646 results on '"Chih Cheng Hsu"'
Search Results
52. Metformin Use before Influenza Vaccination May Lower the Risks of Influenza and Related Complications
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Fu-Shun Yen, James Cheng-Chung Wei, Ying-Hsiu Shih, Chung Y. Hsu, Chih-Cheng Hsu, and Chii-Min Hwu
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influenza ,vaccination ,pneumonia ,mortality ,Medicine - Abstract
Older adults are more likely to have influenza and respond less well to the flu vaccine. We conducted this study to investigate whether pre-influenza vaccination metformin use had an effect on influenza and relevant complications in older adults with type 2 diabetes mellitus. Propensity score matching was used to identify 28,169 pairs of metformin users and nonusers from Taiwan’s National Health Insurance Research Database from 1 January 2000 to 31 December 2018. We used Cox proportional hazards models to calculate the risks of hospitalization for influenza, pneumonia, cardiovascular disease, ventilation, and mortality between metformin users and nonusers. Compared with metformin nonusers, the aHRs (95% CI) for metformin users at risk of hospitalization for influenza, pneumonia, cardiovascular disease, invasive mechanical ventilation, death due to cardiovascular disease, and all-cause mortality were 0.60 (0.34, 1.060), 0.63 (0.53, 0.76), 0.41 (0.36, 0.47), 0.56 (0.45, 0.71), 0.49 (0.33, 0.73), and 0.44 (0.39, 0.51), respectively. Higher cumulative duration of metformin use was associated with lower risks of these outcomes than no use of metformin. This cohort study demonstrated that pre-influenza vaccination metformin use was associated with lower risks of hospitalizations for influenza, pneumonia, cardiovascular disease, mechanical ventilation, and mortality compared to metformin nonusers.
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- 2022
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53. Risk of Dementia after Exposure to Contrast Media: A Nationwide, Population-Based Cohort Study
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Tung-Min Yu, Ya-Wen Chuang, Shih-Ting Huang, Jin-An Huang, Cheng-Hsu Chen, Mu-Chi Chung, Chun-Yi Wu, Pi-Yi Chang, Chih-Cheng Hsu, and Ming-Ju Wu
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dementia ,contrast medium ,Alzheimer’s disease ,vascular dementia ,Biology (General) ,QH301-705.5 - Abstract
Contrast-medium-associated kidney injury is caused by the infusion of contrast media. Small vessel disease is significantly associated with various diseases, including simultaneous conditions of the kidney and brain, which are highly vulnerable to similar vascular damage and microvascular pathologies. Data to investigate the adverse effect of contrast media on the brain remain extremely lacking. In this study, 11,332,616 NHI enrollees were selected and divided into two groups, exposed and not exposed to a contrast medium during the observation period, from which 1,461,684 pairs were selected for analyses through matching in terms of age, sex, comorbidities, and frequency of outpatient visits during the previous year. In total, 1,461,684 patients exposed to a contrast medium and 1,461,684 controls not exposed to one were enrolled. In multivariable Cox proportional hazard models, patients exposed to a contrast medium had an overall 2.09-fold higher risk of dementia. In multivariable-stratified analyses, the risk of Alzheimer’s disease was remarkably high in younger patients without any underlying comorbidity. This study is the first to discover that exposure to contrast media is significantly associated with the risk of dementia. A four-fold increased risk of vascular dementia was observed after exposure to a contrast medium. Further studies on the influence of exposure to contrast media on the brain are warranted.
