26 results on '"Fung-Chang Sung"'
Search Results
2. Relative risk of functional dyspepsia in patients with sleep disturbance: a population-based cohort study
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Robert Stewart, Shu-Chin Chen, Fung-Chang Sung, Yi-Shin Chen, Chen-Ju Lin, Hsu-Han Su, Shu-I Wu, Cheng-Li Lin, and Kai-Liang Kao
- Subjects
Adult ,Male ,Risk ,Sleep Wake Disorders ,medicine.medical_specialty ,Science ,Diseases ,Comorbidity ,Article ,Sex Factors ,Internal medicine ,medicine ,Humans ,Dyspepsia ,Depression (differential diagnoses) ,Aged ,Sleep disorder ,Multidisciplinary ,Depression ,Proportional hazards model ,business.industry ,Incidence ,Hazard ratio ,Age Factors ,Health care ,Sleep apnea ,Middle Aged ,medicine.disease ,Confidence interval ,Relative risk ,Medicine ,Female ,business ,Cohort study - Abstract
Increased prevalence of sleep disorders has been found in patients with functional dyspepsia; however, direction of causality remains unclear. Our aim was to compare the risk of incident functional dyspepsia between patients with and without sleep disturbance from a large population-based sample. Utilizing a nation-wide health insurance administrative dataset, we assembled an 11-year historic cohort study to compare subsequent incidence of diagnosed functional dyspepsia between adult patients with any diagnosis of sleep disturbance and age- and gender-matched controls. Hazard ratios adjusted for other relevant comorbidities and medications were calculated using Cox regression models. 45,310 patients with sleep disorder and 90,620 controls were compared. Patients with sleep apnea had a 3.3-fold (95% confidence interval: 2.82 ~ 3.89) increased hazard of functional dyspepsia compared with controls. This increased risk persisted regardless of previously diagnosed depression coexisted. Sleep disturbance was associated with an increased risk of subsequent functional dyspepsia. Potential mechanisms are discussed.
- Published
- 2021
3. Increased risk of new-onset type 2 diabetes in people with chronic kidney disease
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Cheng-Li Lin, Tsung-Hsun Tsai, Tzung-Hai Yen, Fung-Chang Sung, I-Kuan Wang, Tzu-Yuan Wang, and Yi-Chih Hung
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Adult ,Male ,Nephrology ,medicine.medical_specialty ,Urology ,Taiwan ,030232 urology & nephrology ,Hyperlipidemias ,Type 2 diabetes ,030204 cardiovascular system & hematology ,Young Adult ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Risk Factors ,Diabetes mellitus ,Internal medicine ,medicine ,Humans ,Renal Insufficiency, Chronic ,Diuretics ,Aged ,Proportional hazards model ,business.industry ,Incidence ,Incidence (epidemiology) ,Hazard ratio ,Age Factors ,Middle Aged ,Protective Factors ,medicine.disease ,Diabetes Mellitus, Type 2 ,Case-Control Studies ,Hypertension ,Cohort ,Female ,Steroids ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,business ,Kidney disease - Abstract
This study investigated whether people with chronic kidney disease (CKD) are at the risk of new-onset type 2 diabetes. A cohort comprising 16,624 people with CKD, and an age- and sex-matched control cohort of 66,496 persons without any clinical kidney disease were identified from the Taiwan National Health Insurance Database during the period of 2000–2010. Both cohorts were followed up to 2011 to evaluate the incidence and hazard ratio (HR) of developing new-onset type 2 diabetes. Diseases were identified based on diagnosis coding. The incidence of type 2 diabetes was 1.51-fold higher in the CKD cohort than in the control cohort (16.9 versus 11.2 per 1,000 person-years) with an adjusted hazard ratio of 1.17 (95% confidence interval, (CI)1.10–1.24). In the multivariate Cox regression model considering the competing-risk death, the adjusted subhazard ratio of type 2 diabetes was 1.30 (95% CI1.22–1.38) for the CKD cohort compared to the control cohort. People with CKD patients are at an increased risk of developing new-onset type 2 diabetes. Close surveillance for diabetes should be considered for these people.
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- 2019
4. Ambulance Services Associated with Extreme Temperatures and Fine Particles in a Subtropical Island
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Yu-Chun Wang, Yu-Kai Lin, Yi-Jhih Chen, Yasmin Zafirah, Shih-Chan Hung, and Fung-Chang Sung
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Male ,Risk ,Percentile ,medicine.medical_specialty ,Hot Temperature ,010504 meteorology & atmospheric sciences ,Ambulances ,Population ,Taiwan ,lcsh:Medicine ,010501 environmental sciences ,Fainting ,Chest pain ,01 natural sciences ,Article ,Air Pollution ,medicine ,Humans ,Extreme Weather ,lcsh:Science ,education ,0105 earth and related environmental sciences ,Islands ,Coma ,Public health ,Air Pollutants ,Tropical Climate ,education.field_of_study ,Multidisciplinary ,Respiratory distress ,business.industry ,lcsh:R ,Temperature ,Middle Aged ,Confidence interval ,Risk factors ,Relative risk ,Emergency medicine ,lcsh:Q ,Female ,Particulate Matter ,medicine.symptom ,business ,Out-of-Hospital Cardiac Arrest - Abstract
This study evaluated the association between the risk of events requiring ambulance services and the ambient temperature and particulate matter of 2.5 μm (PM2.5) and 10 μm (PM10) for populations living in subtropical Taiwan. We used a distributed lag nonlinear model with a quasi-Poisson function to assess the roles of ambient temperature, PM10 and PM2.5 in the use of ambulance services for respiratory distress, coma and unconsciousness, chest pain, lying down in public, headaches/dizziness/vertigo/fainting/syncope and out-of-hospital cardiac arrest (OHCA). The relative risk (RR) and 95% confidence interval (CI) of each specific event were calculated in association with the ambient conditions. In general, the events that required ambulance services had a V-shaped or J-shaped association with the temperature, where the risks were higher at extreme temperatures. The RR of each event was significant when the patients were exposed to temperatures in the 5th percentile (th percentile temperatures of >30 °C. The risks for use of ambulance services increased with PM exposure and were significant for events of respiratory distress, chest pain and OHCA after exposure to the 99th percentile PM2.5 after controlling for temperatures. Events requiring ambulance services were more likely to occur when the ambient temperature was low than when it was high for the population on the subtropical island of Taiwan. The association of the risk of events requiring ambulance services with PM were not as strong as the association with low temperatures.
