Longitudinal Health Insurance Database Research Articles

Association of Alzheimer's Disease With Peripheral Vestibular Disorder: A Case-Control Study.

Vestibular disorders can impact cognitive domains, including spatial orientation and memory, which are also affected in Alzheimer's disease. This study aimed to examine the association between Alzheimer's disease and a prior diagnosis of peripheral vestibular disorders in the elderly Taiwanese population. The case-control study sample was retrieved from Taiwan's Longitudinal Health Insurance Database 2010. We included 3138 cases with Alzheimer's disease and 9414 propensity-matched controls. We conducted multivariable logistic regression modeling to investigate the association between Alzheimer's disease and a prior diagnosis of peripheral vestibular disorders after accounting for sociodemographic characteristics and medical comorbidities including diabetes, coronary heart disease, hypertension, hyperlipidemia, and hearing loss. The results revealed a statistically significant difference in the prevalence of prior peripheral vestibular disorders between patients with Alzheimer's disease and controls; 20.6% among patients with Alzheimer's disease and 11.4% among controls (p < 0.001). Multivariable logistic regression analysis found that patients with Alzheimer's disease were twice as likely as controls to have had a prior diagnosis of peripheral vestibular disorders, adjusted odds ratio 2.040 (95% confidence interval: 1.829-2.274). The findings suggest the possibility of shared or related pathophysiological pathways in Alzheimer's disease and vestibular dysfunction disorders. 3 Laryngoscope, 2024.

The risk of secondary spontaneous pneumothorax in patients with chronic obstructive pulmonary disease in Taiwan

IntroductionSecondary spontaneous pneumothorax (SSP) is often linked to chronic obstructive pulmonary disease (COPD). The frequency of SSP occurrence in COPD patients varies among different research findings. SSPs are more commonly found in the elderly population diagnosed with COPD. Previous studies have reported a pneumothorax rate of 26 per 100,000 COPD patients. There is, however, a notable lack of detailed epidemiological information regarding SSP in Asia. Our study focused on determining the occurrence rate of SSP among COPD patients in Taiwan using an extensive national database. Additionally, this study aimed to identify comorbidities associated with SSP in this patient group. MethodsIn this study, we used the Longitudinal Health Insurance Database, which contains records of 2 million people who were randomly chosen from among the beneficiaries of the Taiwan National Health Insurance program. The dataset includes information from 2005 to the end of 2017. Our focus was on individuals diagnosed with COPD, identified through ICD-9-CM codes in at least one hospital admission or two outpatient services, with the COPD diagnosis date as the index date. The exclusion criteria included individuals younger than 40 years, those with incomplete records, or those with a previous diagnosis of pneumothorax before the index date. We conducted a matched comparison by pairing COPD patients with control subjects of similar age, sex, and comorbidities using propensity score matching. The follow-up for all participants started from their index date and continued until they developed pneumothorax, reached the study's end, withdrew from the insurance program, or passed away. The primary objective was to evaluate and compare the incidence of pneumothorax between COPD patients and matched controls. ResultsWe enrolled 65,063 patients who were diagnosed with COPD. Their mean age (±SD) was 66.28 (±12.99) years, and approximately 60 % were male. During the follow-up period, pneumothorax occurred in 607 patients, equivalent to 9.3 % of the cohort. The incidence rate of SSP in COPD patients was 12.10 per 10,000 person-years, whereas it was 6.68 per 10,000 person-years in those without COPD. Furthermore, COPD patients with comorbidities such as atrial fibrillation, congestive heart failure, coronary artery disease, diabetes mellitus, hypertension, and cancer exhibited an increased incidence of SSP compared to COPD patients without such comorbidities. This was observed after conducting a multivariable Cox regression analysis adjusted for age, sex, and other comorbidities. ConclusionOur study revealed an elevated risk of SSP in patients with COPD. It has also been suggested that COPD patients with comorbidities, such as atrial fibrillation, congestive heart failure, coronary artery disease, diabetes mellitus, hypertension, and cancer, have an increased risk of developing SSP.

