This population-based study was conducted using claims data obtained from the National Health Insurance to investigate the trend in incidence of distal radial fractures in adults in Taiwan from 2000 to 2007. Our results revealed an increasing trend, particularly among women >50 years of age.

INTRODUCTION:

This population-based study used insurance claims data from 2000 to 2007 obtained from the National HealthResearch Institute to investigate the longitudinal trend in distal radial fractures in adults ≥20 years old in Taiwan.

METHODS:

We estimated the age- and gender-specific annual incidence rates of distal radial fracture and compared the differences in distribution by sociodemographic status between patients with and those without distal radial fracture and the differences in incidence rates between 2000 and 2007.

RESULTS:

The incidence of fracture was higher in women than in men. The overall female-to-male rate ratios were 1.52 in 2000 (12.3 vs 8.06 per 10,000 persons) and 1.89 in 2007 (18.9 vs 10.0 per 10,000 persons). There was marked increase in age-specific incidence beginning in the 50-54-year age group, particularly among women.

CONCLUSION:

These results imply the need for more effective intervention for the prevention of subsequent fracture and disability, particularly for perimenopausal women.

BACKGROUND:

Patients with Parkinson's disease (PD) are suggested to be at a lower risk for the development of certain cancers and at a higher risk for melanoma. The aim of this study is to evaluate the possible association between PD and malignancy in Taiwan.

MATERIALS AND METHODS:

We used the data of the National Health Insurance System of Taiwan to assess this issue. The PD cohort contained 4,957 patients, and each patient was randomly frequency matched by age and sex with 4 people from the general population without PD. Cox's proportional hazard regression analysis was conducted to estimate the effects of PD on the cancer risk.

RESULTS:

In patients with PD, the risk of developing overall cancer was marginally significantly lower than in subjects without PD [adjusted hazard ratio (HR) = 0.88; 95% CI = 0.78-0.99]. For individual cancers, the risks of developing colorectal and lung cancers among patients with PD were marginally significantly lower than in subjects without PD. In contrast, despite the higher HR for the development of melanoma, it did not reach statistical significance because of the relatively small sample size.

CONCLUSION:

Our study found that Taiwanese patients with PD have a lower risk of developing colorectal and lung cancers. The findings of this study are compatible with those of prior studies from other countries.

BACKGROUND:

Renal vascular resistance [resistive index (RI)] has been associated with albuminuria in patients with type 2 diabetes. We studied the correlations between renal artery RI and urinary albumin excretion in adolescents and young adults.

METHODS:

From May 2006 through September 2008, we established a cohort of adolescents and young adults based on previous history of elevated blood pressure (EBP) or normal blood pressure in childhood. This cohort was selected from the 1992-2000 nationwide mass urine screening of school children aged 6-18 years in Taiwan. From October through December 2008, we called back these adolescents and young adults living in Taipei to participate in a renal vascular stiffness study. Linear mixed regression models were applied to study the correlation between renal artery RI and urinary albumin excretion after controlling for cardiovascular (CV) risk factors.

RESULTS:

Of the 147 subjects enrolled in this study, 67 had macroalbuminuria, 36 had microalbuminuria and 44 had normoalbuminuria. Except for high-density lipoprotein cholesterol, most CV risk factors did not differ significantly among these three groups. Mean RI were similar for the three groups. Neither log (urinary albumin concentration) nor log (urinary albumin:creatinine ratio) correlated with RI. Step-wise linear mixed regression models showed that RI was significantly associated only with male gender and diastolic blood pressure, but not with urinary albumin excretion or EBP in childhood.

CONCLUSION:

Renal artery RI is not associated with urinary albumin excretion in nondiabetic adolescents and young adults.

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.

BACKGROUND:

This study investigated the stroke risk in patients with head and neck cancers (HNCs) using population-based data.

METHODS:

From claims collected in the Taiwan National Health Insurance database, we identified 13,390 HNC patients with diagnosis made in 2000-2002. A reference cohort of 53,517 non-cancer individuals matched for age, gender, and stroke risk factors was used for assessing stroke risk in follow-up to 2008.

RESULTS:

The overall stroke incidence was 1.44-fold higher in the HNC than in the reference cohort (11.4 vs 7.9 per 1000 person-years). Adjusted hazard ratios (HRs) were 1.54 (95% confidence interval (CI): 1.40-1.68) for ischaemic stroke and 1.36 (95% CI: 1.09-1.69) for haemorrhagic stroke. The cancer-to-reference stroke incidence rate ratio was age dependent and the highest in the age group younger than 40 years (5.45, 95% CI: 3.78-7.87) and decreased with aging. Comparing different therapeutic modalities, HNC patients receiving both radiotherapy (RT) and chemotherapy (CT) had the highest stroke risk (HR: 1.46, 95% CI: 1.22-1.74), followed in sequence by those who had CT alone, RT alone, and without therapy.

CONCLUSION:

Patients with HNC are at increased risk of developing stroke, especially in the young age group and in those who received both RT and CT.