen SP, Liao KK, Lin KP, Chen C, Shan DE, Fuh JL, Wang PN, Lee YC, Yu YH, Huang HC, Tsai JY, Wu MH, Chiang SY, Wang CY, Hsu MC, Chen CC, Yeh PY, Tsai YT, Wang KY, Chen TS, Hsieh CY, Chen WF, Yip PK, Wang V, Wang KC, Tsai CF, Chen CC, Chen CH, Liu YC, Chen SY, Zhao ZH, Wei ZP, Wu SL, Liu CK, Lin RH, Chu CH, Yan SH, Lin YC, Chen PY, Hsiao SH, Yip BS, Tsai PC, Chou PC, Kuo TM, Lee YC, Chiu YP, Tsai KC, Liao YS, Tsai MJ, Kao HY. Renal function is associated with 1-month and 1-year mortality in patients with ischemic stroke. Atherosclerosis 2018; 269:288-293. [PMID: 29254692 DOI: 10.1016/j.atherosclerosis.2017.11.029] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Revised: 10/26/2017] [Accepted: 11/29/2017] [Indexed: 10/18/2022]
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Ding DC, Tsai IJ, Wang JH, Lin SZ, Sung FC. Coronary artery disease risk in young women with polycystic ovary syndrome. Oncotarget 2018; 9:8756-8764. [PMID: 29492235 PMCID: PMC5823557 DOI: 10.18632/oncotarget.23985] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 11/16/2017] [Indexed: 11/25/2022] Open
Abstract
Women with polycystic ovary syndrome are characterized by obesity, menstruation irregularity, hirsutism and infertility, and prevalent with cardiometabolic comorbidities, but population-based studies on the risk of developing coronary artery disease are limited. From claims data of the Taiwan National Health Insurance, we identified 8048 women with polycystic ovary syndrome aged 15-49 years newly diagnosed in 1998-2013, and 32192 women without the syndrome and CAD as controls, frequency matched by age and diagnosis date. By the end of 2013, after a mean follow-up period of 5.9 years, the overall incidence of coronary artery disease was 63% higher in women with polycystic ovary syndrome than in controls (2.25 vs. 1.38 per 1000 person-years). The adjusted hazard ratio [aHR] of coronary artery disease was 1.44 (95% confidence interval (CI) = 1.14–1.81) for women with polycystic ovary syndrome, compared with controls. Hazards of coronary artery disease were significant during follow-up periods of 3-4 years (aHR = 1.52, 95% CI = 1.00–2.30) and of 5–9 years (aHR = 1.58, 95% CI = 1.07–2.32). The incidence of coronary artery disease increased further in those with cardiometabolic comorbidities. Among women with polycystic ovary syndrome, those with comorbid diabetes had an incidence of 35.2 per 1000 person-years, 20-fold greater than those without cardiometabolic comorbidities. In conclusion, women with polycystic ovary syndrome are at an elevated risk of coronary artery disease. Preventive interventions should be provided to them, particularly for those with the comorbidity of metabolism symptom.
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Affiliation(s)
- Dah-Ching Ding
- Department of Obstetrics and Gynecology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan.,Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - I-Ju Tsai
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Jen-Hung Wang
- Department of Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Shinn-Zong Lin
- Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Tzu Chi University, Hualien, Taiwan
| | - Fung-Chang Sung
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,Department of Health Services Administration, China Medical University, Taichung, Taiwan
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Fan CY, Lin CS, Chao HL, Huang WY, Su YF, Lin KT, Tsai IJ, Kao CH. Risk of hypothyroidism among patients with nasopharyngeal carcinoma treated with radiation therapy: A Population-Based Cohort Study. Radiother Oncol 2017; 123:394-400. [DOI: 10.1016/j.radonc.2017.04.025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 04/21/2017] [Accepted: 04/25/2017] [Indexed: 01/03/2023]
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Abstract
Background and Purpose—
Previous studies have shown regional and temporal variations in epidemiological features of moyamoya disease, but population-based studies in regions other than Japan are limited. We investigated the incidence and patients characteristics of moyamoya disease during 12 years in Taiwan using claims databases of a universal health insurance system.
Methods—
From the inpatient databases of the Taiwan National Health Insurance program, we identified subjects who had an initial hospitalization with moyamoya disease and had been underwent cerebral angiography as incidence cases during 2000 to 2011. The incidence and the patient characteristics were described by age and time periods of the hospitalization.