Association of distal radial fracture with comorbidities: model development and validation

BackgroundTo better assess the risk of distal radial fracture in the general population, we need models that take into account a wide range of risk factors other than osteoporosis. The objective was to develop and validate a model for association of patients’ characteristics with distal radial fracture that effectively incorporates multifactorial aspects and includes comorbidities. MethodWe analyzed data from a large Longitudinal Health Insurance Database between 2000 and 2013. The outcome of the study was the occurrence of distal radial fracture and the predictors were demographic and comorbidity data. Two machine learning models were developed and validated for patients ≥50 (N = 2745) and <50 (N = 1587) years of age. ResultsFor patients aged ≥50 years, selected characteristics included sex, age, urbanization level, osteoarthritis, carpal tunnel syndrome, obesity, hyperlipidemia, trigger finger, hypertension, hypothyroidism, diabetes, hyperthyroidism, and rheumatoid arthritis. For patients <50 years old, selected characteristics included age, sex, diabetes mellitus, urbanization level, carpal tunnel syndrome, hyperlipidemia, osteoarthritis, obesity, and hypertension. Accuracy, sensitivity, specificity, area under the curve, and likelihood ratio were 0.77, 0.83, 0.72, 0.77, and 2.92 for age ≥50 years and 0.73, 0.79, 0.67, 0.73, and 2.41 for age <50 years. ConclusionThe study models can serve as reliable screening tools to assess the risk of distal radial fracture in the general population before bone mineral density testing. In addition, they can be integrated into decision support systems to help healthcare providers identify high-risk patients for additional evaluation and education, ultimately improving the quality of care.

Association between gabapentin use and risk of dementia in adults with chronic pain: A nested case-control study

Study objectiveTo explore the association between gabapentin use and the risk of dementia in patients with chronic pain, considering the rising concerns of dementia in an aging population and the potential cognitive impacts of chronic pain management. DesignA nested case-control study utilizing data from a longitudinal health insurance database. SettingThe study is based on a longitudinal health insurance database spanning 2000–2019 in Taiwan. PatientsA total of 201,492 patients aged 50 years and older diagnosed with chronic pain between 2001 and 2017 were included. The study focused on individuals with chronic pain, excluding those diagnosed with dementia a year before or after their chronic pain diagnosis. InterventionAnalysis of gabapentin prescription history was conducted, considering the cumulative dose from the chronic pain diagnosis date to the dementia diagnosis date or equivalent period for controls. MeasurementData included demographics, gabapentin prescription history, and comorbidities. Logistic regression was used to estimate odds ratios for dementia risk. Main resultsNo significant difference in the risk of dementia was found between low and high cumulative doses of gabapentin. The adjusted odds ratio for dementia risk associated with gabapentin use was 0.91 (95 % C.I. 0.83–1.01), indicating no substantial increase in risk. ConclusionLong-term Gabapentin therapy for chronic pain is not associated with a differential risk of dementia across dosage levels, irrespective of age or gender. Further study into its potential cognitive impacts is essential.

The Association between Ovarian Cancer and the Incidence of Newly Developed Dry Eye Disease: A Nationwide Population-Based Study.

We aim to investigate the potential correlation between the presence of ovarian cancer and the development of dry eye disease (DED) via the usage of the Longitudinal Health Insurance Database (LHID) of Taiwan. A retrospective cohort study was executed, and patients with ovarian cancer were selected according to the diagnostic and procedure codes. One ovarian cancer patient was matched to four non-ovarian cancer participants which served as control group, and a total of 4992 and 19,968 patients constructed the ovarian cancer and control groups, respectively. The primary outcome in the current study is the development of DED according to the diagnostic and procedure codes. Cox proportional hazard regression was utilized to produce the adjusted hazard ratio (aHR) and related 95% confidence interval (CI) of DED between the two groups. There were 542 and 2502 DED events observed in the ovarian cancer group and the control group, respectively. The ovarian cancer group illustrated a significantly higher incidence of DED development than the control group after the adjustment of several confounders (aHR: 1.10, 95% CI: 1.01-1.21, p = 0.040). In the subgroup analysis stratified by age, ovarian cancer patients aged older than 60 years showed a higher incidence of DED compared to the non-ovarian cancer population (aHR: 1.19, 95% CI: 1.08-1.28, p = 0.011). In addition, ovarian cancer patients with a disease duration longer than five years also showed higher incidence of DED formation than the non-ovarian cancer population (aHR: 1.13, 95% CI: 1.04-1.22, p = 0.027). In conclusion, the presence of ovarian cancer is associated with higher incidence of subsequent DED, especially in those older than 60 years and with a disease interval of more than five years.

