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The aim of this study was to determine whether there is a relationship between appendectomy and pulmonary tuberculosis in Taiwan. We designed a case-control study by analyzing the database from the Taiwan National Health Insurance Program. In total, we found 11,366 individuals (aged 20 years and older) with newly diagnosed pulmonary tuberculosis as the case group and 45,464 individuals without pulmonary tuberculosis as the control group from 1998 to 2011. The case group and the control group were matched on sex, age, and index year of diagnosing pulmonary tuberculosis. Using the multivariable unconditional logistic regression model, we measured the odds ratio (OR) and 95 % confidence interval (CI) for the risk of pulmonary tuberculosis associated with appendectomy and other comorbidities. After controlling for covariables, the multivariable unconditional logistic regression model disclosed that the OR of pulmonary tuberculosis was 1.4 in appendectomized patients (95 % CI = 1.13, 1.75) when compared to individuals without appendectomy. In further analysis, comorbidity with chronic obstructive pulmonary diseases (OR = 4.63, 95 % CI = 3.21, 6.68), pneumoconiosis (OR = 7.80, 95 % CI = 1.43, 42.5), chronic kidney diseases (OR = 5.65, 95 % CI = 1.79, 17.8), or diabetes mellitus (OR = 2.11, 95 % CI = 1.30, 3.44) increased the risk of pulmonary tuberculosis in appendectomized patients. Individuals with appendectomy are at a 1.4-fold increased risk of pulmonary tuberculosis. Comorbidities, including chronic obstructive pulmonary disease, pneumoconiosis, chronic kidney diseases, and diabetes mellitus, enhance the risk of pulmonary tuberculosis. [ABSTRACT FROM AUTHOR]

Background and purpose The aim of this study was to explore whether hearing loss is associated with the risk of Parkinson's disease in the elderly in Taiwan. Methods Using claims data of the Taiwan National Health Insurance Program, 4976 patients (aged 65 years or older) with newly diagnosed hearing loss from 2000 to 2010 were identified and 19 904 subjects without hearing loss were randomly selected as comparisons, frequency matched by sex, age and index year of diagnosing hearing loss. The incidence of Parkinson's disease by the end of 2010 and the associated risk factors were investigated. Results The incidence of Parkinson's disease in the hearing loss group was 1.77-fold higher than that in the non-hearing-loss group (3.11 vs. 1.76 per 1000 person-years). After controlling for confounding factors, the adjusted hazard ratio ( HR) of Parkinson's disease was 1.53 (95% CI 1.17, 1.99) for the hearing loss group compared with the non-hearing-loss group. Male sex ( HR = 1.33, 95% CI 1.02, 1.74), age (for each year, HR = 1.06, 95% CI 1.04, 1.09), hypertension ( HR = 1.70, 95% CI 1.26, 2.30) and cerebrovascular disease ( HR = 1.78, 95% CI 1.37, 2.32) were also significantly associated with the risk of Parkinson's disease. Conclusions Hearing loss correlates with an increased risk of Parkinson's disease in the elderly. Further studies are needed to confirm whether hearing loss could be a non-motor feature of Parkinson's disease. [ABSTRACT FROM AUTHOR]

Summary Background Bullous pemphigoid (BP) has been associated with neurological and psychiatric diseases; however, large-scale population-based study of different comorbid diseases in patients with BP is quite limited. Objectives We sought to analyse the prevalence of neurological, psychiatric, autoimmune and inflammatory skin diseases prior to the diagnosis of BP and their associations with BP among patients with BP from a nationwide database in Taiwan. Methods A total of 3485 patients with BP and 17 425 matching controls were identified from the National Health Insurance Database in Taiwan from 1997 to 2008. Conditional logistic regression analyses for a nested case-control study were performed to examine the prevalence of comorbidities prior to the diagnosis of BP between these two groups. Results Overall, our results showed that stroke [odds ratio (OR) 3·30; 95% confidence interval (95% CI) 3·03-3·60], dementia (OR 4·81; 95% CI 4·26-5·42), Parkinson disease (OR 3·49; 95% CI 3·05-3·98), epilepsy (OR 3·97; 95% CI 3·28-4·81), schizophrenia (OR 2·56; 95% CI 1·52-4·30) and psoriasis (OR 2·02; 95% CI 1·54-2·66) were significantly associated with BP. Among them, the association with schizophrenia and psoriasis was predominant in female and male patients, respectively, with BP. It remains for all these comorbid diseases to be independently associated with BP by multivariate analysis. Conclusions Patients with BP are more likely to have various neurological diseases, schizophrenia and psoriasis prior to the diagnosis of BP, supporting associations found in other studies. Further research is required to elucidate the tentative causal association with BP. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to investigate the prevalence of metabolic syndrome in older people in Taiwan. Methods: This was a hospital-based, cross-sectional study. We retrospectively analysed subjects receiving self-referred health examination at one medical centre in Taiwan from 2000 to 2004. In all, 696 older people without any acute illness were enrolled in this study, 352 men (50.6%) and 344 women (49.4%). The mean age was 70.2 ± 4.6 years (age range 65–87). Metabolic syndrome was estimated according to the criteria proposed by National Cholesterol Education Program Adult Treatment Panel III in 2001 and by International Diabetes Foundation in 2005, with the cut-off values of the waist circumference greater than or equal to either 90 or 80 cm for men or women, respectively. Results: Among this group, 94% of the individuals presented with at least one condition of metabolic syndrome. The prevalence of metabolic syndrome defined by National Cholesterol Education Program Adult Treatment Panel III was 44.1% and was higher in women than in men (52.6 vs 35.8%, P < 0.001). Defined by International Diabetes Foundation, the prevalence was also 44.1% and was higher in women than in men (55.5 vs 33.0%, P < 0.001). Conclusion: The prevalence of metabolic syndrome remains relatively high in Taiwanese older people. [ABSTRACT FROM AUTHOR]

