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Purpose: The purpose of this study is to evaluate the association between lipid‐lowering agent use and the risks of diagnosed dry eye disease (DED). Methods: This retrospective, case–control study included 780 786 patients who received lipid‐lowering agents in 2002–2016, of which 17 409 were newly diagnosed with DED during a ≥2‐year follow‐up period. These patients were matched 1:4 with control participants for age, sex, and comorbidities. Separate odds ratios (OR) were calculated for DED and each of statin and fibrate use. Results: Statin users had significantly higher odds of DED (adjusted OR = 1.12; 95% confidence interval (CI) = 1.08–1.16, p < 0.0001) than nonusers. Fibrate users did not show higher odds of DED than nonusers (adjusted OR = 1.04; 95% CI = 0.99–1.10, p = 0.125). The lipophilic statin users did not show higher odds of DED compared with the hydrophilic statin users (adjusted OR = 0.99, 95% CI = 0.93–1.06, p = 0.729). Among statin users, the odds of DED did not differ significantly between patients receiving statin therapy for >180 days vs. ≤90 days or patients receiving statin therapy for 91–180 days vs. ≤90 days (adjusted OR = 1.00, p = 0.922; adjusted OR = 0.94, p = 0.541, respectively). The odds of DED were not statistically different among patients receiving low‐intensity, moderate‐intensity, and high‐intensity of statin therapy. Conclusions: Patients receiving statin therapy had a higher DED risk than patients not receiving statin therapy. The type of statin, the duration, and the intensity of statin use were not significantly associated with DED risks. Further studies are required to identify the relevant factors related to DED risks with statin. [ABSTRACT FROM AUTHOR]

Objective: To investigate natural‐ and unnatural‐cause mortality at different follow‐up time points in Taiwanese patients with anorexia nervosa (AN) and bulimia nervosa (BN). Method: In this longitudinal cohort study, 330,393 patients, including 2143 patients with AN, 13,590 with BN, and 20 times as many respective non‐AN and non‐BN patients, were followed up for 16 years. We performed conditional Cox regression survival analysis to examine the risk of mortality in the AN and BN groups relative to the comparison group. Results: A total of 1242 patients died, including 101 and 343 patients with AN and BN, respectively. Mortality rates for AN and BN were 5.42 and 2.90 deaths per 1000 person‐years, respectively. Compared with the non‐AN group, the AN group had a significantly higher risk of both natural‐ and unnatural‐cause mortality, and the BN group had a significantly higher risk of unnatural‐cause mortality. Suicide was the most common cause of death, and suicide risk was significantly higher in both the AN and BN groups. All‐cause mortality risk was the highest at the beginning of follow‐up and markedly declined in the AN group. In the BN group, all‐cause mortality risk was lower but stable at follow‐up. The risk of unnatural‐cause mortality remained high throughout the follow‐up period for both the groups. Conclusions: Early detection and treatment for associated physical problems in patients with AN are crucial. Regular monitoring for unnatural‐cause mortality events (mainly suicide) in AN and BN over time is also crucial. Public Significance: AN had a significantly higher risk of both natural‐ and unnatural‐cause mortality and BN had a significantly higher risk of death from unnatural causes. All‐cause mortality risk was highest at the beginning of follow‐up in AN, but unnatural‐cause mortality risk remained high throughout the follow‐up period for both groups. Our findings imply that early detection and treatment in AN and regular monitoring for unnatural‐cause mortality events in AN and BN are crucial. [ABSTRACT FROM AUTHOR]

Objective: To investigate the incidence and risk of renal‐related complications in a nationwide cohort of Taiwanese patients with anorexia nervosa (AN). Method: This longitudinal cohort study analyzed the data of 43,951 individuals—comprising 2091 patients with AN and their controls matched (1:20) using propensity scores according to sex, age, degree of urbanization of residence, socioeconomic status, and year of diagnosis—from a population‐based health insurance database; the study lasted 16 years. We used Kaplan–Meier curves to estimate the cumulative incidence of renal events. We also performed Cox proportional regression and constructed a risk model with death as a competing event (both adjusted for basic characteristics, renal diseases, and psychiatric comorbidities) to examine the risk of dialysis and renal outcomes in the AN group relative to the control group. Results: In total, 204 and 10 patients with AN had renal‐related outcomes and end‐stage renal disease (ESRD), respectively. The cumulative incidence rates of all renal outcomes and ESRD in the AN group were 10.72% and.64%, respectively, at 10‐year follow‐up. Compared with the control group, the AN group had a significantly higher risk of acute dialysis (adjusted hazard ratio 2.10 [95% confidence interval 1.19–3.68]), hypokalemia, hypovolemia, nephritis, acute renal failure, and chronic renal failure. The AN group did not have a significantly higher risk of ESRD. Discussion: The elevated risks of acute dialysis and some renal outcomes in AN highlight the importance of monitoring electrolyte imbalance and renal malfunctioning. Public Significance: Malnutrition and purging behaviors may cause renal complications in patients with AN. In this longitudinal cohort study, we found that the 10‐year cumulative incidence of all renal outcomes in AN was 10.72%, and that patients with AN had a two‐fold higher risk of overall renal outcomes compared with those without AN. Our findings imply that weight restoration and ceasing purging behaviors are crucial for recovery from AN. [ABSTRACT FROM AUTHOR]

Multidrug resistance (MDR) resulting from the overexpression of drug transporters such as P-glycoprotein (Pgp) increases the efflux of drugs and thereby limits the effectiveness of chemotherapy. To address this issue, this work develops an injectable hollow microsphere (HM) system that carries the anticancer agent irinotecan (CPT-11) and a NO-releasing donor (NONOate). Upon injection of this system into acidic tumor tissue, environmental protons infiltrate the shell of the HMs and react with their encapsulated NONOate to form NO bubbles that trigger localized drug release and serve as a Pgp-mediated MDR reversal agent. The site-specific drug release and the NO-reduced Pgp-mediated transport can cause the intracellular accumulation of the drug at a concentration that exceeds the cell-killing threshold, eventually inducing its antitumor activity. These results reveal that this pH-responsive HM carrier system provides a potentially effective method for treating cancers that develop MDR. [ABSTRACT FROM AUTHOR]