Diabetes mellitus is a risk factor for incident chronic kidney disease: A nationwide cohort study

ObjectiveDiabetes mellitus and chronic kidney disease are multifactorial conditions with multiple etiologies that share similar pathophysiologies. This nationwide cohort study examined the impact of diabetes mellitus on the follow-up development of chronic kidney disease. MethodsBy retrieving the Longitudinal Health Insurance Database 2005, 5121 patients with diabetes mellitus were included in this study and 5121 patients without diabetes mellitus, who were matched according to sex, age, and Charlson comorbidity index made up the control group. The adjusted hazard ratios for chronic kidney disease were calculated using Cox proportional hazards regression analysis. Kaplan–Meier analysis was used to estimate the cumulative incidence of chronic kidney disease rate in the diabetes mellitus and control groups. ResultsAfter adjusting for sex, age, and Charlson comorbidity index score, the diabetes mellitus group had a 1.380 times higher (95% CI: 1.277–1.492) risk of developing chronic kidney disease than the control group. Further stratified analysis showed that patients with diabetes mellitus had a significantly higher risk of developing chronic kidney disease regardless of their sex, age, and Charlson comorbidity index score, compared to those without diabetes mellitus. ConclusionsThere is a possibility that diabetes mellitus serves as an independent risk factor for chronic kidney disease development. Early screening and monitoring of diabetes mellitus appear to be of great importance in the prevention of chronic kidney disease.

Increased prevalence of peripheral vestibular disorder among patients with Fabry disease

BackgroundAlthough peripheral vestibular disorder is a non-fatal complication of Fabry disease, fatalities have been reported in some case reports and case series. To date, no studies have examined the relative risk of peripheral vestibular disorder in patients with Fabry disease compared to the general population without the condition. Due to the high prevalence of Fabry disease in East Asia and the potential shared pathogenic pathways between Fabry disease and vasculopathy, we conducted a study using a nationwide population-based dataset to compare the prevalence of peripheral vestibular disorder between patients with Fabry disease and matched comparison patients.MethodsData was sourced from Taiwan’s Longitudinal Health Insurance Database 2010. this study consists of 11,668 sampled patients, 2917 study patients with Fabry disease and 8751 propensity-score-matching comparison patients. We conducted multiple logistic regression analysis to study the association between peripheral vestibular disorder and Fabry disease.ResultsThe study identified notable differences in the prevalence of various vestibular disorders between the study and comparison groups. Specifically, there was a 7.2% increased prevalence of peripheral vestibular disorder in the study group (28.3%) compared to the comparison group (20.9%), Meniere’s disease (5.4% vs. 3.7%), benign paroxysmal positional vertigo (5.1% vs. 3.3%), and other/ unspecified peripheral vestibular dizziness (15.6% vs. 11.8%) (all p < 0.001). The odds ratios for PVD, MD, BPPV, and other PVD were 1.44 (95% CI = 1.29–1.60), 1.50 (95% CI = 1.23–1.83), 1.59 (95% CI = 1.30–1.95), and 1.40 (95% CI = 1.24–1.58), respectively, among the Fabry disease group relative to the comparison group after adjusting for age, monthly income, geographic location, urbanization level, hyperlipidemia, diabetes, coronary heart disease, and hypertension.ConclusionThis study found that patients with Fabry disease had increased prevalence of peripheral vestibular disorder.

Increasing Risk of Dementia Among Patients with Subsequent Epilepsy Within 2 Years Post-Traumatic Brain Injury: A Population-Based Case-Control Study.