Results—
During the 12-year period, 422 patients were identified, representing an annual incidence of 0.15 per 100 000 person-years. Adults exhibited an upward trend in incidence with an incidence rate ratio of 1.74 (95% confidence interval [1.17–2.58]) in years 2010 to 2011 comparing with years 2000 to 2001. However, children had a decreased incidence except a slightly increase in the last 2 years. Compared with patients hospitalized during 2000 to 2005, patients identified during 2006 to 2011 had greater women-to-men ratio (1.7 versus 1.1,
P
=0.048). Children were more likely to have comorbid epilepsy than were adult patients (25.0% versus 3.4%,
P
=0.002). Hemorrhagic stroke was rare among pediatric patients but presented more frequently in adults. However, ischemic stroke was more prevalent in both groups.
Conclusions—
The incidence of moyamoya disease has increased in adults but not in children from 2000 to 2011 in Taiwan. Sex ratio and comorbid conditions differed by age and study period.
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Affiliation(s)
- Pei-Chun Chen
- From the Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (P.-C.C., K.-L.C.); Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, and National Taiwan University, College of Medicine, Taipei, Taiwan (S.-H.Y., M.-F.K.); and National Taiwan University Health Data Research Center, Taipei, Taiwan (I.-J.T.)
| | - Shih-Hung Yang
- From the Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (P.-C.C., K.-L.C.); Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, and National Taiwan University, College of Medicine, Taipei, Taiwan (S.-H.Y., M.-F.K.); and National Taiwan University Health Data Research Center, Taipei, Taiwan (I.-J.T.)
| | - Kuo-Liong Chien
- From the Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (P.-C.C., K.-L.C.); Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, and National Taiwan University, College of Medicine, Taipei, Taiwan (S.-H.Y., M.-F.K.); and National Taiwan University Health Data Research Center, Taipei, Taiwan (I.-J.T.)
| | - I-Ju Tsai
- From the Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (P.-C.C., K.-L.C.); Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, and National Taiwan University, College of Medicine, Taipei, Taiwan (S.-H.Y., M.-F.K.); and National Taiwan University Health Data Research Center, Taipei, Taiwan (I.-J.T.)
| | - Meng-Fai Kuo
- From the Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan (P.-C.C., K.-L.C.); Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, and National Taiwan University, College of Medicine, Taipei, Taiwan (S.-H.Y., M.-F.K.); and National Taiwan University Health Data Research Center, Taipei, Taiwan (I.-J.T.)
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Chen PK, Chiu PY, Tsai IJ, Tseng HP, Chen JR, Yeh SJ, Yeh SJ, Sheu JJ, Chung CP, Wu MH, Hu CJ, Chang CY, Wei CY, Yip PK, Sung SF, Wang SJ, Hsu CY. Onset Headache Predicts Good Outcome in Patients With First-Ever Ischemic Stroke. Stroke 2013; 44:1852-8. [PMID: 23704109 DOI: 10.1161/strokeaha.113.677070] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
The study aimed to assess whether onset headache is an ominous sign in patients with first-ever ischemic stroke.
Methods—
A large population of ischemic stroke patients was obtained from the Taiwan Stroke Registry. Stroke subtypes were classified by the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria. On the basis of the International Classification of Headache Disorders, second version, onset headache was defined as a new headache that developed at the onset of ischemic stroke. Clinical features and impact on stroke outcomes, including in-hospital stroke in evolution, changes in National Institutes of Health Stroke Scale on discharge, and Barthel index and modified Rankin scale ≤6 months after stroke were compared between those with and without onset headache.
Results—
Among 11 523 patients with first-ever ischemic stroke, 848 had onset headache (7.4%). Patients with specific cause, large-artery atherosclerosis, or cardioembolism were more likely to have onset headache. Patients with onset headache were younger, predominantly female, and more likely to have posterior circulation ischemic lesions. Compared with patients without onset headache, those with onset headache had a lower frequency of stroke in evolution (4.5% versus 6.7%; adjusted relative risk, 0.64; 95% confidence interval, 0.52–0.79), greater improvement in National Institutes of Health Stroke Scale score on discharge (0.08 versus −0.20;
P
=0.02), higher mean Barthel index scores (86.5±20.0 versus 83.9±23.3; adjusted difference, 1.43; 95% confidence interval, 0.28–2.89), and a lower frequency of modified Rankin scale higher than 2 (27.6% versus 31.5%; adjusted relative risk, 0.85; 95% confidence interval, 0.72–0.95) at 1-month follow-up. There was also a trend for better functional outcome in 3- and 6-month follow-ups.
