OBJECTIVE:

This study investigated whether outpatient visits of acute upper respiratory infections for children aged less than 15 years are associated with temperature, air pollutants and circulating respiratory viruses in Taipei, Taiwan, from 2003 to 2007.

METHODS:

Outpatient records for acute upper respiratory infections (ICD9 CM codes: 460, 462, 463,464, 465.9 and 487) in a randomly selected sample (n=39,766 children in 2005) was used to estimate the cumulative relative risks (RR) associated with average temperature lasting for 8 days (lag 0-7 days), air pollutants (NO2, O3 and PM(2.5)) lasting for 6 days (lag 0-5 days), and virus-specific positive isolation rate lasting for 11 days (lag 0-10 days) using distributed lag non-linear models after controlling for relative humidity, wind speed, day of week, holiday effects and long-term trend.

RESULTS:

Average temperature of 33 °C was associated with the lowest risk for outpatient visits of acute upper respiratory infections. Relative to 33 °C, cumulative 8-day RR was highest at 15 °C of ambient average temperature [RR=1.94; 95% confidence interval (CI): 1.78, 2.11]. With the first quartile as reference, cumulative 6-day RRs were 1.25 (95% CI: 1.21, 1.29) for NO2, 1.04 (95% CI: 1.01, 1.06) for O3, and 1.00 (95% CI: 0.98, 1.03) for PM(2.5) at the 95th percentile. Per-standard deviation (SD) increase of virus-specific isolation rate for influenza type A (SD=13.2%), type B (SD=8.76%), and adenoviruses (SD=5.25%) revealed statistical significance for overall 11-day RRs of 1.02 (95% CI: 1.01, 1.03), 1.05 (95% CI: 1.03, 1.06) and 1.04 (95% CI: 1.03, 1.05), respectively.

CONCLUSIONS:

Current study suggested a positive association between outpatient visits for acute upper respiratory infections and ambient environment factors, including average temperature, air pollutants, and circulating respiratory viruses.

BACKGROUND/AIMS:

Although the effect of exercise on health is well established, nephrologists seldom consider physical activity in the treatment of chronic kidney disease (CKD) or CKD in the presence of diabetes mellitus (DM/CKD). The aim of the present study was to analyze the benefits of leisure-time physical activity (LTPA) in DM/CKD.

METHODS:

A total of 445,075 adult participants who underwent a medical screening program between 1996 and 2008 were prospectively recruited. Of these, 7,863 DM/CKD subjects were identified. Each participant was categorized according to LTPA level (a product of duration and intensity) as inactive, low-active or fully active. Hazard ratios (HRs) for mortality risk were calculated.

RESULTS:

Fully active LTPA was associated with lower odds of DM/CKD development and lower risk of mortality among patients with DM/CKD in a dose-response relationship. The fully active and low-active DM/CKD groups had a 26% (HR 0.74, 95% CI 0.66-0.85) and 13% (HR 0.87, 95% CI 0.75-1.01) lower risk of all-cause mortality, respectively, in comparison to the inactive group. The association of exercise with mortality rate reduction was more pronounced among DM/CKD subjects (mortality rate reduction of 446.5 per 100,000 person-years) than among subjects with diabetes alone or CKD alone.

CONCLUSION:

Exercise, at the recommended level or more, is associated not only with lower odds of DM/CKD but also with a 26% lower mortality risk among DM/CKD patients. Nephrologists should encourage all DM/CKD subjects to be physically active

This study examines the utilization patterns of myocardial perfusion imaging (MPI) and cardiac catheterization (CC) under Taiwan's national health insurance program. This study used the longitudinal health insurance database with 1,000,000 people were randomly selected from the national health insurance research database. This study obtained data from these patients with coronary artery disease (CAD) and comparison with the utilization of MPI or CC between 2005 and 2009. The incidence of CAD did not significantly change, while the prevalence of CAD, utilization of MPI, and the utilization of CC for the CAD patients increased annually. There were the most CAD patients in Northern Taiwan (43.5%), followed by Southern, Central, and Eastern Taiwan. The utilizations of both of MPI (12.7 per 100 CAD patients) and CC (10.6 per 100 CAD patients) were most frequent in Northern Taiwan followed by Southern, Central, and Eastern Taiwan. However, the MPI/CC ratio was 1.20 in Northern Taiwan, followed by Southern, Central, and EasternTaiwan (0.88, 0.64, and 0.52, respectively, P = 0.0008). The use of MPI was higher than CC only in Northern Taiwan. MPI may be underutilized to serve the role of gatekeeper for CC in the other regions.

BACKGROUND:

The prevalence of type 2 diabetes has rapidly increased in the Taiwanese population with the increasing prevalence of a sedentary lifestyle and high-calorie dietary intake. This study aims to determine the annual trends of the prevalence and incidenceof diagnosed type 2 diabetes among adults in Taiwan from 2000 to 2007.

METHODS:

A population-based study of all residents aged 20 years and over (12,191,076 in 2000 and 18,772,180 in 2007) enrolled in the National Health Insurance (NHI) program, the database of which was used to identify patients diagnosed with type 2 diabetes. The annual prevalence and incidence of diagnosed type 2 diabetes were estimated using the International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes based on age, gender, insurance premium, and urbanization degree. Logistic regression was used to estimate the odds ratios (OR) of risk factors, as well as to examine the trend in the annual prevalence orincidence of diagnosed type 2 diabetes from 2000 to 2007.

RESULTS:

The crude annual prevalence of diagnosed type 2 diabetes increased significantly from 5.79% in 2000 to 8.30% in 2007. The increase was highest in 2007, among men, individuals aged ≥ 80 years, and individuals residing in aging society areas [OR (95% CI): 1.416 (1.412-1.420), 1.033 (1.032-1.034), 31.810 (31.690-31.931), and 1.090 (1.085-1.094), respectively]. The crude incidencefluctuated throughout the study period, ranging from 7.72 per 1,000 in 2006 to 8.98 per 1,000 in 2000. The decrease was highest in 2006, among individuals with an insurance premium ≥ median value [0.933 (0.925-0.942) and 0.810 (0.805-0.815), respectively]. The greatest increase was among men, individuals aged 60 to 79 years, and individuals residing in aging society areas [1.150 (1.145-1.155), 15.452 (15.329-15.576), and 1.127 (1.113-1.142), respectively].

CONCLUSION:

This study demonstrated the substantial increase in annual prevalence of diagnosed type 2 diabetes among adults inTaiwan from 2000 to 2007. The incidence fluctuated between 2000 and 2007.

Abstract