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- 2022
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54. Study design and recruitment for a prospective controlled study of diabesity: Taiwan Diabesity Study
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Wei-Jei Lee, Yi-Cheng Chang, Owaid Almalki, Seh-Huang Chao, Chieh Hsiang Lu, Ching-Chu Chen, Yu-Yao Huang, Yi-Chih Lee, and Chih-Cheng Hsu
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Surgery ,RD1-811 - Abstract
Summary: Background: Strong evidence has shown that metabolic surgery is more effective than medical treatment in the treatment of type 2 diabetic patients. However, no study demonstrated a survival benefit and reduction of diabetes-related end-organ damage. Here, we describe the study design of a large prospective cohort study, the Taiwan Diabesity Study (TDS) which would compare the long-term survival rate and end-organ damage between overweight/obese type 2 diabetic patients receiving metabolic surgery and medical treatment. Methods: Eligibility criteria include type 2 diabetic patients with duration > 6 months, body mass index (BMI) over 25 kg/m2 and age between 20 and 67 years. Exclusion criteria are serum creatinine over 2.0 mg/dL, C-peptide below 1.0 ng/ml, recent history of cancer, and major diabetic complications. Eligible participants were recruited from six medical centers in Taiwan. The survival rate and diabetes-related end organ damage will be compared between the metabolic surgery group and medical group after follow-up for 10 years. Results: In 3 years, 1016 participants were identified from 38,751 patients. The average BMI of patients was 30.6 (±2.6) kg/m2 and the average hemoglobin A1c was 8.2% (±1.5%) with 18% of them receiving insulin treatment. Among them, 126 patients received metabolic surgery and 890 patients received conventional medical treatment. The metabolic surgery group are younger, have a higher proportion of females, higher BMI and blood lipids as compared to the medical group. Conclusion: The TDS recruited 1016 overweight/obese type 2 diabetic patients including 126 patients receiving metabolic surgery and 890 patients receiving medical treatment. Keywords: Type 2 diabetes mellitus, Obesity, Diabesity, Metabolic surgery, Bariatric surgery, Recruitment
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- 2019
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55. Can peripheral biomarkers reflect the psychological condition in geriatric populations? The influence of cardiovascular comorbidities
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Wei‐Chia Huang, Chi‐Shin Wu, Kai‐Chieh Chang, Hsin‐Shui Chen, Chin‐Kai Chang, Juey‐Jen Hwang, Su‐Hua Huang, Yung‐Ming Chen, Bor‐Wen Cheng, Min‐Hsiu Weng, Chih‐Cheng Hsu, and Wei‐Lieh Huang
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Psychiatry and Mental health ,Geriatrics and Gerontology ,Gerontology - Published
- 2023
56. Author Correction: Aberrant serum parathyroid hormone, calcium, and phosphorus as risk factors for peritonitis in peritoneal dialysis patients
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Chia-Te Liao, Cai-Mei Zheng, Yen-Chung Lin, Mei-Yi Wu, Yuh-Feng Lin, Yung-Ho Hsu, Chih-Cheng Hsu, and Mai-Szu Wu
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Medicine ,Science - Published
- 2022
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57. Urate-lowering therapy may mitigate the risks of hospitalized stroke and mortality in patients with gout.
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Fu-Shun Yen, Chih-Cheng Hsu, Hsin-Lun Li, James Cheng-Chung Wei, and Chii-Min Hwu
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Medicine ,Science - Abstract
ObjectivesAlthough studies have demonstrated the association of hyperuricemia with cardiovascular (CV) diseases, few have explored the effect of urate-lowering therapy (ULT) on the incidence of CV diseases. Therefore, we compared the risks of hospitalized coronary artery disease (CAD), stroke, heart failure (HF), and all-cause mortality between ULT users and nonusers among patients with gout.MethodsWe performed this retrospective cohort study using Taiwan's population-based National Health Insurance Research Database. In total, 5218 patients with gout were included from 2000 to 2012. We compared the incidence rates (IRs) of hospitalized CAD, stroke, HF, and all-cause mortality between ULT users and matched nonusers.ResultsThe IRs of hospitalized stroke were 0.6 and 1.0 per 100 person-years for ULT users and nonusers, respectively, after adjusting for age, sex, residence, comorbidities, and medications. ULT users showed lower adjusted hazard ratios (aHR) for hospitalized stroke (aHR: 0.52, p < 0.001) and all-cause mortality (aHR: 0.6, p = 0.02) than nonusers. Subgroup analyses revealed that uricosuric agents and xanthine oxidase inhibitors were significantly associated with lower risks of hospitalized stroke and all-cause mortality, respectively. The effect of uricosuric agents on the decrease in hospitalized stroke risk indicated a dose-response relationship.ConclusionsOur study showed lower risks of hospitalized stroke and all-cause mortality in ULT users than in nonusers among patients with gout. Therefore, patients with gout may receive ULT to mitigate the risks of hospitalized stroke and mortality.