Conclusions—
By adopting standard classification criteria, this large-scale study demonstrated that onset headache was associated with modest but significantly better outcomes after ischemic stroke.
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Affiliation(s)
- Ping-Kun Chen
- Graduate Institute of Clinical Medicine Science, China Medical University, Taichung, Taiwan
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Lai HC, Tsai IJ, Chen PC, Muo CH, Chou JW, Peng CY, Lai SW, Sung FC, Lyu SY, Morisky DE. Gallstones, a cholecystectomy, chronic pancreatitis, and the risk of subsequent pancreatic cancer in diabetic patients: a population-based cohort study. J Gastroenterol 2013; 48:721-7. [PMID: 23053420 DOI: 10.1007/s00535-012-0674-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Accepted: 08/21/2012] [Indexed: 02/07/2023]
Abstract
BACKGROUND The causal association between diabetes and pancreatic cancer remains unclear in Asian populations. This study examined whether gallstones, a cholecystectomy, chronic pancreatitis and the treatment of antidiabetic agents affect the risk of subsequent pancreatic cancer for patients with diabetes in a Taiwanese population. METHODS Using claims data from the universal health insurance program in Taiwan, 449,685 newly diagnosed diabetic cases among insured people from 2000 to 2003 were identified as the case group. The comparison group, matched for gender, age, and the index year of the diabetes cohort, consisted of 325,729 persons without diabetes. Pancreatic cancer incidence was measured in both groups until the end of 2008. Other risk factors associated with this cancer were also measured. RESULTS The incidence of pancreatic cancer in the diabetic cohort was 2-fold greater than that in the comparison group (1.46 vs. 0.71 per 10,000 person-years) with an adjusted hazard ratio (HR) of 1.75 [95 % confidence interval (CI) 1.45-2.10]. The risk slightly increased for diabetic patients with gallstones, cholecystitis, and a cholecystectomy (HR 1.92, 95% CI 1.18-3.11), but greatly increased for those with comorbidity of chronic pancreatitis (HR 22.9, 95% CI 12.6-41.4). Pancreatic cancer risk also increased significantly for those patients who used more insulin for treating diabetes (OR 2.20, 95% CI 1.40-3.45). CONCLUSION Our data suggest that the risk of pancreatic cancer is moderately increased in patients with diabetes, especially those using insulin therapy. The risk is greatly increased for diabetic patients with chronic pancreatitis.
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Affiliation(s)
- Hsueh-Chou Lai
- School of Chinese Medicine, China Medical University, Taichung, 404, Taiwan.
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Tsou YA, Lin CC, Lai CH, Wang CY, Lin CD, Chen PC, Tsai IJ, Chen CM, Sung FC, Tsai MH. Does Adenotonsillectomy really reduced clinic visits for pediatric upper respiratory tract infections? A national database study in Taiwan. Int J Pediatr Otorhinolaryngol 2013; 77:677-81. [PMID: 23394793 DOI: 10.1016/j.ijporl.2013.01.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 01/07/2013] [Accepted: 01/12/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To investigate whether adenotonsillectomy reduces upper respiratory tract infections (URIs) in the pediatric population. METHODS AND SUBJECTS We identified 415 children, aged ≤18 years who had undergone adenoidectomy and/or tonsillectomy during the period from 1999 to 2006, from the Taiwan National Health Insurance Research Database. The comparison group consisted of 1630 children without the surgery randomly selected from the same database frequency matched with sex, age and the surgery date (index date). Changes in physician visits for URIs 2-year period before and 2-year period after the index date were compared between the two groups of children. RESULTS The number of outpatient visits for URIs decreased with time, children with tonsillectomy and/or adenoidectomy had a greater reduction than comparison children (mean changes, -14 times and -6 times, respectively) in the 2-year period after the index date. Multivariate analyses using generalized estimated equation revealed a significant effect in reducing URIs visits from the surgery (relative ratio=0.85, p<0.0001), strongest for children undergoing both tonsillectomy and adenoidectomy (relative ratio=0.76, p<0.0001). The association between surgery and the decrease in URIs was more pronounced for children aged 12 years and less. CONCLUSION This population-based study suggests that tonsillectomy and/or adenoidectomy is associated with fewer physician visits for URIs. The association is weakened in old children.