The article offers the study on the examining the association between hydroxychloroquine and retinopathy using Real-world database. Topics discussed include information on the retinopathy as the adverse effect of hydroxychloroquine therapy and posses visual impairment; discussions on the examination of the risk of retinopathy associated with cumulative duration of hydroxychloroquine therapy; and the information on the suggestions on periodic retinal screening to patients.

Introduction: Our objective was to evaluate the association between patient profiles and sustained diabetes management (SDM) among patients with type 2 diabetes., Methods: We collected HbA 1c values recorded from 2014 through 2020 for 570 patients in a hospital in Taipei, Taiwan, and calculated a standard level based on an HbA 1c level less than 7.0% to determine SDM. We used patients' self-reported data on diabetes self-care behaviors to construct profiles. We used 8 survey items to perform a latent profile analysis with 3 groups (poor management, medication adherence, and good management). After adjusting for other determining factors, we used multiple regression analysis to explore the relationship between patient profiles and SDM., Results: The good management group demonstrated better SDM than the poor management group (β = 0.183; P = .003). Using the most recent HbA 1c value and the 7-year average of HbA 1c values as the outcome, we found lower HbA 1c values in the good management group than in the poor management group (β = -0.216 [P = .01] and -0.217 [P = .008], respectively)., Conclusion: By using patient profiles, we confirmed a positive relationship between optimal patient behavior in self-care management and SDM. Patients with type 2 diabetes exhibited effective self-care management behavior and engaged in more health care activities, which may have led to better SDM. In promoting patient-centered care, using patient profiles and customized health education materials could improve diabetes care.

The optical design and performance of the recently opened 13A biological small-angle X-ray scattering (SAXS) beamline at the 3.0 GeV Taiwan Photon Source of the National Synchrotron Radiation Research Center are reported. The beamline is designed for studies of biological structures and kinetics in a wide range of length and time scales, from angstrom to micrometre and from microsecond to minutes. A 4 m IU24 undulator of the beamline provides high-flux X-rays in the energy range 4.0-23.0 keV. MoB 4 C double-multilayer and Si(111) double-crystal monochromators (DMM/DCM) are combined on the same rotating platform for a smooth rotation transition from a high-flux beam of ∼4 × 10 14  photons s -1 to a high-energy-resolution beam of ΔE/E ≃ 1.5 × 10 -4 ; both modes share a constant beam exit. With a set of Kirkpatrick-Baez (KB) mirrors, the X-ray beam is focused to the farthest SAXS detector position, 52 m from the source. A downstream four-bounce crystal collimator, comprising two sets of Si(311) double crystals arranged in a dispersive configuration, optionally collimate the DCM (vertically diffracted) beam in the horizontal direction for ultra-SAXS with a minimum scattering vector q down to 0.0004 Å -1 , which allows resolving ordered d-spacing up to 1 µm. A microbeam, of 10-50 µm beam size, is tailored by a combined set of high-heat-load slits followed by micrometre-precision slits situated at the front-end 15.5 m position. The second set of KB mirrors then focus the beam to the 40 m sample position, with a demagnification ratio of ∼1.5. A detecting system comprising two in-vacuum X-ray pixel detectors is installed to perform synchronized small- and wide-angle X-ray scattering data collections. The observed beamline performance proves the feasibility of having compound features of high flux, microbeam and ultra-SAXS in one beamline., (open access.)

Aims/introduction: This study investigated whether participation by patients with type 2 diabetes in Taiwan's pay-for-performance (P4P) program and maintaining good continuity of care (COC) with their healthcare provider reduced the likelihood of future complications, such as retinopathy., Materials and Methods: The analysis used longitudinal panel data for newly diagnosed type 2 diabetes from the National Health Insurance claims database in Taiwan. COC was measured annually from 2003 to 2013, and was used to allocate the patients to low, medium and high groups. Cox regression analysis was used with time-dependent (time-varying) covariates in a reduced model (with only P4P or COC), and the full model was adjusted with other covariates., Results: Despite the same significant effects of treatment at primary care, the Diabetes Complications Severity Index scores were significantly associated with the development of retinopathy. After adjusting for these, the hazard ratios for developing retinopathy among P4P participants in the low, medium and high COC groups were 0.594 (95% confidence interval [CI] 0.398-0.898, P = 0.012), 0.676 (95% CI 0.520-0.867, P = 0.0026) and 0.802 (95% CI 0.603-1.030, P = 0.1062), respectively. Thus, patients with low or median COC who participated in the P4P program had a significantly lower risk of retinopathy than those who did not., Conclusions: Diabetes care requires a long-term relationship between patients and their care providers. Besides encouraging patients to participate in P4P programs, health authorities should provide more incentives for providers or patients to regularly survey patients' lipid profiles and glucose levels, and reward the better interpersonal relationship to prevent retinopathy., (© 2020 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.)

