BACKGROUND:

The associations of laboratory-based ABO phenotypes with cancer risks and mortality have not been systematically determined.

METHODS:

The study subjects were 339,432 healthy individuals with laboratory-based blood types from a Taiwan cohort.

RESULTS:

Compared to blood type O, blood type A was significantly associated with an elevated risk of stomach cancer incidence (Hazard Ratio [HR], 1.38 [95% CI, 1.11-1.72]) and mortality (HR, 1.38 [95% CI, 1.02-1.86]) compared with blood type O, after adjusting for age, sex, education, smoking, alcohol drinking, physical activity, and body mass index. Non-O blood types were associated with an elevated risk of pancreatic cancer, with blood type B reaching statistical significance for incidence (HR, 1.59 [95% CI, 1.02-2.48]) and mortality (HR, 1.63 [95% CI, 1.02-2.60]). In contrast, kidney cancer risk was inversely associated with blood type AB (HR, 0.41 [95% CI, 0.18-0.93]) compared to type O.

CONCLUSION:

Cancer risks vary in people with different ABO blood types, with elevated risks of stomach cancer associated with blood type A and pancreatic cancer associated with non-O blood types (A, B, and AB).

The aim of this study is to assess whether there is an association between clopidogrel use and risk of acute pancreatitis in Taiwan. We conducted a case-control study using the database of the Taiwan National Health Insurance Program from 2000 to 2011. There were 5644 subjects aged 20-84 years with a first-time attack of acute pancreatitis as the case group and 22,576 randomly selected sex-matched and age-matched subjects without acute pancreatitis as the control group. We defined clopidogrel use as "actively using" if the final clopidogrel prescription was filled between 0 and 7 days before the date of diagnosing acute pancreatitis, or "not actively using" if the final clopidogrel prescription was filled ≧ 8 days before the date of diagnosing acute pancreatitis. Subjects who never used clopidogrel were defined as never used. The multivariable logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) of acute pancreatitis associated with clopidogrel use. Comparing the subjects actively using clopidogrel to those who never used clopidogrel, the adjusted OR of acute pancreatitis was 8.46 (95%CI 5.25, 13.7). The adjusted OR decreased to 1.16 among subjects not actively using clopidogrel (95%CI 0.95, 1.43). Persons actively using clopidogrel are at an increased risk of acute pancreatitis. Further studies are necessary to prove the causal relationship.

BACKGROUND:

Chronic rhinosinusitis (CRS) is a chronic illness with a high prevalence worldwide. The purpose of this study was to investigate the characteristics of adjunctive traditional Chinese medicine (TCM) use in patients with CRS.

METHODS:

Data were retrieved from a dataset made available by the Taiwan National Health Insurance Research Database (NHIRD) containing the medical records of 1,000,000 randomly sampled beneficiaries insured in the year 2000. Patients newly diagnosed with CRS in the year 2000 were enrolled, and their medical records during the period 2000 to 2011 were collected and analyzed.

RESULTS:

A total of 14,806 CRS subjects were enrolled in this study: 10,512 were non-TCM users and 4294 were TCM users. TCM group had a significantly higher proportion of females, were younger, and a greater proportion lived in urban areas compared with the non-TCM group (all p < 0.0001). Ninety-seven percent (97%) of the TCM users received herbal remedies. The most common Chinese herbal formula used was Xin-Yi-Qing-Fei-Tang and the most commonly used single herb was Baizhi. The hazard ratio (HR) for functional endoscopic sinus surgery (FESS) was 0.17 for TCM users (95% confidence interval [CI], 0.15 to 0.20) compared with non-TCM users after adjusting for age, sex, urbanization, and comorbidities.

CONCLUSION:

Our investigation found that 29% of CRS patients used TCM in addition to Western medical treatment. A lower proportion of patients in the TCM group underwent ESS compared with that in the non-TCM group. These findings may be of value in further studies evaluating the efficacy and safety of TCM use in CRS patients.

BACKGROUND:

Traditional Chinese medicine (TCM) is an alternative treatment for cancer with its effect by stimulating host immune response for cytotoxic activity against liver cancer. No studies evaluated TCM treatment on survival of liver cancer patients.

PATIENTS AND METHODS:

This study determined whether the combination of TCM and conventional cancer treatment affects the survival of liver cancer patients. A retrospective cohort study was conducted in 127 237 newly diagnosed liver cancer patients from 2000 to 2009 in the National Health Insurance Program database.

RESULTS:

Among these patients, 30 992 (24.36%) used TCM for liver cancer care. All patients were followed up until 2011. The mean follow-up was 5.67 years (SD 1.47) for TCM users and 5.49 years (SD 3.64) for non-TCM users. Compared with patients without TCM use, patients with TCM use were significantly associated with a decreased risk of death [hazard ratio (HR) = 0.65, 95% confidence interval (CI) = 0.64-0.66] with multivariate adjustment. A similar significant protective effect of TCM use across various subgroups of chronic liver diseases was also observed. Jia Wei Xiao Yao San (HR = 0.89, 95% CI = 0.81-0.96) and Chai Hu Shu Gan Tang (HR = 0.86, 95% CI = 0.78-0.95) were the most effective TCM agents that improved survival.

CONCLUSIONS:

This cohort study provided information that adjunctive therapy with TCM may improve the survival in liver cancer patients. Further studies are needed to confirm the potential role of TCM in HCC.

BACKGROUND:

Studies on the association between adult asthma and dementia are few. We investigated the risk of dementia in patients diagnosed with adult asthma compared with that of people without asthma who were age and sex matched to the study patients.

METHODS:

We used data from the National Health Insurance Research Database. A total of 12 771 patients with newly diagnosed asthma between 2001 and 2003 were evaluated and 51 084 people without asthma were used as the comparison cohort. Cox proportional hazard regression analysis was used to measure the HR of dementia for the asthmatic cohort, compared with that of the non-asthmatic cohort.

RESULTS:

The HR of dementia was 1.27 (95% confidence interval (CI) 1.15 to 1.41) for the asthmatic cohort, compared with the non-asthmatic cohort after adjusting for age, sex, comorbidities, annual outpatient department visits and medicine used. The HR of dementia development increased substantially as frequency of asthma exacerbation and hospitalisation increased.

CONCLUSIONS:

This nationwide cohort study suggests that the risk of dementia development is significantly increased in patients with asthma compared with that of the general population. In addition, dementia risk increases substantially with asthma exacerbation and hospitalisation frequency increases.