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Affiliation(s)
- Yung-An Tsou
- Department of Otolaryngology-Head and Neck Surgery, China Medical University Hospital, Taichung, Taiwan
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Lin SY, Liu JH, Lin CL, Tsai IJ, Chen PC, Chung CJ, Liu YL, Wang IK, Lin HH, Huang CC. A comparison of herpes zoster incidence across the spectrum of chronic kidney disease, dialysis and transplantation. Am J Nephrol 2012; 36:27-33. [PMID: 22699521 DOI: 10.1159/000339004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2012] [Accepted: 04/17/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND The effect of different renal replacement therapies on the risk of developing herpes zoster in renal failure patients is unknown. We aimed to investigate the incidence of herpes zoster attack among renal failure patients who were receiving different dialysis modalities, renal transplantation (RT), or not receiving any of the above mentioned therapies yet. METHODS A retrospective cohort study of the national health insurance register database was conducted. This observational cohort study involved 79,581 study controls, 15,802 chronic kidney disease patients, 3,694 hemodialysis (HD) patients, 317 peritoneal dialysis (PD) patients, and 159 RT patients. RESULTS The RT group had the worst risk of herpes zoster (hazard ratio, HR, 8.46; 95% CI 5.85-12.2), followed by PD (HR 3.61; 95% CI 2.49-4.83) and HD (HR 1.35; 95% CI 1.18-1.55), compared with the comparison group (p < 0.0001). The RT group had also the highest risk of developing herpes zoster with complications among all groups (adjusted HR 15.3). The HRs of the PD group were higher than the HRs of the HD group in terms of herpes zoster or its complications (p < 0.0001 and p = 0.0002, respectively). CONCLUSIONS This study suggests that different treatment modalities are associated with different risks of herpes zoster attacks in renal failure patients. PD patients had higher risks than the HD group in terms of herpes zoster or its complications.
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Affiliation(s)
- Shih-Yi Lin
- Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan, ROC
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Chang YT, Chen PC, Tsai IJ, Sung FC, Chin ZN, Kuo HT, Tsai CH, Chou IC. Bidirectional relation between schizophrenia and epilepsy: a population-based retrospective cohort study. Epilepsia 2011; 52:2036-42. [PMID: 21929680 DOI: 10.1111/j.1528-1167.2011.03268.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PURPOSE Schizophrenia and epilepsy may share a mutual susceptibility. This study examined the bidirectional relation between the two disorders. METHODS We used claims data obtained from the Taiwan National Health Insurance database to conduct retrospective cohort analyses. Analysis 1 compared 5,195 patients with incident schizophrenia diagnosed in 1999-2008 with 20,776 controls without the disease randomly selected during the same period, frequency matched with sex and age. Analysis 2 comprised a similar method to compare 11,527 patients with newly diagnosed epilepsy with 46,032 randomly selected sex- and age-matched controls. At the end of 2008, analysis 1 measured the incidence and risk of developing epilepsy and analysis 2 measured the incidence and risk of developing schizophrenia. KEY FINDINGS In analysis 1, the incidence of epilepsy was higher in the schizophrenia cohort than in the nonschizophrenia cohort (6.99 vs. 1.19 per 1,000 person-years) with an adjusted hazard ratio (aHR) of 5.88 [95% confidence interval (CI) 4.71-7.36] for schizophrenia patients. In analysis 2, the incidence of schizophrenia was higher in the epilepsy cohort than in the nonepilepsy comparison cohort (3.53 vs. 0.46 per 1,000 person-years) with an aHR of 7.65 (95% CI 6.04-9.69) for epilepsy patients. The effect of schizophrenia on subsequent epilepsy was greater for women, but the association between epilepsy and elevated incidence of schizophrenia was more pronounced in men. SIGNIFICANCE We found a strong bidirectional relation between schizophrenia and epilepsy. These two conditions may share common causes. Further studies on the mechanism are required.
