PURPOSE:

To assess the relationship between diabetic polyneuropathy (DPN) and the risk of diabetic retinopathy (DR).

METHODS:

From 1997 to 2010, we identified 5031 newly diagnosed DPN patients and 20 124 controls matched for sex, age, and index year. Cox proportional hazards regression analyses were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of DR between the DPN patients and the non-DPN group. The adjusted hazard ratio was calculated and adjusted for age, sex, duration of diabetes and comorbidities of hypertension, cardiovascular disease and diabetic nephropathy.

RESULTS:

The incidence rate of DR was 5.87-fold higher in the DPN patients than in the non-DPN group (44.0 vs. 7.22 per 1000 person-years), with an adjusted HR of 5.41(95% CI = 4.92-5.94). The DPN-to-non-DPN DR incidence rate ratio decreased with age (adjusted HR = 6.63 for subgroup younger than 65 years and adjusted HR = 3.91 for subgroup aged 65 years or older). Compared with the non-DPN group, the DPN patients had a 5.63-fold risk of non-proliferative DR (adjusted HR = 5.63, 95% CI = 5.11-6.21) and a 3.67-fold risk of proliferative DR (adjusted HR = 3.67, 95% CI = 2.57-5.23).

CONCLUSION:

The patients with DPN had an increased risk of developing DR and advanced DR compared with the non-DPN group, particularly among the subgroup aged younger than 65 years.

OBJECTIVES:

The goal of this study was to evaluate the association between digoxin use and acute pancreatitis in Taiwan.

METHODS:

Utilizing the database of the Taiwan National Health Insurance Program, this case-control study consisted of 6116 subjects aged 20-84years with a first-attack of acute pancreatitis since 2000 to 2011 as the cases and 24,464 randomly selected subjects without acute pancreatitis as the controls. Both cases and controls were matched by sex, age and index year of diagnosing acute pancreatitis. The absence of digoxin prescription was defined as "never use". Active use of digoxin was defined as subjects who at least received 1 prescription for digoxin within 7days before the date of diagnosing acute pancreatitis. Non-active use of digoxin was defined as subjects who did not receive a prescription within 7days but at least received 1 prescription for digoxin ≥8days before the date of diagnosing acute pancreatitis. The odds ratio (OR) and 95% confidence interval (CI) were measured to evaluate the association between digoxin use and acute pancreatitis by a multivariable unconditional logistic regression model.

RESULTS:

After adjusting for potential confounding factors, the adjusted OR of acute pancreatitis was 5.29 for subjects with active use of digoxin (95% CI 3.61, 7.73), when compared with subjects with never use of digoxin. The adjusted OR of acute pancreatitis decreased to 1.04 for subjects with non-active use of digoxin (95% CI 0.89, 1.21), but no statistical significance.

CONCLUSIONS:

These data indicate that only persons actively using digoxin may have the high relative odds of acute pancreatitis. Further research or case report is warranted to evaluate the pathophysiological basis underlying the relationship between digoxin use and acute pancreatitis.

BACKGROUND:

Endogenous factors such as stress-induced immune system reactivity were also associated with dyshidrosis. Herpes zoster (HZ) incidence has been demonstrated to increase with immune deficiencies. Therefore, a relationship between dyshidrosis and HZ may exist.

OBJECTIVE:

This study investigated whether there is an association between dyshidrosis and HZ.

METHODS:

We conducted a population-based cohort study by using Taiwan's Longitudinal Health Insurance Database (LHID2000) records from 1996 to 2011. The dyshidrosis group comprised 8488 patients with newly identified dyshidrosis and no history of HZ prior to diagnosis of dyshidrosis. For the non-dyshidrosis group, each dyshidrosis patient frequency matched according to age (5-year intervals), sex and index date year with four controls selected randomly from the LHID2000.

RESULTS:

After adjustments for confounding risk factors, the hazard ratio for HZ in the dyshidrosis group was 1.31 compared with the non-dyshidrosis group. Regardless of comorbidities, patients with dyshidrosis had a higher risk of HZ than did controls without dyshidrosis. Patients with more hospital visits that were due to dyshidrosis had a higher risk of HZ.

CONCLUSION:

Dyshidrosis is strongly associated with HZ. Patients treated for dyshidrosis should be warned of HZ risk.

In Taiwan, cancer is the top cause of death, and the mortality rate of lung cancer is the highest of all cancers. Some studies have demonstrated that multidisciplinary team (MDT) care can improve survival rates of non-small cell lung cancer (NSCLC) patients. However, no study has discussed the effect of MDT care on different stages of NSCLC. The target population for this study consisted of patients with NSCLC newly diagnosed in the 2005-2010 Cancer Registry. The data was linked with the 2002-2011 National Health Insurance Research Database and the 2005-2011 Cause of Death Statistics Database. The multivariate Cox proportional hazards model was used to explore whether the involvement of MDT care had an effect on survival. This study applied the propensity score as a control variable to reduce selection bias between patients with and without involvement of MDT care. The adjusted hazard ratio (HR) of death of MDT participants with stage III & IV NSCLC was significantly lower than that of MDT non-participants (adjusted HR = 0.87, 95% confidence interval = 0.84-0.90). This study revealed that MDT care are significantly associated with higher survival rate of patients with stage III and IV NSCLC, and thus MDT care should be used in the treatment of these patients.

Enterovirus (EV) infection is a major public health issue throughout the world with potential neurological complications. This study evaluated the relationship between attention deficit hyperactivity disorder (ADHD) and EV encephalitis in children.Data of reimbursement claims from the National Health Insurance Research Database of Taiwan were used in a population-based case-control design. The study comprised 2646 children with ADHD who were matched according to sex, age, urbanization level of residence, parental occupation, and baseline year, to people without ADHD at a ratio of 1:10. The index date of the ADHD group was the ADHD date of diagnosis. Histories of EV infections before the index dates were collected and recategorized according to the severity of infection.Compared with children without EV infection, the children with mild EV infection had a 1.16-fold increased risk of ADHD (odds ratio [OR] = 1.16, 95% confidence interval [CI] = 1.07-1.26), and the children with severe EV infection had a greater risk of ADHD (OR = 2.82, 95% CI = 1.05-7.57). The results also revealed a significant correlation between ADHD and the severity of EV infection (P for trend = 0.0001).Patients with EV encephalitis have an increased risk of developing ADHD. Although most EV encephalitis in children has a favorable prognosis, it may be associated with significant long-term neurological sequelae, even in children considered fully recovered at discharge. Neuropsychological testing should be recommended for survivors of childhood EV encephalitis. The causative factors between EV encephalitis and the increased risk of ADHD require further investigation.