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Lai S.-W.,China Medical University at Taichung | Muo C.-H.,Data Management | Liao K.-F.,Taichung Tzu Chi General Hospital | Sung F.-C.,Data Management | Chen P.-C.,Data Management
American Journal of Gastroenterology | Year: 2011

Objectives: The objective of this study was to assess the risk of acute pancreatitis among patients with type 2 diabetes mellitus (DM) and identify the roles of co-morbidities and anti-diabetic drugs. Methods: From claims data of one million enrollees randomly sampled from a population covered by the Taiwan National Health Insurance, 19,518 adults with type 2 DM diagnosed between 2000 and 2005 were identified. In addition, 78,072 DM-free persons, frequency matched with sex, age, and index year for comparison were identified. Subjects were followed up until the end of 2008 or censored to ascertain incident acute pancreatitis cases and associations with co-morbidities and anti-diabetic drugs. Results: Patients with type 2 DM had 1.95-fold greater incidence of acute pancreatitis compared with non-diabetics (27.7 vs. 14.2 per 10,000 person-years), with an adjusted hazard ratio (HR) of 1.89 (95% confidence interval (CI)=1.65-2.18) based on multivariable Cox regression analysis. Additive Poisson regression analysis revealed an absolute risk increase of 14.4 per 10,000 person-years (95% CI=13.4-15.5) among type 2 DM patients. Co-morbid alcoholism, hepatitis C infection, and gallstones yielded additional risk of acute pancreatitis among type 2 DM patients (absolute risk increase ranges 86.3, 41.1, and 23.5 per 10,000 person-years, respectively). Patients taking anti-diabetic drugs had a reduced risk of acute pancreatitis, however. The adjusted HR decreased to 0.31 (95% CI=0.18-0.56) among patients who took five different anti-diabetic drugs. Conclusions: Patients with type 2 DM are at an elevated risk of acute pancreatitis. Alcoholism, hepatitis C infection, and gallstones increase the risk further. However, anti-diabetic drugs reduce the risk as the number of drugs used increases and as the duration of treatment increases. © 2011 by the American College of Gastroenterology. Source


Yang C.-C.,Taichung Tzu Chi General Hospital | Hsieh Y.-L.,China Medical University at Taichung
Journal of Tissue Engineering and Regenerative Medicine | Year: 2016

Transplantation of mesenchymal stem cells (MSCs) has been proposed to exert beneficial effects on peripheral nerve regeneration after a peripheral nerve injury, but the functional recovery in the denervated limb is still limited. In this study, we used low-level laser therapy (LLLT) as an adjunct therapy for MSC transplantation on the functional recovery of crushed sciatic nerve in rats. Peripheral nerve injury was induced in 48 Sprague-Dawley rats by crushing the unilateral sciatic nerve, using a vessel clamp. The animals with crushed injury were randomly divided into four groups: control group, with no treatment; MSC group, treated with MSC alone; LLLT group, treated with LLLT alone; and MSCLLLT group, treated with a combination of MSC and LLLT. The sciatic function index (SFI), vertical activity of locomotion (VA) and ankle angle (AA) of rats were examined for functional assessments after treatment. Electrophysiological, morphological and S100 immunohistochemical studies were also conducted. The MSCLLLT group showed a greater recovery in SFI, VA and AA, with significant difference from MSC, LLLT and control groups (p<0.05). Moreover, markedly enhanced electrophysiological function and expression of S100 immunoreactivity, as well as fewer inflammatory cells and less vacuole formation were also demonstrated after nerve crush injury in the MSCLLLT group when compared with the groups receiving a single treatment (p<0.05). MSC transplantation combined with LLLT could achieve better results in functional recovery than a conventional treatment of MSC or LLLT alone. LLLT has a synergistic effect in providing greater functional recovery with MSC transplantation after nerve crush injury. Copyright © 2016 John Wiley & Sons, Ltd. Source


Lai S.-W.,China Medical University at Taichung | Lin C.-L.,China Medical University at Taichung | Lin C.-L.,Data Management | Liao K.-F.,China Medical University at Taichung | Tsai S.-M.,Taichung Tzu Chi General Hospital
European Journal of Clinical Microbiology and Infectious Diseases | Year: 2014