This study investigated whether there was an association between splenectomy and pulmonary tuberculosis. This was a case-control study using the database of the Taiwan National Health Insurance Programme. We identified 18 960 patients (aged 20 years or older) with newly diagnosed pulmonary tuberculosis as the case group and 73 988 participants without pulmonary tuberculosis as the control group from 1998 to 2011. Both groups were matched for sex, age (per 5 years) and index year of pulmonary tuberculosis diagnosis. The risk of pulmonary tuberculosis associated with splenectomy and other co-morbidities was estimated. After controlling for confounders, multivariable logistic regression analysis showed that the odds of pulmonary tuberculosis were 1.91 in patients with splenectomy (95% CI 1.06-3.44), compared with the participants without splenectomy. Chronic obstructive pulmonary diseases (OR 3.07, 95% CI 2.94-3.21), pneumoconiosis (OR 2.20, 95% CI 1.90-2.56), chronic kidney diseases (OR 1.49, 95% CI 1.33-1.67), diabetes mellitus (OR 1.57, 95% CI 1.50-1.64) and chronic liver diseases (OR 1.31, 95% CI 1.25-1.37) were associated with an increased risk of pulmonary tuberculosis. The sub-analysis demonstrated that the odds of pulmonary tuberculosis were 4.81 (95% CI 2.31-10.0) for patients co-morbid with splenectomy and any of the above diseases. Splenectomy is associated with a 1.9-fold increased risk of pulmonary tuberculosis in Taiwan. There is a synergistic effect between splenectomy and other co-morbidities on the risk of pulmonary tuberculosis., (© 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.)

Background: Few studies have focused on the clandestinely consumed amphetamine as a primary drug. The purpose of this study was to estimate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and the related factors in male amphetamine-inhaling abusers., Methods: This was a cross-sectional study. From November 2004 to February 2005, 285 amphetamine-inhaling male subjects at one prison in Taiwan and 285 age-matched healthy men without history of using illicit drugs or tattooing were enrolled. A face-to-face interview focusing on amphetamine-addicted history and sociodemographic information was used. Hepatitis B surface antigen (HBsAg) and anti-HCV were tested., Results: The mean age of the subjects was 34.1 +/- 8.6 years (range 17-75 years). Among 285 subjects, 13.3% were positive for HBsAg, 20.0% positive for anti-HCV and 2.5% positive for combined HBsAg and anti-HCV. Multivariate logistic regression analysis showed that tattoo (odds ratio (OR) 2.97, 95% confidence interval (CI) 1.37-6.43) and elevated alanine aminotransferase (ALT) (OR 3.15, 95% CI 1.49-6.66) were independently related to persons being anti-HCV positive. Elevated ALT was related to persons being HBsAg positive (OR 2.60, 95% CI 1.15-5.89)., Conclusion: Screening of HBV and HCV infection among amphetamine-inhaling abusers remains necessary. Tattoo and elevated ALT are identified as the related factors for being anti-HCV positive. Elevated ALT is the related factor for being HBsAg positive.

Background: Problem-based learning (PBL) in small-group tutorials has been a trend in medical education. Chinese students are known to be reserved and passive; thus, they may not be adaptable to PBL. Neuroanatomy, important to clinical neurology, is difficult to learn. We incorporated clinical neurology with PBL, complementary to the traditional neuroanatomy curriculum, to evaluate the feasibility of PBL for Chinese students in Taiwan., Methods: Forty-two second-year medical students and seven tutors participated in the clinical neurology PBL small-group tutorials. Twelve case reports were discussed weekly beginning in February, 1999. Each case was designed to meet the progressive curriculum of the neuroanatomy course. The tutors evaluated the students by the degree of their preparation, participation, key-point comprehension and interaction. All tutors and students filled out questionnaires at the end of each session., Results: The majority of the students and tutors agreed that the case materials were clearly written. Ninety percent of the students agreed that the case materials matched the traditional content of neuroanatomy. Eighty-five percent of students and 71% of tutors were satisfied and found the class rewarding. Ninety-one percent of students and 74% of tutors were in favor of PBL being continued., Conclusions: This preliminary PBL, small-group tutorial learning in clinical neurology showed satisfactory results and was, indeed, complementary to a traditional neuroanatomy course. The students, as early as during the second year of their medical school education, were able to learn through the PBL. More integration of basic and clinical sciences by PBL may be considered in future curricula designs.