Although the association between neurodegenerative diseases, such as dementia, and traumatic brain injury (TBI) has long been known, the association between dementia and TBI with epilepsy has been controversial. This data-driven population-based study is designed to investigate the association between dementia and epilepsy after TBI within a 2-year period. This case-control cohort study was conducted using the Longitudinal Health Insurance Database 2000 (LHID2000). We included 784 individuals ambulatory or hospitalized for TBI with epilepsy from 2001 to 2011, compared with 2992 patients with TBI without epilepsy who were matched for characteristics including sex, age, and healthcare resource use index date. Every participant was followed up for 5 years to ascertain any dementia development. Data were stratified and analyzed using the Cox proportional hazards regression. Through the 5-year follow-up period, 39 patients (5.21%) with TBI with epilepsy and 55 (1.53%) with TBI without epilepsy developed dementia. TBI with epilepsy was independently associated with a >3.03 times risk of dementia after correcting for age, sex, and comorbidities. These findings suggest an increased risk of dementia in patients with TBI with epilepsy. Our research recommends that individuals with TBI and epilepsy be monitored more intensively.

Usage Patterns of Traditional Chinese Medicine for Patients with Bipolar Disorder: A Population-Based Study in Taiwan.

Patients with bipolar disorder (BD) receive traditional Chinese medicine (TCM) for clinical needs unmet with psychotropic medications. However, the clinical characteristics of practices and outcomes of TCM in BD are not fully understood. This cohort study investigated the clinical characteristics, principal diagnoses, TCM interventions, and TCM prescriptions in patients with BD. Data for a total of 12,113 patients with BD between 1996 and 2013 were withdrawn from Taiwan's longitudinal health insurance database 2000 (LHID 2000). The chi-square test was used for categorical variables, and the independent t-test was used for continuous variables. A p-value less than 0.05 indicated significance. One thousand three hundred nineteen patients who visited TCM clinics after the diagnosis of BD were in the TCM group, while those who never visited TCM were in the non-TCM group (n = 1053). Compared to the non-TCM group, patients in the TCM group had younger average age, a higher percentage of female individuals, more comorbidities of anxiety and alcohol use disorders, and higher mood stabilizer usage rates. The TCM group exhibited pain-related indications, including joint pain, myalgia, myositis, headache, and sleep disturbances. Corydalis yanhusuo and Shu-Jing-Huo-Xue-Tang were the most useful single herbs and herbal formulae. Physicians need to be aware of the use of TCM in patients with BD.

Advancing breastfeeding promotion: leveraging integrative natural galactagogues and unveiling their potential roles-Insights from a 19-year Taiwan nationwide registry to address lactation insufficiency in postpartum women.

Lactation insufficiency is a prevalent challenge for nursing mothers globally. There is a growing interest in the use of herbal galactagogues for enhancing lactation, but their therapeutic efficacy and underlying mechanisms need thorough investigation. This study aims to investigate the efficacy and mechanisms of action of herbal galactagogues in addressing lactation insufficiency by utilizing real-world data and employing a network analysis approach. Our retrospective study used Taiwan's Longitudinal Health Insurance Database 2000 (LHID2000) to identify 490 patients diagnosed with lactation insufficiency from 2000 to 2018. We analyzed demographic characteristics, co-existing diseases, and prescription patterns for both users and non-users of Chinese herbal products (CHP). Additionally, we utilized a network analysis approach to explore potential compounds and targets in the most frequently used CHP, the Wang Bu Liu Xing and Lu Lu Tong herb pair (WLHP) combination. Out of 490 patients, 81% were CHP users. There were no significant differences in demographic characteristics between CHP users and non-users, but we observed a notable divergence in the prevalence of co-existing diseases. A detailed examination of CHP prescriptions revealed the predominance of WLHP, prompting further investigation. Comprehensive analysis identified 29 major compounds in WLHP, which were associated with 215 unique targets. Intersection analysis revealed 101 overlapping targets between WLHP and lactation, suggesting their potential as therapeutic targets for lactation insufficiency treatment. Topological analysis of the protein-protein interaction (PPI) network identified 13 hub genes potentially crucial for the therapeutic effect of WLHP. Functional enrichment analysis showed that these targets were involved in critical lactation regulation pathways, including the PI3K-Akt signaling pathway, prolactin signaling pathway, estrogen signaling pathway, and AMPK signaling pathway. This study emphasizes the potential of CHP, specifically the WLHP combination, in managing lactation insufficiency. The multi-compound, multi-target approach of WLHP and its interaction with key biological processes and signaling pathways offer valuable insights into the underlying mechanisms of its therapeutic effects. These findings warrant further experimental validation and can guide future research and clinical applications of CHP in lactation insufficiency treatment.