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- 2020
5. Increased risk of developing psychiatric disorders in children with attention deficit and hyperactivity disorder (ADHD) receiving sensory integration therapy: a population-based cohort study
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Hui-Chun Huang, Robert Stewart, Ruu-Fen Tzang, Fung-Chang Sung, Yu-Chiao Wang, Chih-Hsin Muo, Yue-Cune Chang, Yu-Hsin Huang, Shu-I Wu, and Kai-Liang Kao
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Sensory integration therapy ,medicine.medical_specialty ,Population ,03 medical and health sciences ,0302 clinical medicine ,Developmental and Educational Psychology ,Child and adolescent psychiatry ,Medicine ,Attention deficit hyperactivity disorder ,0501 psychology and cognitive sciences ,Psychiatry ,education ,education.field_of_study ,business.industry ,05 social sciences ,General Medicine ,medicine.disease ,Comorbidity ,030227 psychiatry ,Psychiatry and Mental health ,Conduct disorder ,Pediatrics, Perinatology and Child Health ,Cohort ,business ,050104 developmental & child psychology ,Cohort study - Abstract
Parents of children with attention deficit hyperactivity disorder (ADHD) have been found to prefer sensory integration (SI) training rather than guideline-recommended ADHD treatment. This study investigated whether SI intervention for children with ADHD was associated with a reduced risk of subsequent mental disorders. From children
- Published
- 2018
6. Is Partial or Total Thyroidectomy Associated with Risk of Long-Term Osteoporosis: A Nationwide Population-Based Study
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Chih Ching Yeh, Chih-Hsin Muo, Chien-Ling Hung, Pi Shan Sung, Fung-Chang Sung, Chung-Jye Hung, I-Ming Jou, and Kuen Jer Tsai
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Adult ,Male ,medicine.medical_specialty ,Databases, Factual ,medicine.medical_treatment ,Taiwan ,030209 endocrinology & metabolism ,Comorbidity ,Cohort Studies ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Bone Density ,Risk Factors ,Internal medicine ,medicine ,Humans ,Postoperative Period ,Propensity Score ,Aged ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Proportional hazards model ,Incidence ,Incidence (epidemiology) ,Hazard ratio ,Thyroidectomy ,Retrospective cohort study ,Middle Aged ,Thyroid Diseases ,Research Design ,Propensity score matching ,Cohort ,Osteoporosis ,Female ,Surgery ,business ,030217 neurology & neurosurgery ,Cohort study - Abstract
Whether thyroidectomy contributes to osteoporosis (OP) and osteoporotic fracture (OF) is a subject of debate. This study aimed to determine the effect of thyroidectomy on the risk of OP and OF. This retrospective cohort study is based on patient data between January 2000 to December 2005 from the National Health Insurance Research Database. Patients who underwent thyroidectomy were enrolled in the thyroidectomy cohort, and the control cohort was selected by propensity score matching at a ratio of 1:4. Incident OP and OF cases were identified until the end of 2013. The thyroidectomy cohort to control cohort adjusted hazard ratio (aHR) for OP/OF was assessed through multivariable Cox proportional hazard regression analysis. Totals of 1426 and 5704 patients were included in the thyroidectomy and control cohorts, respectively. The incidence density of OP was higher in the thyroidectomy cohort (7.91/1000 person-years) than in the control cohort (5.98/1000 person-years), with an aHR of 1.43 (95% CI 1.16–1.77, p
- Published
- 2018
7. Reply to critical comments on the article ‘Increased risk of developing psychiatric disorders in children with attention deficit and hyperactivity disorder (ADHD) receiving sensory integration therapy: a population-based cohort study’
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Chih-Hsin Muo, Robert Stewart, Kai-Liang Kao, Fung-Chang Sung, Shu-I Wu, and Ruu-Fen Tzang
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Conduct Disorder ,Sensory integration therapy ,medicine.medical_specialty ,business.industry ,MEDLINE ,General Medicine ,medicine.disease ,Cohort Studies ,Psychiatry and Mental health ,Population based cohort ,Increased risk ,Attention Deficit Disorder with Hyperactivity ,Conduct disorder ,Pediatrics, Perinatology and Child Health ,Developmental and Educational Psychology ,Attention deficit ,Child and adolescent psychiatry ,Humans ,Medicine ,Child ,business ,Psychiatry ,Cohort study - Published
- 2019
8. Risk of developing pleural empyema in patients with stroke: a propensity-matched cohort study
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Te Chun Hsia, Chi-Yu Lin, Wu-Huei Hsu, Chih Yen Tu, Fung Chang Sung, Chuen Ming Shih, Te Chun Shen, Chia-Hung Chen, and Cheng-Li Lin
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Adult ,Male ,medicine.medical_specialty ,Taiwan ,Risk Assessment ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Internal Medicine ,medicine ,Humans ,In patient ,cardiovascular diseases ,030212 general & internal medicine ,Propensity Score ,Stroke ,Empyema, Pleural ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Aged, 80 and over ,Proportional hazards model ,business.industry ,Incidence ,Pleural empyema ,Hazard ratio ,Middle Aged ,respiratory system ,medicine.disease ,Confidence interval ,respiratory tract diseases ,Surgery ,Propensity score matching ,Emergency Medicine ,Female ,Complication ,business ,030217 neurology & neurosurgery - Abstract
Pleural empyema is an important complication of pneumonia. Patients with stroke are at a higher risk developing pneumonia; however, the association between stroke and pleural empyema risk is largely unknown. We used the data from the National Health Insurance Research Database of Taiwan to establish a stroke group consisting of 466,170 patients diagnosed between 2000 and 2010, and a non-stroke group consisting of the same number of individuals matched by the propensity score. Incident pleural empyema was monitored toward the end of 2011. Adjusted hazard ratios (aHRs) of pleural empyema in the stroke group, compared to the non-stroke group, were estimated using the Cox proportional hazards model. We found that the incidence of pleural empyema is 2.69-fold higher in the stroke group than in the non-stroke group (15.2 vs. 5.59/10,000 person-years, p
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- 2017
9. Association between allergic diseases and risks of HSP and HSP nephritis: a population-based study
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Te Chun Shen, Chang-Ching Wei, Tsai-Chung Li, An Chyi Chen, Cheng-Li Lin, and Fung-Chang Sung
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Male ,0301 basic medicine ,IgA Vasculitis ,Disease ,03 medical and health sciences ,0302 clinical medicine ,Hypersensitivity ,medicine ,Humans ,Child ,Asthma ,030203 arthritis & rheumatology ,Nephritis ,business.industry ,Odds ratio ,medicine.disease ,Allergic conjunctivitis ,Acute stage ,Population based study ,030104 developmental biology ,Increased risk ,Child, Preschool ,Population Surveillance ,Pediatrics, Perinatology and Child Health ,Immunology ,Female ,business - Abstract
Some allergic inflammation–associated mediators have been reported in acute stage of Henoch–Schonlein purpura (HSP). However, the association of children with allergic diseases and their subsequent risks of HSP and HSP nephritis remain unknown. In this study, we included 2,240 children with HSP diagnosed between 2000 and 2008 as well as 8,960 non-HSP controls matched for age, sex, and level of urbanization. The odds ratios (ORs) of HSP were calculated with respect to associations with pre-existing allergic diseases. Children with allergic diseases had an increased subsequent risk of HSP; the lowest adjusted OR (aOR) was 1.33 for allergic conjunctivitis (95% confidence interval (CI): 1.17–1.52) and the highest was 1.68 for asthma (95% CI: 1.48–1.91). The aOR increased to 2.03 (95% CI: 1.80–2.31) in children with at least two allergic diseases. Children who visited medical institutes more often per year for associated allergic diseases had an increased risk of HSP. Of the 2,240 children with HSP, 249 (11%) had HSP nephritis and 45.8% of those with nephritis had history of any allergic disease. Atopic children had an increased subsequent risk of HSP but not an increased risk of HSP nephritis.