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- 2020
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58. Sulfonylureas may be useful for glycemic management in patients with diabetes and liver cirrhosis.
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Fu-Shun Yen, Jung-Nien Lai, James Cheng-Chung Wei, Lu-Ting Chiu, Chii-Min Hwu, Ming-Chih Hou, and Chih-Cheng Hsu
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Medicine ,Science - Abstract
This study aimed to investigate the long-term outcomes of sulfonylurea (SU) use in patients with T2DM and compensated liver cirrhosis. From January 1, 2000, to December 31, 2012, we selected the data of 3781 propensity-score-matched SU users and nonusers from Taiwan's National Health Insurance Research Database. The mean follow-up time for this study was 5.74 years. Cox proportional hazards models with robust sandwich standard error estimates were used to compare the risks of main outcomes between SU users and nonusers. The incidence of mortality during follow-up was 3.24 and 4.09 per 100 person-years for SU users and nonusers, respectively. The adjusted hazard ratios and 95% confidence intervals for all-cause mortality, major cardiovascular events, and decompensated cirrhosis in SU users relative to SU nonusers were 0.79 (0.71-0.88), 0.69 (0.61-0.80), and 0.82 (0.66-1.03), respectively. The SU-associated lower risks of death and cardiovascular events seemed to have a dose-response trend. This population-based cohort study demonstrated that SU use was associated with lower risks of death and major cardiovascular events compared with SU non-use in patients with T2DM and compensated liver cirrhosis. SUs may be useful for glycemic management for patients with liver cirrhosis.
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- 2020
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59. 2019 Diabetes Atlas: Achievements and challenges in diabetes care in Taiwan
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Chih-Cheng Hsu, Shih-Te Tu, and Wayne Huey-Herng Sheu
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Medicine (General) ,R5-920 - Abstract
The 2019 Diabetes Atlas delineated both accomplishments and challenges in diabetes care in Taiwan between 2005 and 2014. The series reported that Taiwan had significantly improved aspects of care quality for patients with diabetes. For example, the mortality rate decreased, the difference between the life expectancies of patients with diabetes and those of the general population decreased, and the rates of hospitalization because of heart diseases, cerebrovascular diseases, chronic kidney diseases, and unsatisfactory glycemic control decreased. However, despite these achievements, the 2019 Diabetes Atlas also reported some substantial challenges that have not been overcome. For example, the incidence of diabetes among women aged
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- 2019
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60. Trends in antidiabetic medical treatment from 2005 to 2014 in Taiwan
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Chih-Hsun Chu, Chih-Cheng Hsu, Shih-Yi Lin, Lee-Ming Chuang, Jia-Sin Liu, and Shih-Te Tu
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Medicine (General) ,R5-920 - Abstract
Background/Purpose: Several new antidiabetic drugs have been introduced in Taiwan. However, the trends in antidiabetic treatment remain unexamined. Methods: We studied data from the Taiwan National Health Insurance Database to identify outpatient prescriptions for antidiabetic drugs from 2005 to 2014. The patterns in antidiabetic treatment and the number of different classes of antidiabetic drugs were analyzed. The proportions of prescriptions of antidiabetic monotherapy, combination therapy, or insulin therapy were further analyzed. Results: The total and mean prescriptions gradually increased during the study period. Prescription of oral antidiabetic drugs (OADs) only or insulin-only therapy decreased slightly. Prescriptions