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Purpose: Little is known about whether allergic disease is associated with a subsequent increased risk of childhood-onset epilepsy. We used a large, population-based cohort study to examine whether children with antecedent allergic rhinitis (AR) were associated with a subsequent increased risk of epilepsy.Methods: This retrospective population-based cohort study was conducted by using data from the 2000-2012 Taiwan's National Health Insurance Research Database. We enrolled 67,537 children aged 0-18 years diagnosed with AR and 67,537 age- and gender-matched children without the diagnosis of AR. The incidence rate (per 10,000 person-years) of epilepsy was calculated. We used Cox proportional hazards regression analysis to estimate hazard ratios (HRs) and 95 % confident interval (CI).Results: Of the 135,074 children included in the analyses, those with AR had a higher incidence rate of epilepsy (6.84 versus 3.95 per 10,000 person-years, p < 0.001) and an earlier age at diagnosis of epilepsy than those without AR [8.54 (4.90) versus 9.33 (5.40) years, p = 0.03)]. The Kaplan-Meier survival analysis demonstrated that the children with AR had a higher likelihood of developing epilepsy than those without AR (p < 0.001). After adjusting for confounding factors in multivariate model, children with AR had a 76 % increased risk of epilepsy (HR 1.76, 95 % CI 1.51-2.04) than those without AR. Boys had a 21 % increased risk of epilepsy (HR 1.21, 95 % CI 1.05-1.40) than girls.Conclusions: These results suggest that children with AR were associated with an increased subsequent risk of epilepsy. [ABSTRACT FROM AUTHOR]

Background: Medical complications following stroke often result in significant morbidity. This study was designed to investigate the prevalence and risk of gastroesophageal reflux disease (GERD) between patients with stroke and those without stroke in Taiwan.Methods and Results: This retrospective cohort study was conducted using the Taiwan National Health Insurance Research Database. The study included 18,412 patients newly diagnosed as having stroke during 2000-2006 and 18,412 patients without stroke frequency-matched by sex, age, and index year. All patients were followed from the index date to December 31, 2011. The Cox proportional hazards regression model was used to estimate the GERD risk. The GERD risk was approximately 1.51-times higher in the stroke group than in the nonstroke group, after adjustment for age, sex, and the cumulative incidence of some comorbidities. GERD was positively associated with stroke; the male sex (adjusted hazard ratio [HR] = 1.31); an age of 65 years or older (adjusted HR = 1.11); hyperlipidemia (adjusted HR = 1.14); ischemic heart disease (adjusted HR = 1.27); renal disease (adjusted HR = 1.45); and use of aspirin (adjusted HR = 2.34), clopidogrel (adjusted HR = 1.41), and dipyridamole (adjusted HR = 1.30).Conclusions: This study indicates a significantly higher GERD risk in patients with stroke than in the nonstroke group. In clinical practice, neurologists should focus on the risk of GERD symptoms. [ABSTRACT FROM AUTHOR]

Purpose This study evaluated the effect of epilepsy on the development of hyperlipidemia (HL) in Taiwan. Methods We conducted a nationwide population-based cohort study based on data obtained from the National Health Insurance Research Database of Taiwan. We identified 990 cases involving patients whose epilepsy was newly diagnosed between 2000 and 2005, and we also selected a comparison cohort comprising 3960 patients without epilepsy. Cox proportional hazards regression models were used to examine the association between epilepsy and HL. Results The mean follow-up period was 6.63 years for the epilepsy cohort and 7.49 years for the comparison cohort. The incidence rate of HL was 1.28-fold higher in the epilepsy cohort than it was in the comparison cohort (34.14 vs. 26.96 per 1000 person-years), with an adjusted hazard ratio of 1.17 (95% confidence interval, 1.01–1.36) after adjusting the model to account for the effects of sex and comorbidities. The most at-risk patients were those aged 50 to 59 years (hazard ratio, 1.35; 95% confidence interval, 1.04–1.79). For the epilepsy patients, the combined effect of ischemic heart disease, hypertension, and diabetes was associated with a significantly higher risk of developing HL compared with the patients with neither epilepsy nor any comorbidity. Conclusions Middle-aged epilepsy patients are at a significantly higher risk of developing HL. The results could assist in explaining the high risk of cerebral and cardiac vascular disease in epilepsy patients. [ABSTRACT FROM AUTHOR]

The use of traditional Chinese medicine (TCM) as a complementary and alternative medicine for the treatment of nasopharyngeal carcinoma (NPC) and its treatment-related side effects has been increasing. We investigated the utilization of Chinese herbal products (CHPs) for NPC in Taiwan. This retrospective, nationwide, population-based study was conducted and obtained data from the Registry for Catastrophic Illnesses Patient Database from 2001 through 2011 in Taiwan. The top ten most frequently prescribed formulae and single CHPs for treating NPC were assessed. Demographic characteristics, including sex and age at diagnosis of NPC, were examined, together with existing comorbidities. Descriptive statistics and multiple logistic regression analysis were employed to estimate the adjusted odds ratios (aORs) for CHP utilization. In total, 17,816 patients aged ≥20 years were newly diagnosed with NPC. Of these, 4749 patients used TCM outpatient services for NPC treatment. NPC patients using TCM were more likely to be women (aOR, 1.47; 95% CI, 1.37–1.58), young, and residents of central Taiwan (aOR, 1.49; 95% CI, 1.37–1.62) and southern Taiwan (aOR, 1.12; 95% CI, 1.05–1.21). The most commonly prescribed formula CHP was Gan-Lu-Yin (2.99%), followed by Xin-Yi-Qing Fei-Tang (1.52%) and Shan-Shen-Mai-Men-Dong-Tang (0.92%). The most commonly prescribed single CHP was Bai Hua She She Cao (Hedyotis diffusa) (3.23%), followed by Xuan Shen (Scrophularia ningpoensis) (2.24%) and Mai Men Dong (Radix Ophiopogonis) (1.84%). These findings provide information regarding personalized therapies for NPC and can promote further clinical experiments and pharmacological research on CHPs for NPC treatment in Taiwan. [ABSTRACT FROM AUTHOR]