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. © 2014 Springer-Verlag. Source


Lai S.-W.,China Medical University at Taichung | Lin C.-L.,China Medical University at Taichung | Lin C.-L.,Data Management | Liao K.-F.,China Medical University at Taichung | Lin C.-Y.,Taichung Tzu Chi General Hospital
Heart Rhythm | Year: 2015

BACKGROUND: There is still lack of strong evidence, based on systematic studies, that support the relationship between amiodarone use and the risk of acute pancreatitis. OBJECTIVE: The aim of this study was to explore the relationship between amiodarone use and the risk of acute pancreatitis in Taiwan. METHODS: This case-control study was based on the analysis of the claim data from Taiwan's national health insurance program from 2000 to 2011. There were 4986 subjects aged 20-84 years with a first episode of acute pancreatitis as the case group and 19,944 randomly selected subjects without acute pancreatitis matched for sex, age, and index year as the control group. Amiodarone use was defined as "current," "recent," or "past" if the most recent amiodarone prescription was filled within 3 months, between 3 and 6 months, or >6 months before the date of acute pancreatitis diagnosis, respectively. The relative risk of acute pancreatitis associated with amiodarone use was measured by the odds ratio with 95% confidence interval using the multivariable unconditional logistic regression model. RESULTS: After adjustment for confounding factors, current use of amiodarone was positively associated with acute pancreatitis (adjusted odds ratio 5.21; 95% confidence interval 3.22-8.43). There was no significant association between recent or past amiodarone use and acute pancreatitis. CONCLUSION: People with current use of amiodarone are at an increased risk of acute pancreatitis. Physicians should be more cautious about acute pancreatitis risk when prescribing amiodarone. © 2015 Heart Rhythm Society. All rights reserved. Source


Lai S.-W.,China Medical University at Taichung | Lin C.-L.,China Medical University at Taichung | Lin C.-L.,Data Management | Liao K.-F.,China Medical University at Taichung | Chang-Ou K.-C.,Taichung Tzu Chi General Hospital
Parkinsonism and Related Disorders | Year: 2015

Background: The purpose of this study was to investigate whether there is an association between cataracts and Parkinson's disease in Taiwan. Methods: A retrospective cohort study was conducted to analyze the database of the Taiwan National Health Insurance Program from 1999 to 2002. This study consisted of 26,031 individuals aged 40-84 years with newly diagnosed cataracts as the cataract group and 25,937 randomly selected individuals without cataracts as the non-cataract group. Both groups were matched for sex, age and index year of diagnosing cataracts. The incidence of Parkinson's disease by the end of 2011 and the association of Parkinson's disease with cataracts and other comorbidities were measured. Results: The overall incidence of Parkinson's disease was 1.48-fold higher in the cataract group than the non-cataract group (3.18 vs. 2.15 per 1000 person-years, crude HR 1.48, 95% CI 1.32, 1.66). After adjusting for confounding factors, the adjusted HR of Parkinson's disease was 1.26 (95% CI 1.12, 1.42) for the cataract group, when compared with the non-cataract group. Dementia (HR 2.72, 95% CI 1.92, 3.84), depression (HR 2.09, 95% CI 1.63, 2.66), hypertension (HR 1.42, 95% CI 1.26, 1.61), cerebrovascular disease (HR 1.32, 95% CI 1.07, 1.63) and age (every one year, HR 1.08, 95% CI 1.07, 1.09) were other factors significantly related to Parkinson's disease. Conclusions: Overall, this study discloses a 26% increased hazard of Parkinson's disease in cataract patients. Further studies are required to investigate whether cataracts are one of non-motor manifestations of Parkinson's disease. •Cataract patients had a 1.48-fold higher in the incidence of Parkinson's disease•Cataract patients had a 26% increased hazard of Parkinson's disease.•Mitochondrial dysfunction may play a key role in this issue. © 2014 Elsevier Ltd. Source

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