of monotherapy and dual therapy decreased, whereas those of triple or higher order combinations increased. Prescriptions of sulfonylureas (SUs) decreased, whereas those of metformin and dipeptidyl peptidease-4 (DPP4) inhibitors increased. Insulin prescriptions increased but accounted for only 13.07% of prescriptions in 2014. Among monotherapy prescriptions, SU prescriptions decreased, but metformin and DPP4 inhibitor prescriptions increased. Among dual OAD prescriptions, those including SUs decreased, and those of metformin and DPP4 inhibitors increased. Although prescriptions of the metformin–SU combination decreased, they remained the most common among all dual OAD prescriptions, followed by the metformin–DPP4 inhibitor combination. Prescriptions of human insulin decreased and those of insulin analogs increased considerably; those of basal insulin increased, and those of mixed insulin decreased. However, mixed insulin was prescribed more than basal–bolus insulin. Conclusion: Antidiabetic treatment has become complex in Taiwan. Although combination therapy would become the major treatment strategy gradually, the underuse of insulin therapy must improve. Keywords: Antidiabetic drugs, Diabetes, Insulin, Oral antidiabetic drugs
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- 2019
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61. Diabetes-related kidney, eye, and foot disease in Taiwan: An analysis of nationwide data from 2005 to 2014
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Kun-Der Lin, Chih-Cheng Hsu, Horng-Yih Ou, Chih-Yuan Wang, Ming-Chu Chin, and Shyi-Jang Shin
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Medicine (General) ,R5-920 - Abstract
Background/Purpose: Patients with diabetes have a higher risk of developing chronic complications and cause a huge burden to the public health care system as well as on patients and their families. We studied these diabetic complications about kidney, eye and peripheral vascular diseases to understand their prevalence and distributions in a national survey. Methods: We analyzed diabetic complications using National-Health-Insurance claims filed from 2005 to 2014. We used this database to evaluate their developments of kidney, eye, and peripheral vascular diseases according to the International-Classification-of-Diseases, Ninth Revision using clinical modification diagnosis codes. Results: The prevalence of diabetic kidney disease (DKD) significantly increased from 10.49% to 17.92% from 2005 to 2014. The prevalence rate of diabetic foot significantly decreased from 1.34% to 1.05% from 2005 to 2014, and the rate of severe infection also significantly decreased from 50.69% to 45.85%. The amputation rate significantly decreased from 24.91% to 17.47% among all patients with diabetic foot. Conclusion: In this study, the trends in DKD and dialysis prevalence were similar to those of the 2012 report. The rate of increase in dialysis prevalence is lower in this study than in the 2012 report. The prevalence of diabetic foot, severe infection, and amputation in this report exhibited significantly decreasing trends. This improvement may be attributable to care from multidisciplinary teams. We should dedicate more resources to our prevention program of DKD and retinopathy to further improve outcomes in the future. Keywords: Diabetic foot, Diabetic kidney disease, Diabetic nephropathy, Diabetic retinopathy, End-stage kidney disease
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- 2019
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62. A Numerical Investigation on Bubble Formation in Coolant Channel with Various Ethylene Glycol and Water Compositions and Change in Contact Angle.
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Vamshi Krishna Chitikase and Chih-Cheng Hsu
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- 2016
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63. Latch Clustering for Minimizing Detection-to-Boosting Latency Toward Low-Power Resilient Circuits.