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- 2015
10. Impact of dialysis modality on the survival of patients with end-stage renal disease and prior stroke
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Cheng-Li Lin, Wen Miin Liang, Yao-Lung Liu, Chiz-Tzung Chang, I-Kuan Wang, Chiu-Ching Huang, Tzung-Hai Yen, and Fung-Chang Sung
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Taiwan ,030232 urology & nephrology ,Comorbidity ,030204 cardiovascular system & hematology ,Peritoneal dialysis ,End stage renal disease ,03 medical and health sciences ,0302 clinical medicine ,Renal Dialysis ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Humans ,Medicine ,Propensity Score ,Intensive care medicine ,Stroke ,Dialysis ,Survival analysis ,Aged ,business.industry ,Hazard ratio ,Middle Aged ,medicine.disease ,Survival Rate ,Treatment Outcome ,Nephrology ,Kidney Failure, Chronic ,Female ,Hemodialysis ,business - Abstract
Of patients with end-stage renal disease (ESRD), 8–16 % had a history of stroke at dialysis initiation. We used the National Health Insurance Research Database of Taiwan to evaluate whether peritoneal dialysis (PD) or hemodialysis (HD) confers a survival advantage for patients with incident ESRD and prior stroke. We identified 975 patients undergoing PD and 975 propensity score-matched patients with newly diagnosed ESRD and prior stroke undergoing HD between 2000 and 2010. Both cohorts were followed up until the end of 2011. Comparisons of the risks of mortality between PD and HD were analyzed using the Cox proportional hazards regression model. In the propensity score-matched cohorts, there was a 2.4 per 100 person-years greater mortality in patients with PD (20.4 vs. 18.0 per 100 person-years) with an adjusted hazard ratio (HR) of 1.20 (95 % CI 1.06–1.36). For patients with diabetes, ESRD and prior stroke, patients undergoing PD had inferior survival compared with those undergoing HD (adjusted HR 1.22, 95 % CI 1.05–1.43), particularly among female patients (adjusted HR 1.55, 95 % CI 1.25–1.91). For patients with ESRD and prior stroke but without diabetes, there was no significant difference in mortality between PD and HD (adjusted HR 1.20, 95 % CI 0.96–1.50). PD was associated with overall poorer survival among patients with diabetes, ESRD and prior stroke and with similar overall survival among patients with ESRD and prior stroke, but without diabetes, compared with HD.
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- 2015
11. Increased osteoporosis risk in dermatomyositis or polymyositis independent of the treatments: a population-based cohort study with propensity score
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Ji An Liang, Chung Y. Hsu, Fung-Chang Sung, Chih Hsin Muo, Cynthia Wei-Sheng Lee, and Chia-Hung Kao
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Adult ,Male ,medicine.medical_specialty ,Databases, Factual ,Endocrinology, Diabetes and Metabolism ,Population ,Taiwan ,Kaplan-Meier Estimate ,Risk Assessment ,Polymyositis ,Dermatomyositis ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Adrenal Cortex Hormones ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Propensity Score ,education ,Aged ,Retrospective Studies ,030203 arthritis & rheumatology ,education.field_of_study ,Proportional hazards model ,business.industry ,Incidence ,Incidence (epidemiology) ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Cohort ,Physical therapy ,Osteoporosis ,Female ,business ,Immunosuppressive Agents ,Follow-Up Studies ,Cohort study - Abstract
We investigated the relationship between dermatomyositis/polymyositis (DM/PM) and the risk of subsequent osteoporosis development. A population-based retrospective cohort analysis was conducted using the National Health Insurance Research Database and the Catastrophic Illness Patients Database of Taiwan. We included 1179 patients and 4716 patients from 1999 to 2008 as the DM/PM cohort and the comparison cohort, respectively, and calculated the incidence rates of newly diagnosed osteoporosis. We used Cox proportional hazards models stratified on matched pair to assess the effect of DM/PM. The Kaplan-Meier method was applied to estimate the cumulative osteoporosis incidence curves. Patients with DM/PM were 2.99 times more likely to experience osteoporosis than those without DM/PM. The risk for osteoporosis in DM/PM patients was higher than comparisons in different propensity score quartiles. DM/PM cohort, no matter treated with or without corticosteroids and immunosuppressant, had a higher risk than the comparison cohort. The incidence of osteoporosis in Taiwan is associated with a priori DM/PM history. This risk was independent of the corticosteroids and immunosuppressant treatment.