Background This study is a nationwide population-based retrospective cohort study to investigate the risk for developing dementia in thalassemia population. Methods In a longitudinal cohort of 1 million insured people, we identified 871 thalassemia patients who were newly diagnosed between 2000 and 2004 and selected a comparison cohort of 3484 subjects without thalassemia. We analyzed the risks for thalassemia and dementia using Cox proportional hazard regression models to assess the dementia risk in thalassemia patients after adjusting for age, gender, insured amount, urbanization and comorbidities. Results The overall risks for developing dementia were 1.88-fold (95% CI = 1.10–3.21) in patients with thalassemia compared with the comparison cohort after adjusting for age, sex, insured amount, urbanization and comorbidities. The combined effects measured for patients afflicted with thalassemia and the comorbidities of diabetes, hypertension, CAD, head injury, depression, CKD, or substance-related disorder exhibited a significant association with hyperlipidemia risk compared with that measured for patients without thalassemia and without any counterpart comorbidities. In subgroup analysis, the HRs of dementia increased, from 1.69 (95% CI = 0.93–3.07) for those who had not undergone transfusion to 2.72 (95% CI = 1.09–6.78) for those experienced transfusion compared with the no thalassemia cohort (p for trend < 0.01). Conclusion Our long-term cohort study result showed that thalassemia should be considered a crucial risk factor for developing dementia. [ABSTRACT FROM AUTHOR]

Background: Colonic diverticular disease is a chronic gastrointestinal disorder. Previous studies have suggested that chronic gastrointestinal tract is involved in the pathophysiology of Parkinson's disease.Object: This study investigated the potential link between colonic diverticular disease and risk of Parkinson's disease.Methods: Data in this nationwide population-based cohort study were obtained from the National Health Insurance Research Database. Patients with colonic diverticular disease were identified from among 23.22 million insured Taiwanese residents who had been diagnosed between 2000 and 2005 and were aged ≥20 years (n = 23367). The comparison cohort included patients without colonic diverticular disease, matched by sex, age, and all comorbidities with the colonic diverticular disease patients cohort (n = 23367). Using univariable and multivariable Cox proportional hazard regression models, we estimated the adjusted hazard ratio (aHR) for PD with a 95% confidence interval (CI) after adjusting for age, sex, and all of comorbidities.Results: The risk of Parkinson's disease was higher in the CDD cohort than in the comparison cohort (HR = 1.27, 95%CI = 1.10-1.47). Compared with patients aged ≥65 years without CDD, the CDD patients in the equal age group had a 1.25-fold increased risk of PD (95% CI = 1.07-1.46).Conclusion: Colonic diverticular disease may be associated with an increased risk of Parkinson's disease. Thus, the risk of this neurodegenerative disease should be considered in patients with colonic diverticular disease. [ABSTRACT FROM AUTHOR]

Background Inflammation-related microvasculr disease, albuminuria, and rapid deterioration of renal function can accelerate the development of end-stage renal disease (ESRD). The role of hip fracture (HFr), a disorder that involves inflammation, in the development of ESRD has not been fully investigated. This study explored whether HFr increases the risk of ESRD. Methods Taiwan National Health Insurance inpatient claims were used to identify 83,550 patients newly diagnosed with HFr from 2000 to 2006, and 83,550 age- and sex-matched patients without HFr were randomly selected for comparison. Hazards of ESRD combined with HFr, comorbidities, including hypertension, hyperlipidemia, peripheral arterial disease, osteoporosis and asthma, and general health status, with Charlson comorbidity index (CCI), were assessed using data to the end of 2011. Results ESRD risk was 1.42-fold higher (95% confidence interval [CI]:1.29–1.33) in the HFr cohort than in the control group, which was computed using the Cox proportional model. Age-specific analysis revealed that the adjusted hazard ratios (aHRs) of ESRD for HFr patients increased slightly as age increased, with an aHR of 1.56 (95% CI:1.35–1.81) for patients 65–74 years old, which gradually decreased to 0.88 (95% CI:0.66–1.18) for patients ≥ 85 years old. ESRD risk increased as HFr severity increased, with an aHR of 6.71 (95% CI:5.90–7.63) for patients with severe HFr. Conclusion This study is the first to report that HFr, in combination with underlying osteoporosis-related chronic illness, microvascular disease and chronic inflammation, is associated with an increased risk of ESRD, particularly among relatively younger people. [ABSTRACT FROM AUTHOR]