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Chih-Cheng Hsu, Mark Po-Hung Lin, and Masanori Hashimoto
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- 2016
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64. Diabetes, Hypertension, and the Risk of Dementia
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Fu-Shun, Yen, James Cheng-Chung, Wei, Hei-Tung, Yip, Chii-Min, Hwu, and Chih-Cheng, Hsu
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Male ,Dementia, Vascular ,General Neuroscience ,Taiwan ,General Medicine ,Cohort Studies ,Psychiatry and Mental health ,Clinical Psychology ,Diabetes Mellitus, Type 2 ,Risk Factors ,Hypertension ,Humans ,Female ,Geriatrics and Gerontology ,Retrospective Studies - Abstract
Background: Type 2 diabetes (T2D) and hypertension (HTN) are well-known modifiable risk factors for dementia, but their intricate attributes accounting for dementia development has not been clearly delineated. Objective: We conducted this study to investigate and compare the effects of T2D and HTN on dementia risk. Methods: We screened data of matched pairs of patients with T2D or HTN between January 1, 2000 and December 31, 2017 from Taiwan’s National Health Insurance Research Database. Fine and Gray’s subdistribution hazard models were used for calculating the risk of dementia. Results: Patients with T2D and subsequent HTN were associated with significantly higher risks of all-cause dementia (aHR 1.51, 95% CI 1.25–1.83) and vascular dementia (aHR 2.30, 95% CI 1.71–3.13) compared with those without subsequent HTN. Patients with HTN and subsequent T2D were associated with significantly higher risks of all-cause dementia (aHR 1.15, 95% CI 1.08–1.21), vascular dementia (aHR 1.25, 95% CI 1.62–1.34), and other dementia (aHR 1.31, 95% CI 1.03–1.66) compared with those without subsequent HTN. The subgroups of male and female patients, age of 50–69 and 70–90 years with subsequent comorbidity were associated with significantly higher risks of all-cause dementia and vascular dementia than those without subsequent comorbidity. Conclusion: This nationwide cohort study demonstrated that patients with T2D and subsequent HTN had association with higher risks of all-cause dementia and vascular dementia, and those with HTN and subsequent T2D were associated with higher risks of all-cause dementia, vascular dementia, and other dementia.
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- 2022
65. Data Analysis of the Risks of Type 2 Diabetes Mellitus Complications before Death Using a Data-Driven Modelling Approach: Methodologies and Challenges in Prolonged Diseases
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Ming-Yen Lin, Jia-Sin Liu, Tzu-Yang Huang, Ping-Hsun Wu, Yi-Wen Chiu, Yihuang Kang, Chih-Cheng Hsu, Shang-Jyh Hwang, and Hsing Luh
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type 2 diabetes ,complication ,discrete event simulation ,electronic health record ,Information technology ,T58.5-58.64 - Abstract
(1) Background: A disease prediction model derived from real-world data is an important tool for managing type 2 diabetes mellitus (T2D). However, an appropriate prediction model for the Asian T2D population has not yet been developed. Hence, this study described construction details of the T2D Holistic Care model via estimating the probability of diabetes-related complications and the time-to-occurrence from a population-based database. (2) Methods: The model was based on the database of a Taiwan pay-for-performance reimbursement scheme for T2D between November 2002 and July 2017. A nonhomogeneous Markov model was applied to simulate multistate (7 main complications and death) transition probability after considering the sequential and repeated difficulties. (3) Results: The Markov model was constructed based on clinical care information from 163,452 patients with T2D, with a mean follow-up time of 5.5 years. After simulating a cohort of 100,000 hypothetical patients over a 10-year time horizon based on selected patient characteristics at baseline, a good predicted complication and mortality rates with a small range of absolute error (0.3–3.2%) were validated in the original cohort. Better and optimal predictabilities were further confirmed compared to the UKPDS Outcomes model and applied the model to other Asian populations, respectively. (4) Contribution: The study provides well-elucidated evidence to apply real-world data to the estimation of the occurrence and time point of major diabetes-related complications over a patient’s lifetime. Further applications in health decision science are encouraged.
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- 2021
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66. Minimizing detection-to-boosting latency toward low-power error-resilient circuits.
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Chih-Cheng Hsu, Masanori Hashimoto, and Mark Po-Hung Lin
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- 2017
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67. Low-power gated clock tree optimization for three-dimensional integrated circuits.