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- 2015
12. Nationwide population-based cohort study on the association of acute coronary syndrome in patients with malignancies
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Yen-Nien Lin, Yen Jung Chang, Po-Yen Ko, Kuan-Cheng Chang, Cheng-Li Lin, Fung-Chang Sung, Yin Huei Chen, and Chia-Hung Kao
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Adult ,Male ,Risk ,medicine.medical_specialty ,Acute coronary syndrome ,Taiwan ,Subgroup analysis ,Comorbidity ,Malignancy ,Cohort Studies ,Prostate cancer ,Neoplasms ,Internal medicine ,medicine ,Humans ,Acute Coronary Syndrome ,Intensive care medicine ,Aged ,business.industry ,Hazard ratio ,Cancer ,Middle Aged ,medicine.disease ,Oncology ,Female ,business ,Cohort study - Abstract
Patients with malignancy are suggestive of having a tendency toward an association with vascular thrombosis risk. The aim of this study was to evaluate the possible relationship between malignancy and the risk of acute coronary syndrome (ACS) in Taiwan. We used data from the National Health Insurance (NHI) system of Taiwan to assess the issue. Cox proportional hazards regression analysis was conducted to estimate the effects of malignancy on the risk of ACS. ACS risk in patients with malignancies was marginally significantly greater when adjusted for age, sex (hazard ratio (HR) = 1.09, 95 % confidence interval (CI) = 0.99–1.20), and comorbidities (HR = 1.03, 95 % CI = 0.93–1.13). A subgroup analysis indicated that patients with prostate cancer and head and neck cancer (HEENT) had a significantly higher risk of ACS (HR = 1.30, 95 % CI = 1.01–1.67; HR = 3.03, 95 % CI = 1.47–6.50). We suggest careful surveillance of ACS symptoms and regular electrocardiography during follow-up of these patients. However, further large-scale studies for patients with prostate and HEENT cancer and cancer survivors (especially from post-hormone or radiotherapy) are needed.
- Published
- 2014
13. Chronic hepatitis infection is associated with extrahepatic cancer development: a nationwide population-based study in Taiwan
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Chih Ching Yeh, Wen Chang Wang, Shih-Ni Chang, Fu Hsiung Su, Abram Bunya Kamiza, and Fung-Chang Sung
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Adult ,Male ,Hepatitis B virus ,Cancer Research ,medicine.medical_specialty ,Hepatitis, Viral, Human ,Colorectal cancer ,Hepatitis C virus ,Population ,Taiwan ,Comorbidity ,medicine.disease_cause ,Gastroenterology ,Cancer risk ,03 medical and health sciences ,Hepatitis B, Chronic ,0302 clinical medicine ,Neoplasms ,Internal medicine ,Pancreatic cancer ,Genetics ,medicine ,Humans ,education ,Aged ,Proportional Hazards Models ,Aged, 80 and over ,education.field_of_study ,Coinfection ,business.industry ,Incidence ,Liver Neoplasms ,Cancer ,Middle Aged ,medicine.disease ,Hepatitis C ,Oncology ,Population Surveillance ,030220 oncology & carcinogenesis ,Chronic Disease ,Female ,030211 gastroenterology & hepatology ,business ,Liver cancer ,Kidney cancer ,Biomarkers ,Research Article - Abstract
Background Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the major causes of chronic hepatitis infection (CHI). This longitudinal cohort study investigated the association of CHI with hepatic and extrahepatic cancer development in Taiwan. Methods Patients with HBV infection and HCV infection were identified from the Taiwan National Health Insurance Research Database. A Cox proportional hazard model was used to calculate hazard ratios (HRs) and 95 % confidence intervals (CIs) for determining the association between CHI and cancer development. Results The patients with HBV infection exhibited an increased risk of colorectal cancer (HR: 1.36, 95 % CI: 1.09–1.70), liver cancer (HR: 21.47, 95 % CI: 18.0–25.6), gallbladder and extrahepatic bile duct cancer (HR: 2.05, 95 % CI: 1.07–3.91), pancreatic cancer (HR: 2.61, 95 % CI: 1.47–4.61), kidney cancer (HR: 1.72, 95 % CI: 1.10–2.68), ovarian cancer (HR: 2.31, 95 % CI: 1.21–4.39), and non-Hodgkin’s lymphoma (HR: 2.10, 95 % CI: 1.25–3.52). The patients with HCV infection exhibited an increased risk of liver cancer (HR: 25.10, 95 % CI: 20.9–30.2), gallbladder and extrahepatic bile duct cancer (HR: 2.60, 95 % CI: 1.42–4.73), ovarian cancer (HR: 5.15, 95 % CI: 1.98–13.4), and non-Hodgkin’s lymphoma (HR: 2.30, 95 % CI: 1.34–3.96). Conclusion The present population-based study revealed that in addition to its association with primary liver cancer, CHI is associated with an increased risk of extrahepatic cancer.
- Published
- 2016
14. Subsequent cancer risk of children receiving post voiding cystourethrography: A nationwide population-based retrospective cohort study
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Wu-Chung Shen, Chia-Hung Kao, Chang-Ching Wei, Cheng-Li Lin, Tsai-Chung Li, Fung-Chang Sung, Po-Pang Tsai, and Yen Hsiu Liao
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Male ,Risk ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Population ,Taiwan ,Population based ,Cohort Studies ,Sex Factors ,Cystourethrography ,Neoplasms ,Humans ,Medicine ,Child ,education ,Survival analysis ,Retrospective Studies ,Vesico-Ureteral Reflux ,education.field_of_study ,business.industry ,Age Factors ,Infant ,Urography ,Retrospective cohort study ,Survival Analysis ,Socioeconomic Factors ,Nephrology ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,Radiation-induced cancer ,Cancer risk ,business ,Cohort study - Abstract
To estimate the subsequent cancer risk of children receiving post voiding cystourethrography (VCUG), a nationwide population-based retrospective cohort study with the data from the Taiwan National Health Insurance Research Database (NHIRD) were used for the analysis.In the VCUG cohort, 31,908 participants younger than 18 years of age who underwent VCUG between 1997 and 2008 were identified from the NHIRD. A comparison cohort, the non-VCUG cohort, was randomly selected among children without VCUG examination histories during 1997-2008, frequency matched for age (every 5 years), sex, geographic region area, parents' occupation, and index year based on a 1:4 ratio. Cox's proportional hazard regression analysis was conducted to estimate the subsequent cancer risk of children receiving VCUG.The overall cancer risk of the VCUG cohort is 1.92-fold (95 % CI = 1.34-2.74) higher than that of the non-VCUG cohort with statistical significance. The genital cancer and urinary system cancer risks of the VCUG cohort are respectively 6.19-fold (95 % CI = 1.37-28.0) and 5.8-fold (95 % CI = 1.54-21.9) higher than those of the non-VCUG cohort with statistical significance. The hazard ratios are higher in genital cancer, urinary system cancer (the major radiation exposure area), and cancer of the abdomen, except for the genitourinary system (the minor radiation exposure area), in sequence.Pediatric VCUG is associated with increased subsequent cancer risk, especially in the genitourinary system.