Association of thyroid cancer with human papillomavirus infections

While Human Papillomavirus (HPV) particles have been detected in a small proportion of benign thyroid nodules or thyroid cancer cases, a role of HPV in these thyroid conditions has not been established. This study aims to investigate the association of HPV infection with thyroid cancer (TC) using a nationwide population-based study. We retrieved data for this case–control study from Taiwan's Longitudinal Health Insurance Database 2010. The study sample included 3062 patients with TC and 9186 propensity-scored matched controls. We employed multivariate logistic regression models to quantitatively evaluate the association of TC with HPV infections after taking age, sex, monthly income, geographic location and urbanization level of the patient's residence, diabetes, hypertension, and hyperlipidemia into considerations. Chi-squared test revealed that there was a significant difference in the prevalence of prior HPV infections between patients with TC and controls (15.3% vs. 7.6%, p < 0.001). The adjusted odds ratio of prior HPV infections for patients with TC was 2.199 (95% CI = 1.939–2.492) relative to controls. The adjusted ORs of prior HPV infections for patients with TC was similar for males and females. Our research suggests a significant link between HPV infection and the development of TC.

Association of maternal constipation and risk of atopic dermatitis in offspring.

Objectives: Atopic dermatitis (AD) is a chronic and relapsing dermatologic disease that can affect individuals of all ages, including children and adults. The prevalence of AD has increased dramatically over the past few decades. AD may affect children's daily activities, increase their parents' stress, and increase health expenditure. Constipation is a worldwide issue and may affect the gut microbiome. Some research has indicated that constipation might be associated with risk of atopic disease. The primary objective of this retrospective cohort study was to extend and to explore the link between maternal constipation and risk of atopic dermatitis in offspring. Methods: Using the Longitudinal Health Insurance Database, a subset of Taiwan's National Health Insurance Research Database, we identified 138,553 mothers with constipation and 138,553 matched controls between 2005 and 2016. Propensity score analysis was used matching birth year, child's sex, birth weight, gestational weeks, mode of delivery, maternal comorbidities, and antibiotics usage, with a ratio of 1:1. Multiple Cox regression and subgroup analyses were used to estimate the adjusted hazard ratio of child AD. Results: The incidence of childhood AD was 66.17 per 1,000 person-years in constipated mothers. By adjusting child's sex, birth weight, gestational weeks, mode of delivery, maternal comorbidities, and received antibiotics, it was found that in children whose mother had constipation, there was a 1.26-fold risk of AD compared to the children of mothers without constipation (adjusted hazard ratio [aHR]: 1.26; 95% CI, 1.25-1.28). According to subgroup analyses, children in the maternal constipation group had a higher likelihood of AD irrespective of child's sex, birth weight, gestational weeks, mode of delivery, and with or without comorbidities, as well as usage of antibiotics during pregnancy. Compared to the non-constipated mothers, the aHR for the constipated mothers with laxative prescriptions <12 and ≥12 times within one year before the index date were 1.26; 95% CI, 1.24 -1.28 and 1.40; 95% CI, 1.29-1.52, respectively. Conclusion: Maternal constipation was associated with an elevated risk of AD in offspring. Clinicians should be aware of the potential link to atopic dermatitis in the children of constipation in pregnant women and should treat gut patency issues during pregnancy. More study is needed to investigate the mechanisms of maternal constipation and atopic diseases in offspring.

Increased prevalence of hearing loss, tinnitus and sudden deafness among patients with Sjögren’s syndrome

BackgroundThis study aimed to provide an updated prevalence of hearing loss, tinnitus, vertigo and sudden deafness on patients with Sjögren’s syndrome and matched comparison patients.MethodsData for this study were retrieved...

Trends in the incidence of peripheral vestibular disorders: a Nationwide population-based study.