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Affiliation(s)
- Yu-Tzu Chang
- Division of Pediatric Neurology, Department of Pediatrics, China Medical University and Hospital, Taichung, Taiwan
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Lin KM, Tsou HH, Tsai IJ, Hsiao MC, Hsiao CF, Liu CY, Shen WW, Tang HS, Fang CK, Wu CS, Lu SC, Kuo HW, Liu SC, Chan HW, Hsu YT, Tian JN, Liu YL. CYP1A2 genetic polymorphisms are associated with treatment response to the antidepressant paroxetine. Pharmacogenomics 2011; 11:1535-43. [PMID: 21121774 DOI: 10.2217/pgs.10.128] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
AIM Paroxetine is a drug of choice in the treatment of major depressive disorder (MDD). Its metabolism has recently been reported to be mediated through the CYP enzymes 1A2 and 2D6. In our current study, we tested whether genetic polymorphisms in CYP1A2 are associated with the treatment efficacy and side effects of paroxetine. MATERIALS & METHODS A total of 241 MDD patients who had taken paroxetine continually for 8 weeks were recruited, and their steady state paroxetine concentrations were measured at weeks 2, 4 and 8. The genotypes of these patients were then assessed for the presence of nine SNPs, which were selected from either the HapMap Chinese ethnic group, the literature report or through their functional role in the CYP1A2 gene. RESULTS The allele types for SNPs rs4646425 (permutation p = 0.03), rs2472304 (permutation p = 0.01) and rs2470890 (permutation p = 0.004) demonstrated significant associations with paroxetine treatment remission at week 8. Response rates in the Hamilton Rating Scale for Depression (HAM-D) and for The Hamilton Rating Scale for Anxiety (HAM-A) were significantly associated with the SNPs rs4646425 (p = 0.0126 and 0.0088 for HAM-D and HAM-A, respectively) and rs4646427 (p = 0.0067 and 0.0196 for HAM-D and HAM-A, respectively). The inducible SNP rs762551 had a significant association with paroxetine dose at week 4 (permutation p = 0.012). We did not find an association between these SNPs and the side effects or serum concentrations of paroxetine. CONCLUSION Genetic variants in the CYP1A2 region may be indicators of treatment response in MDD patients to paroxetine.
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Affiliation(s)
- Keh-Ming Lin
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
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Tsai IJ, Croft KD, Puddey IB, Beilin LJ, Barden A. 20-Hydroxyeicosatetraenoic acid synthesis is increased in human neutrophils and platelets by angiotensin II and endothelin-1. Am J Physiol Heart Circ Physiol 2011; 300:H1194-200. [PMID: 21239640 DOI: 10.1152/ajpheart.00733.2010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The cytochrome P-450 arachidonic acid metabolite 20-HETE is central to the regulation of vascular tone, renal function, and blood pressure and is synthesized in the rat kidney in response to angiotensin II (ANG II) and endothelin-1 (ET-1). There are very few studies examining the cellular synthesis of 20-HETE in humans. We aimed to measure human neutrophil and platelet 20-HETE levels under basal conditions and after ANG II, ET-1, and calcium ionophore (CaI). 20-HETE was measured in human platelets and neutrophils after saline (control), CaI (2.5 μg/ml), and ANG II or ET-1 (10 nmol/l-1 μmol/l) incubations. The effect of cells, which were preincubated with the ω-hydroxylase inhibitor N-hydroxy-N'-(4-butyl-2-methylphenyl) (HET0016, 10 nM), ANG II types 1 or 2 (AT(1) or AT(2)) receptor inhibition with irbesartan (1 μmol/l) or PD-123319 (1 μmol/l), or endothelin receptor subtypes A or B (ET(A) or ET(B)) receptor inhibition with BQ-123 or BQ-778 (100 nmol/l), was studied. Neutrophil and platelet content and release of 20-HETE was significantly increased by CaI and blocked by the ω-hydroxylase inhibitor HET0016. ANG II and ET-1 significantly increased neutrophil and platelet content and release of 20-HETE. ANG II increased 20-HETE via the AT(2) receptor. ET-1 increased 20-HETE through the ET(B) receptor in platelets and both the ET(A) and ET(B) receptors in neutrophils. These studies show that human platelets and neutrophils synthesize 20-HETE in response to ANG II and ET-1. 20-HETE synthesis in both cell types was predominantly mediated via the AT(2) and ET(B) receptors. Stimulation via these receptor pathways has generally been thought to be cardioprotective and requires further studies in clinical situations associated with low-grade inflammation or where ANG II and ET-1 are elevated to clarify the role of 20-HETE.