- Published
- 2013
15. Increased risk of dementia in patients with osteoporosis: a population-based retrospective cohort analysis
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Trong-Neng Wu, Fung-Chang Sung, Kuang-Hsi Chang, Chia-Hung Kao, Chi Jung Chung, and Cheng-Li Lin
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Male ,Aging ,medicine.medical_specialty ,Osteoporosis ,Taiwan ,Lower risk ,Article ,law.invention ,Double-Blind Method ,Randomized controlled trial ,Risk Factors ,law ,Internal medicine ,medicine ,Humans ,Dementia ,Risk factor ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Incidence ,Incidence (epidemiology) ,Hazard ratio ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Population Surveillance ,Physical therapy ,Female ,Geriatrics and Gerontology ,business ,Follow-Up Studies - Abstract
Osteoporosis is a common systemic skeletal disease that predominantly affects people older than 50 years and often co-occurs with dementia. The purpose of this study was to evaluate the risk of dementia in osteoporosis patients in Taiwan. Using data from Taiwan's National Health Insurance Research Database (NHIRD), we identified 23,941 patients with osteoporosis from 2000 to 2010 and 47,579 nonosteoporosis control patients, frequency-matched for age, sex, and index year, excluding patients with dementia at the baseline. We conducted univariate and multiple Cox proportional-hazards regression analyses to calculate the hazard ratios (HRs) and 95 % confidence intervals (CIs) of the association between osteoporosis and risk of dementia. After adjustment for potential risk factors, the osteoporosis patients exhibited 1.46-fold and 1.39-fold higher risk of dementia (95 % CI = 1.37-1.56) and Alzheimer's disease (95 % CI = 0.95-2.02), respectively, compared with the matched nonosteoporosis patients. We observed increased risk of dementia in both men and women with osteoporosis. The osteoporosis patients receiving bisphosphonate treatment or estrogen supplementation were associated with significantly lower risk of dementia compared with the osteoporosis patients who did not receive any treatment. Overall, our results suggest higher risks of dementia in osteoporosis patients than in nonosteoporosis patients. Osteoporosis could thus be considered an early risk factor for dementia. Future large-scale double-blind randomized clinical trials are required to clarify the role of medication in osteoporosis-related dementia.
- Published
- 2013
16. Diabetes mellitus and accompanying hyperlipidemia are independent risk factors for adhesive capsulitis: a nationwide population-based cohort study (version 2)
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Chung-Ming Huang, Fung-Chang Sung, Wei-Cheng Huang, Nai-Hsin Meng, Chih-Hsin Muo, Sui-Foon Lo, Ssu-Wei Chu, and Li-Wei Chou
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Immunology ,Taiwan ,Hyperlipidemias ,Kaplan-Meier Estimate ,Young Adult ,Sex Factors ,Rheumatology ,Bursitis ,Risk Factors ,Diabetes mellitus ,Internal medicine ,Diabetes Mellitus ,Odds Ratio ,medicine ,Humans ,Immunology and Allergy ,Aged ,Proportional Hazards Models ,Retrospective Studies ,business.industry ,Incidence ,Incidence (epidemiology) ,Hazard ratio ,Age Factors ,Middle Aged ,medicine.disease ,Comorbidity ,Confidence interval ,Capsulitis ,Multivariate Analysis ,Cohort ,Physical therapy ,Female ,business ,Cohort study - Abstract
Previous case–control studies of Caucasian ethnicity have reported the association of adhesive capsulitis (AC) with diabetes mellitus (DM). To further investigate the risk of AC in subjects with DM in an Asian population, we performed the present cohort study featured the analyses of a randomly selected sub-dataset of one million individuals insured by the Taiwan National Health Insurance for the period spanning 1996–2008. The study and comparison cohorts consisted of 5,109 newly diagnosed diabetic patients and 20,473 randomly selected non-diabetic subjects aged ≥20 years in the year 2000. Both cohorts were followed up until December 2008 to measure AC incidence. We found that the incidence density of AC in the DM cohort was 3.08 times that of the comparison cohort (146.9 vs. 47.7 per 10,000 person-years), and rate ratios varied from 1.23 to 4.98 by categorized sociodemographic factors and comorbidity. The hazard ratio (HR) of AC for DM subjects remained significantly higher than that for non-DM subjects (p
- Published
- 2013
17. Associations Between Genetic Polymorphisms of Epidermal Growth Factor Receptor (EGFR) and Survival of Colorectal Cancer (CRC) Patients Treated with 5-Fluorouracil-Based Chemotherapy
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Ching Yu Lai, Hung Yi Chiou, Chih Ching Yeh, Fung-Chang Sung, Fang Yang Wu, Reiping Tang, and Ling-Ling Hsieh
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Male ,Oncology ,Antimetabolites, Antineoplastic ,medicine.medical_specialty ,Colorectal cancer ,Adjuvants, Immunologic ,Surgical oncology ,Internal medicine ,Genotype ,Biomarkers, Tumor ,Humans ,Medicine ,Survival rate ,Neoplasm Staging ,Polymorphism, Genetic ,business.industry ,Proportional hazards model ,Hazard ratio ,Middle Aged ,Prognosis ,medicine.disease ,ErbB Receptors ,Survival Rate ,Log-rank test ,Drug Combinations ,Levamisole ,Fluorouracil ,Female ,Surgery ,Neoplasm Grading ,Colorectal Neoplasms ,business ,Follow-Up Studies ,medicine.drug - Abstract
This retrospective cohort study investigated the association between epidermal growth factor receptor (EGFR) polymorphisms and clinical outcomes in colorectal cancer (CRC) patients treated with 5-fluorouracil (5-FU)-based chemotherapy. We genotyped 3 EGFR polymorphisms including R497K, G-216T, and the (CA)n repeat, among 499 histologically confirmed CRC patients who had received 5-FU-based chemotherapy after surgery between 1995 and 2001. Survival analyses of EGFR polymorphisms were performed by the log rank test and Kaplan–Meier curves. We used the Cox proportional hazard model to evaluate the association between EGFR genotypes and clinical outcomes. Stratification analysis by gender, tumor stage, and subsite were also carried out. CRC patients with the EGFR (CA)n L/L genotype compared to those with the S/S+S/L genotype had a significantly better overall survival (L, ≥20 repeats; S