This study aimed to examines the long-term trend of incidence of peripheral vestibular disorders between 2010 and 2018 in Taiwan. Study-eligible patients were identified from Taiwan's Longitudinal Health Insurance Database 2005 maintained by the Ministry of Health and Welfare in Taiwan. We retrieved 230,566 patients with a first-time diagnosis of peripheral vestibular disorders between 2010 and 2018. We calculated annual incidence rates of peripheral vestibular disorders per 100,000 population. We used the annual percent change (APC) to test the trend of peripheral vestibular disorders over time. The mean annual incidence rate of peripheral vestibular disorders during the study period was 1489.6 per 100,000 population. Incidence showed a statistically significant steady decrease from 2010 to 2018 with a mean APC of -6.15% (95% CI = -6.97% ~ -5.32%). The decline was led by Meniere's disease (APC = -9.83, 95% CI = -10.66% ~ -8.99%), followed by benign paroxysmal positional vertigo (APC = -3.69, 95% CI = -4.53% ~ -3.03%), vestibular neuritis (APC = -7.85, 95% CI = -8.96 ~ -6.73), and other peripheral vestibular dizziness (APC = -5.56, 95% CI = -6.69% ~ -4.43%). The incidence of peripheral vestibular disorders, overall, and the four major subgroups, benign paroxysmal positional vertigo, Meniere's disease, vestibular neuritis, and other peripheral vestibular dizziness, all decreased substantially, year by year within the 2010-2018 period.

Trends in Coprescription Among Taiwanese Children from 2002 to 2012.

Coprescription means that patients use different prescription medications at the same time, which can lead to polypharmacy and subsequent complications. In Taiwan, prescriptions can be ordered by Western physicians, traditional Chinese physicians and dentists. It is essential to disclose the trends in coprescription to prevent possible polypharmacy among children. We used the Longitudinal Health Insurance Database 2000 in Taiwan. Children <18 years old who had coprescription from 2002 to 2012 are included. The odds ratio and 95% confidence interval are estimated by a logistic regression model to evaluate the correlation between basic characteristics and coprescription. A total of 44,801 children are included in the analysis. The numbers of children with coprescription and the numbers of coprescriptions ordered for children increased with calendar years. Children aged 3-5 year and 6-8 years constituted the majority of coprescriptions, while those aged <3 years constituted the minority of coprescriptions. Compared to those in the Western medication-alone group, aged 3-5 years and children who lived in central and southern Taiwan are more likely to have coprescription. Coprescription among Taiwanese children is not uncommon. Healthcare providers, policymakers and parents should be aware of the real coprescription situation among the children.

From Infection to Malignancy: Tracing the Impact of Human Papillomavirus on Uterine Endometrial Cancer in a Nationwide Population-Based Cohort Study.

Uterine endometrial cancer (EC) is the most common gynecological malignancy in Taiwan. This study aimed to investigate the association between human papillomavirus (HPV) infection and the development of uterine EC among Taiwanese women. A nationwide population cohort research approach was employed, leveraging longitudinal health insurance databases (LHID 2007 and 2015) from the National Health Insurance Research Database alongside data from the Taiwan Cancer Registry datasets. A comparative analysis examined 472,420 female patients with HPV infection and 944,840 without HPV infection. The results demonstrated that the HPV cohort exhibited a significantly elevated risk of uterine EC, as evidenced by an adjusted hazard ratio (aHR) of 1.588 (95% CI: 1.335-1.888). Furthermore, this elevated risk extended to type 1 EC with an aHR of 1.671 (95% CI: 1.376-2.029), specifically the endometrioid adenocarcinoma subtype with an aHR 1.686 (95% CI: 1.377-2.065). Importantly, these findings were statistically significant (p < 0.001). In conclusion, this research unveils a potential association between HPV infection and an increased risk of uterine EC, particularly the type 1 endometrial cancer subtype, within the Taiwanese female population. These findings have implications for preventive measures and screening programs targeting HPV infection to reduce the risk of this prevalent gynecological malignancy in Taiwan.

Association Between Endometriosis and Mental Disorders Including Psychiatric Disorders, Suicide, and All-Cause Mortality -A Nationwide Population-Based Cohort Study in Taiwan.