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Affiliation(s)
- I J Tsai
- School of Medicine and Pharmacology, Royal Perth Hospital, University of Western Australia, Australia
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Hsieh SL, Tsai IJ, Huang BY, Jian JJ. Protecting Copyrights of Color Images using a Watermarking Scheme Based on Secret Sharing and Wavelet Transform. ACTA ACUST UNITED AC 2008. [DOI: 10.4304/jmm.3.4.42-49] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Tsai IJ, Beilin LJ, Puddey IB, Croft KD, Barden A. Impaired ex vivo leukotriene B4 production characterizes the metabolic syndrome and is improved after weight reduction. J Clin Endocrinol Metab 2007; 92:4747-52. [PMID: 17925339 DOI: 10.1210/jc.2007-1417] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
CONTEXT Neutrophil (polymorphonuclear neutrophil) production of leukotriene B4 (LTB4) may be associated with alterations in immune and inflammatory function that characterize the metabolic syndrome (MetS). OBJECTIVE We investigated whether polymorphonuclear neutrophil production of LTB(4) and its metabolites 20-hydroxy-LTB4 (20-OH-LTB4) and 20-carboxyl-LTB4 were altered in subjects with features of the MetS before and after weight reduction. DESIGN, SETTING, PATIENTS, AND INTERVENTION In a case-controlled comparison, men and postmenopausal women with features of the MetS were matched with controls. Subjects with MetS were then matched and randomly assigned to either a 12-wk weight reduction study followed by 4-wk weight stabilization or 16-wk weight maintenance. MAIN OUTCOME MEASURES Measurements were performed at baseline and at the end of the 16-wk period. Stimulated neutrophil LTB4 and its metabolites were measured by HPLC. RESULTS In the case-controlled study, body mass index, waist circumference, blood pressure, fasting triglycerides, and glucose were all significantly increased in subjects with features of the MetS (P < 0.05). Production of LTB4 and 20-OH-LTB4 was significantly lower compared with controls (P < 0.005). The weight loss intervention resulted in a 4.6-kg reduction in body weight and 6.6-cm decrease in waist circumference relative to controls and a significant increase in LTB4 and 20-OH-LTB4. CONCLUSIONS Subjects with features of the MetS have lower stimulated LTB4, which is not due to increased metabolism of LTB4. Weight reduction restored the production of neutrophil LTB4, suggesting that in addition to modifying cardiovascular risk, weight loss may also help with the management of perturbed inflammatory responses in overweight subjects.
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Affiliation(s)
- I J Tsai
- University of Western Australia, School of Medicine and Pharmacology, Royal Perth Hospital, Perth, Western Australia 6001, Australia
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Lin YH, Chiu YW, Shiau YC, Yen RF, Tsai IJ, Ho YL, Huang PJ. The relation between serum level of amioterminal propeptide of type I procollagen and diastolic dysfunction in hypertensive patients without diabetes mellitus: A pilot study. J Hum Hypertens 2006; 20:964-7. [PMID: 17024136 DOI: 10.1038/sj.jhh.1002092] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Y H Lin
- Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan
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Abstract
The combination of hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccinations can offer convenience, increased compliance and cost saving. We have studied the immunogenicity, reactogenicity and safety of combined hepatitis A and B vaccination in young adults (16-35 years old). Eighty healthy young adults were divided into two random groups. One group received the combined hepatitis A and B vaccine (HAB) in one arm while the other group was administered concomitant hepatitis A and B vaccines (HAV + HBV) in the right and left arms, respectively. The immunogenicity, reactogenicity and safety were assessed after each dose in both the groups. In local symptoms, the percentage of the combined HAB group was lower than the HAV + HBV group, and the general symptoms were noted in approximately 30% of each group without any significant difference. No serious adverse effects were noted. All the subjects were seropositive for antibody to hepatitis A virus (anti-HAV) after one dose of vaccine, and remained seropositive after three doses in both groups. The seropositive rate for antibody to hepatitis B surface antigen (anti-HBs) was significantly higher (84%) in the combined HAB group than the concomitant HAV + HBV group (62%), (p<0.05) after dose two, and all the subjects were seropositive (100%) after the third dose. The GMTs of anti-HAV and anti-HBs were not significantly different between groups 1 and 2 (p>0.1) except in month 6 when the GMT of anti-HBs was higher in HAB group (p=0.0039). The combined HAB vaccine was found to be safe, well tolerated and had less local symptoms in young adults. The immunogenicity and reactogenicity were similar to the concomitant HAV + HBV vaccines.
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Affiliation(s)
- I J Tsai
- Department o Pediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan
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