- Published
- 2013
18. Gallstones, a cholecystectomy, chronic pancreatitis, and the risk of subsequent pancreatic cancer in diabetic patients: a population-based cohort study
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Donald E. Morisky, Shu-Yu Lyu, Jen Wei Chou, Chih-Hsin Muo, Pei-Chun Chen, Cheng Yuan Peng, Hsueh Chou Lai, I-Ju Tsai, Shih-Wei Lai, and Fung-Chang Sung
- Subjects
Male ,Risk ,medicine.medical_specialty ,Gallstones ,Gastroenterology ,Cohort Studies ,Diabetes Complications ,Pancreatitis, Chronic ,Pancreatic cancer ,Internal medicine ,Diabetes mellitus ,medicine ,Humans ,Hypoglycemic Agents ,Cholecystectomy ,Retrospective Studies ,business.industry ,Cancer ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Pancreatic Neoplasms ,Cohort ,Pancreatitis ,Female ,business ,Cohort study - Abstract
The causal association between diabetes and pancreatic cancer remains unclear in Asian populations. This study examined whether gallstones, a cholecystectomy, chronic pancreatitis and the treatment of antidiabetic agents affect the risk of subsequent pancreatic cancer for patients with diabetes in a Taiwanese population. Using claims data from the universal health insurance program in Taiwan, 449,685 newly diagnosed diabetic cases among insured people from 2000 to 2003 were identified as the case group. The comparison group, matched for gender, age, and the index year of the diabetes cohort, consisted of 325,729 persons without diabetes. Pancreatic cancer incidence was measured in both groups until the end of 2008. Other risk factors associated with this cancer were also measured. The incidence of pancreatic cancer in the diabetic cohort was 2-fold greater than that in the comparison group (1.46 vs. 0.71 per 10,000 person-years) with an adjusted hazard ratio (HR) of 1.75 [95 % confidence interval (CI) 1.45–2.10]. The risk slightly increased for diabetic patients with gallstones, cholecystitis, and a cholecystectomy (HR 1.92, 95 % CI 1.18–3.11), but greatly increased for those with comorbidity of chronic pancreatitis (HR 22.9, 95 % CI 12.6–41.4). Pancreatic cancer risk also increased significantly for those patients who used more insulin for treating diabetes (OR 2.20, 95 % CI 1.40–3.45). Our data suggest that the risk of pancreatic cancer is moderately increased in patients with diabetes, especially those using insulin therapy. The risk is greatly increased for diabetic patients with chronic pancreatitis.
- Published
- 2012
19. Exploring the spatial and temporal relationships between mosquito population dynamics and dengue outbreaks based on climatic factors
- Author
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Patrick S. Chen, Ching-Tsan Tsai, Shu-Chiung Lin, and Fung-Chang Sung
- Subjects
Environmental Engineering ,Climax ,biology ,Southern taiwan ,fungi ,Outbreak ,Mosquito population ,Aedes aegypti ,biology.organism_classification ,medicine.disease ,Dengue outbreak ,Dengue fever ,Geography ,Weather data ,medicine ,Environmental Chemistry ,Safety, Risk, Reliability and Quality ,Cartography ,General Environmental Science ,Water Science and Technology - Abstract
Identifying the impact of climatic factors on mosquito population dynamics is of great importance for dengue outbreak control. The purpose of this study is to develop an approach to predict spatial/temporal mosquito reproduction and disease outbreaks. The prediction of a dengue outbreak is only possible if the temporal relationship between mosquito replication and the weather is known. At present, this is unclear and needs to be examined. Moreover, because the development of mosquito density is a dynamic process in the course of time, it should be observed as closely as possible, in this study in a 1-day timeframe. This paper makes a thorough study of the situation in southern Taiwan and analyzes a large amount of data from 1999 to 2004 related to dengue cases and larval density. We first use the method, k-means, to conduct data clustering and derive representative larvae replication patterns. Then, we propose mathematical models to approximate the development of larval density, describe the expansion of mosquito activity areas, and construct a surveillance system to raise alerts based on real-time input of weather data and larval indices. Analysis of historic data reveals some new information on the spatial and temporal relationships between larval density and dengue outbreaks. In Taiwan, if the weather becomes or remains warm and humid for 6 days after a bout of rain, there can be a sharp increase in the larval mosquito population. About 7 days after the Breteau index begins to rise, larval density reaches its climax; and, about 12 days after the climax of larval density, cases of dengue may be reported. The system is tested using subsequent data from 2005 to 2009 and shows satisfactory accuracy. Numerous data support these findings, and this new knowledge is thus validated and can be used to assist public health professionals to take effective dengue control measures.
- Published
- 2011
20. Increase in stroke risk in patients with head and neck cancer: a retrospective cohort study
- Author
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Shang Wen Chen, C. H. Mou, Chin Nan Chu, Chung Y. Hsu, Fung-Chang Sung, and Li Yuan Bai
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Epidemiology ,Population ,Taiwan ,Comorbidity ,Rate ratio ,head and neck cancers ,Cohort Studies ,Risk Factors ,Internal medicine ,medicine ,Humans ,education ,Stroke ,Retrospective Studies ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Hazard ratio ,Age Factors ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Combined Modality Therapy ,stroke ,Surgery ,Oncology ,Head and Neck Neoplasms ,population-based study ,Population Surveillance ,Cohort ,incidence ,Female ,business ,Cohort study - Abstract
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.