A multitude of previous studies has substantiated that endometriosis correlated highly with psychiatric health. This study aims to investigate the association between endometriosis and psychiatric health. Utilizing the National Health Insurance Research Database of Taiwan, 100,770 enrolled participants, including 20,154 patients with endometriosis and 80,616 in the control group (1:4), matched for age, and index date from Taiwan's Longitudinal Health Insurance Database between January 1, 2000, and December 31, 2015. The Cox proportional regression model was used to compare the risk of mental disorders during the 16 years of follow-up after adjusting for confounding factors. Of the study patients, 4083 (20.26%) developed mental disorders; 9225 of the 80,616 controls (11.44%) developed mental disorders. The Cox regression demonstrated that, after adjusting for age, monthly income, urbanization level, etc., people with endometriosis are more likely to suffer from mental disorders compared to those without endometriosis (hazard ratio [HR]=2.131; 95% confidence interval [CI]= 1.531-2.788; p<0.001). The result illustrated that women over 40 years old had a more significant risk. Compared to people without endometriosis, this study provides evidence that patients with endometriosis are at a 2.131-fold higher risk of developing mental disorders, especially in elder women. Regular psychiatric follow-up might be needed for those patients.

Dose–response association of benzodiazepine use and development of deep vein thrombosis

Benzodiazepines have sedative effects that cause reduced activity in users and may increase the risk of deep vein thrombosis. However, few studies have examined this potential risk of benzodiazepine use. This study examined the association between benzodiazepine use and the risk of deep vein thrombosis (DVT) in adults in Taiwan using a longitudinal health insurance database. The study population included 12,546 individuals with DVT and 50,184 matched controls. Results showed that benzodiazepine use was associated with an increased risk of DVT occurrence (adjusted odds ratio [aOR]: 1.66; 95 % CI, 1.54–1.79; P <0.001), with a dose-response relationship. Patients with a higher defined daily dose had a higher risk of DVT, with ORs of 1.65-, 2.09-, and 2.16-fold higher for those with an average benzodiazepine dose of <0.5, 0.5–0.9, or ≥1 (DDD/day), respectively, compared to nonbenzodiazepine users. Stratification by age, sex, and follow-up duration yielded similar results. This study highlights the need to evaluate the association and benefits of benzodiazepine prescription to decrease the risk of DVT development.

Maternal constipation is associated with allergic rhinitis in the offspring: A nationwide retrospective cohort study.

Allergic rhinitis (AR) is a common atopic disease worldwide, and it was found that babies with constipation in their early life might have an increased risk of atopic diseases, including AR. Furthermore, recent studies also indicate that the maternal gut microbiota may influence babies. Thus, we extended the definition of early life in utero and evaluated the association between maternal constipation and the risk of AR in their babies. Using the Longitudinal Health Insurance Database, a subset of Taiwan's National Health Insurance Research Database, we identified 102,820 constipated mothers and 102,820 matched controls between 2005 and 2015. Propensity score analysis was used to match birth year, child sex, birth weight, gestational age, mode of delivery, maternal comorbidities, and children antibiotics taken. Multiple Cox regression and subgroup analyzes were conducted to estimate the adjusted hazard ratio of childhood AR. The incidence of childhood AR was 83.47 per 1,000 person-years in constipated mothers. Adjusting children's sex, birth weight, gestational age, mode of delivery, maternal comorbidities, and children antibiotic use, the results showed that the children whose mothers had constipation had a 1.20-fold risk of AR compared to children of mothers without constipation. Maternal constipation was associated with an increased risk of AR. Therefore, it is important to pay close attention to pregnant mothers with constipation.

Increased prevalences of head and neck cancers in patients with Sjögren's syndrome.

This study aimed to investigate prevalences of head and neck cancers in patients with and those without Sjögren's syndrome using a population-based dataset. We retrieved sampled patients from Taiwan's Longitudinal Health Insurance Database. This study included 38 930 patients with Sjögren's syndrome and 155 720 propensity-score matched comparison patients without Sjögren's syndrome. Chi-squared tests revealed that there was a statistically significant difference in the prevalences of head and neck cancers between patients with Sjögren's syndrome and comparison patients (1.77% vs. 1.22%, p < 0.001). The odds ratio for head and neck cancers for patients with Sjögren's syndrome relative to the comparison group was 1.452 (95% CI = 1.325-1.592). Our study demonstrated that patients with Sjögren's syndrome face increased odds of head and neck cancers, encompassing several sites including the oral cavity, oropharynx, nasopharynx, and thyroid.