- Published
- 2011
21. Prediction models for the risk of new-onset hypertension in ethnic Chinese in Taiwan
- Author
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Ta-Chen Su, Hsiu-Ching Hsu, Yuan-The Lee, Ming-Fong Chen, Fung-Chang Sung, Kuo-Liong Chien, and Wei-Tien Chang
- Subjects
Adult ,Male ,medicine.medical_specialty ,Taiwan ,Blood Pressure ,Body Mass Index ,Cohort Studies ,Asian People ,Risk Factors ,Interquartile range ,Internal medicine ,Internal Medicine ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,Aged ,Models, Statistical ,business.industry ,Ethnic chinese ,Middle Aged ,Confidence interval ,Surgery ,Blood pressure ,Area Under Curve ,Hypertension ,Female ,business ,Body mass index ,Predictive modelling ,Cohort study - Abstract
Prediction model for hypertension risk in Chinese is still lacking. We aimed to propose prediction models for new-onset hypertension for ethnic Chinese based on a prospective cohort design on community, which recruited 2506 individuals (50.8% women) who were not hypertensive at the baseline (1990-91). Total 1029 cases of new-onset hypertension developed during a median of 6.15 (interquartile range, 4.04-9.02) years of follow-up. In the clinical model, gender (2 points), age (8 points), body mass index (10 points), systolic blood pressure (19 points) and diastolic blood pressure (7 points) were assigned. The biochemical measures, including white blood count (3 points), fasting glucose (1 point), uric acid (3 points), additional to above clinical variables, were constructed. The areas under the receiver operative characteristic curves (AUCs) were 0.732 (95% confidence interval (CI), 0.712-0.752) for the point-based clinical model and 0.735 (95% CI, 0.715-0.755) for the point-based biochemical model. The coefficient-based models had a good performance (AUC, 0.737-0.741). The point-based clinical model had a similar net reclassification improvement as the coefficient-based clinical model (P=0.30), and had a higher improvement than the point-based biochemical model (P=0.015). We concluded that the point-based clinical model could be considered as the first step to identify high-risk populations for hypertension among Chinese.
- Published
- 2010
22. Risk factors and their interaction on chronic kidney disease: A multi-centre case control study in Taiwan
- Author
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Yu Mei Hsueh, Ying Chin Ko, Sui-Lung Su, Yu Yang, Shang Jyh Hwang, Chih Wei Yang, Kuo Cheng Lu, Hung Yi Chiou, Chien Te Lee, Yung Ho Hsu, Fung-Chang Sung, Senyeong Kao, Ming Cheng Wang, Chin Lin, Ching-Huang Lai, Yu-Lung Chiu, Chia-Chao Wu, Jin Shuen Chen, Hsin Yi Yang, Mei Yi Wu, and Yuh Feng Lin
- Subjects
Male ,urologic and male genital diseases ,Risk Factors ,Chronic kidney disease ,Odds Ratio ,Outpatient clinic ,Groundwater ,education.field_of_study ,Smoking ,Age Factors ,Anemia ,Hepatitis C ,Middle Aged ,Hepatitis B ,Nephrology ,Hypertension ,Income ,Female ,Research Article ,Adult ,medicine.medical_specialty ,Interaction ,Alcohol Drinking ,Population ,Taiwan ,Anaemia ,Hyperlipidemias ,Hyperuricemia ,Sex Factors ,Internal medicine ,Diabetes mellitus ,Diabetes Mellitus ,medicine ,Humans ,cardiovascular diseases ,Renal Insufficiency, Chronic ,Risk factor ,education ,Areca ,Aged ,business.industry ,Case-control study ,Odds ratio ,medicine.disease ,Hyperlipidaemia ,Case-Control Studies ,Multivariate Analysis ,Linear Models ,Sedentary Behavior ,business ,Kidney disease - Abstract
Background Chronic kidney disease (CKD) is highly prevalent in Taiwan. More than two-thirds of end-stage renal disease is associated with diabetes mellitus (DM) or hypertension (HTN). Therefore, the formulation of a special preventative policy of CKD in these patients is essential. This study surveyed 14 traditional risk factors and identified their effects on CKD in patients with HTN/DM and compared these with their effects in the general population. Methods This study included 5328 cases and 5135 controls in the CKD/HTN/DM outpatient and health centres of 10 hospitals from 2008 to 2010. Fourteen common effect factors were surveyed (four demographic, five disease and five lifestyle), and their effects on CKD were tested. Significance tests were adjusted by the Bonferroni method. Results of the stratified analyses in the variables were presented with significant heterogeneity between patients with different comorbidities. Results Male, ageing, low income, hyperuricemia and lack of exercise habits were risk factors for CKD, and their effects in people with different comorbidities were identical. Anaemia was a risk factor, and there was an additive effect between anaemia and HTN on CKD. Patients with anaemia had a higher risk when associated with HTN [odds ratio (OR) = 6.75, 95 % confidence limit (95 % CI) 4.76–9.68] but had a smaller effect in people without HTN (OR 2.83, 95 % CI 2.16–3.67). The association between hyperlipidaemia-related factors and CKD was also moderated by HTN. It was a significant risk factor in people without HTN (OR = 1.67, 95 % CI 1.38–2.01) but not in patients with HTN (OR =1.03, 95 % CI 0.89–1.19). Hepatitis B, hepatitis C, betel nut chewing, smoking, alcohol intake and groundwater use were not associated with CKD in multivariate analysis. Conclusions We considered that patients with HTN and anaemia were a high CKD risk population. Physicians with anaemic patients in outpatient clinics need to recognise that patients who also have HTN might be latent CKD cases. Electronic supplementary material The online version of this article (doi:10.1186/s12882-015-0065-x) contains supplementary material, which is available to authorized users.
- Published
- 2015
23. Association between polymorphisms of biotransformation and DNA-repair genes and risk of colorectal cancer in Taiwan
- Author
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Chih Ching Yeh, Chung Rong Chang-Chieh, Fung-Chang Sung, Reiping Tang, and Ling-Ling Hsieh
- Subjects
Male ,Oncology ,medicine.medical_specialty ,DNA Repair ,DNA repair ,Colorectal cancer ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Taiwan ,Biology ,XRCC1 ,GSTP1 ,XRCC3 ,Internal medicine ,Epidemiology ,Genotype ,medicine ,Humans ,Pharmacology (medical) ,Allele ,Molecular Biology ,Biotransformation ,Genetics ,Polymorphism, Genetic ,Biochemistry (medical) ,Cell Biology ,General Medicine ,medicine.disease ,Enzymes ,Female ,Colorectal Neoplasms - Abstract
The relationship between diet and colorectal cancer has been previously demonstrated and supported with strong epidemiological evidence. The role of genetic polymorphisms has, however, been less well elaborated upon. We conducted a hospital-based case-control study including 727 cases and 736 healthy controls to evaluate the associations of the polymorphic phase-I and -II biotransformations (CYP1A1, CYP1A2, GSTM1, GSTT1, GSTP1, NAT1 and NAT2) and DNA-repair enzymes (XRCC1, XRCC3 and XPD) with the risk of contracting colorectal cancer. We found that men featuring the CYP1A1*2C G/G genotype, the GSTT1 null genotype and XPD 751 with the Gln allele were associated with an elevated risk of colorectal cancer than were men who did not exhibit such genetic features. Multivariate logistic regression analysis revealed that individuals featuring more than two high-risk genotypes increased the colorectal-cancer risk 3.1-fold (OR = 3.1, 95% CI = 1.8-5.2). For women, subjects featuring the CYP1A1*2C G/G genotype and the XRCC3 Thr/Thr genotype faced a 3.1-fold greater risk (95% CI = 1.3-7.0) of colorectal cancer when compared to those featuring the CYP1A1*2C A allele and the XRCC3 Met allele. Taken together, this study suggests that polymorphisms of genes involved in biotransformation and DNA repair could modulate colorectal-cancer risk in Taiwan.
- Published
- 2006
24. Blood and Urine Cadmium Levels in Relation to Demographic and Life Style in Middle Aged and Elderly Men
- Author
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Ruey-Hseng Lin, Yeong-Shiau Pu, Chun-Yuh Yang, Ming-Kuen Lai, Fung-Chang Sung, Yuh-Lin Chen, and S. H. Liu
- Subjects
Male ,medicine.medical_specialty ,Health, Toxicology and Mutagenesis ,Taiwan ,Toxicology ,Biological fluid ,Risk Factors ,Environmental health ,Epidemiology ,medicine ,Humans ,Life Style ,Aged ,Demography ,Aged, 80 and over ,Life style ,business.industry ,Public health ,Age Factors ,Prostatic Neoplasms ,Environmental Exposure ,General Medicine ,Middle Aged ,Health Surveys ,Pollution ,Environmental Pollutants ,business ,Cadmium - Abstract
1 Institute of Environmental Health, National Taiwan University, 1-1 Jen-Ai Road, Taipai, Taiwan, 100 2 Department of Urology, National Taiwan University, Taipai, Taiwan, 100 3 Institute of Epidemiology, National Taiwan University, Taipei, Taiwan, 100 4 Kaohsiung Medical University School of Public Health, Kaohsiung, Taiwan, 807 5 Department of Public Health, National Defense University, Taipei, Taiwan, 100
- Published
- 2001
25. Early utilization of hypertonic peritoneal dialysate and subsequent risks of non-traumatic amputation among peritoneal dialysis patients: a nationwide retrospective longitudinal study
- Author
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Fung-Chang Sung, Horng-Che Yeh, Chi Jung Chung, C.-L. Lin, I-Wen Ting, Chiu Chin Huang, Che-Chen Lin, Shih-Yi Lin, and I-Kuan Wang
- Subjects
Adult ,Male ,Nephrology ,medicine.medical_specialty ,Time Factors ,Hypertonic dialysate ,medicine.medical_treatment ,Peritoneal dialysis ,Hypertonic Solutions ,Population ,Amputation, Surgical ,Cohort Studies ,Young Adult ,Internal medicine ,medicine ,Humans ,Longitudinal Studies ,Young adult ,education ,Non-traumatic amputation ,Aged ,Retrospective Studies ,education.field_of_study ,business.industry ,Retrospective cohort study ,Middle Aged ,Surgery ,Treatment Outcome ,Amputation ,Female ,Hemodialysis ,business ,Research Article ,Cohort study - Abstract
Background The hemodialysis (HD) population has a particularly high incidence of amputation, which is likely associated with decreased tissue oxygenation during HD. However, information about the risk factors leading to amputation in peritoneal dialysis (PD) patients is limited. Here, we have investigated the association between the use of hypertonic peritoneal dialysate (HPD) and subsequent amputation in PD patients. Methods Based on the data from the Taiwan National Health Insurance research database, this observational cohort study enrolled 203 PD patients who had received HPD early during treatment and had not undergone amputation and 296 PD controls who had not undergone amputation. Subjects were followed through until the end of 2009 and the event rates of new non-traumatic amputation were compared between groups. Results The incidence of amputation was 3 times higher for the HPD cohort than for the comparison cohort (23.68 vs. 8.01 per 1000 person-years). The hazard ratio (HR) for this group, estimated using a multivariable Cox model, was 2.48 (95% confidence interval [CI] = 1.06–5.79). The HR for patients with both diabetes and early adoption of HPD increased to 44.34 (95% CI = 5.51-357.03), compared to non-HPD non-diabetic PD controls. Conclusion Early utilization of HPD in PD patients is associated with increasing risk of amputation; this risk considerably increases for those with concomitant diabetes.
- Published
- 2013
26. Decreased survival among lung cancer patients with co-morbid tuberculosis and diabetes
- Author
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Wen-Chen Tsai, Shwn-Huey Shieh, Fung-Chang Sung, Janice C. Probst, Ya Shin Li, and Chih Yi Chen
- Subjects
Adult ,Male ,Cancer Research ,medicine.medical_specialty ,Lung Neoplasms ,Tuberculosis ,Survival ,Comorbidity ,lcsh:RC254-282 ,Surgical oncology ,Diabetes mellitus ,Internal medicine ,Genetics ,medicine ,Risk of mortality ,Humans ,Lung cancer ,Aged ,Neoplasm Staging ,Aged, 80 and over ,business.industry ,Diabetes ,Hazard ratio ,Cancer ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Surgery ,Oncology ,Female ,business ,Research Article - Abstract
Background Comorbid conditions influence the survival of cancer patients. This study evaluated the influence of comorbidity on survival among lung cancer patients. Methods The authors evaluated the medical records of 1111 lung cancer patients of a medical center in Taiwan. Days of survival were calculated for each patient and mortality hazard ratios were estimated for associations with demographic status, comorbidity and cancer stage at diagnosis. Results On average, the survival time was slightly longer among women than among men (838 ± 689 vs. 749 ± 654 days, p = 0.050). Survival days increased with age (from 580 ± 526 [≤ 50 years] to 803 ± 693 [≥ 71 years] days, p = 0.020) and decreased with stage (from 1224 ± 656 [stage I] to 489 ± 536 [stage IV] days, p p = 0.002) and a higher mortality hazard ratio (1.30, 95% CI: 1.03 - 1.65). A similar trend was observed in lung cancer patients with diabetes. Conclusions Lung cancer patients with comorbid tuberculosis or diabetes are at an elevated risk of mortality. These patients deserve greater attention while undergoing cancer treatment.
- Published
- 2012
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