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Yu-Chuan Chen, Chih-Cheng Hsu, and Mark Po-Hung Lin
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- 2015
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68. Association of Nonsteroidal Anti-inflammatory Drug Use With Stroke Among Dialysis Patients
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Chih-Cheng Hsu, Yu-Kang Chang, Yueh-Han Hsu, Yu-Ru Lo, Jia-Sin Liu, Chao A. Hsiung, and Hui-Ju Tsai
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dialysis ,nonsteriodal anti-inflammatory drugs ,stroke ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Limited studies have evaluated risk of stroke associated with the use of NSAIDs in patients with end-stage kidney disease. We examined the adverse effects of selective and nonselective NSAID use on the risk of stroke in dialysis patients. Methods: A case-crossover study was conducted using medical claims data from the National Health Insurance Research Database in Taiwan. We identified patients with ischemic and hemorrhagic stroke (defined as International Classification of Diseases, 9th revision, Clinical Modification codes 433, 434, and 436 for ischemic stroke and 430 and 431 for hemorrhagic stroke) from inpatient claims during the period from 2003 to 2012. Conditional logistic regression models with adjustment for potential confounders were used to determine the effects of NSAID use on stroke. Results: A total of 1190 dialysis patients with stroke were identified from 2003 to 2012. The results indicate a 1.31-fold increased risk of stroke related to NSAID use during the 30 days prior to a stroke (AOR = 1.31; 95% CI: 1.03–1.66); likewise, an excessive risk of ischemic stroke was observed (AOR = 1.34; 95% CI: 1.02–1.77). When classifying NSAIDs into selective and nonselective groups, nonselective NSAID use was significantly associated with an increased risk of stroke (AOR = 1.27; 95% CI: 1.00–1.61). Discussion: In summary, the results show supportive evidence that NSAID use increased the risk of stroke in dialysis patients, which suggests the importance of closely monitoring the transient effects of initial NSAID treatment to patients on dialysis.
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- 2017
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69. Role of Physical Activity in Lowering Risk of End-Stage Renal Disease
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Min-Kuang, Tsai, Wayne, Gao, Kuo-Liong, Chien, Chih-Cheng, Hsu, and Chi-Pang, Wen
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Male ,Leisure Activities ,Risk Factors ,Diabetes Mellitus ,Humans ,Kidney Failure, Chronic ,Female ,General Medicine ,Motor Activity ,Exercise - Abstract
To investigate the association between the amount and intensity of leisure-time physical activity (LTPA) and the risk of end-stage renal disease (ESRD).The study examined a cohort of 543,667 participants aged 20 years and older who participated in a health screening program from January 1, 1996, through December 31, 2017. We identified 2520 individuals undergoing dialysis or who had a kidney transplant by linking participants' encrypted personal identification with the registry for ESRD with a median follow-up of 13 years. We classified participants into 5 categories measured by metabolic equivalent of tasks. Within each category, we analyzed the effect of moderate- and vigorous-intensity LTPA in reducing risk of ESRD. We used a Cox proportional hazards model to calculate hazard ratios (HRs).We observed a dose-response relationship between LTPA and the risk of ESRD. The fully active group had a 12% lower hazard of ESRD compared with the no reported LTPA group (HR, 0.88; 95% CI, 0.80 to 0.98) adjusting for covariates including baseline estimated glomerular filtration rate and proteinuria. Within the same category of LTPA, vigorous-intensity exercise carried a 35% lower HR for ESRD compared with moderate-intensity exercise (HR, 0.65; 95% CI, 0.52 to 0.81). The effect was observed stronger among men, younger participants, and participants with diabetes or hyperlipidemia.Sustained LTPA (≥ 150 minutes per week), particularly with vigorous intensity, significantly lowered the ESRD risk, even among individuals with comorbidities such as diabetes or hyperlipidemia. This finding suggested that patients with no reported LTPA with cardiovascular risks should engage in more LTPA to lower their risk of ESRD.
- Published
- 2022
70. Multiparametric graph theoretical analysis reveals altered structural and functional network topology in Alzheimer's disease
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Shih-Yen Lin, Chen-Pei Lin, Tsung-Jen Hsieh, Chung-Fen Lin, Sih-Huei Chen, Yi-Ping Chao, Yong-Sheng Chen, Chih-Cheng Hsu, and Li-Wei Kuo
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Computer applications to medicine. Medical informatics ,R858-859.7 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Alzheimer's disease (AD), an irreversible neurodegenerative disease, is the most common type of dementia in elderly people. This present study incorporated multiple structural and functional connectivity metrics into a graph theoretical analysis framework and investigated alterations in brain network topology in patients with mild cognitive impairment (MCI) and AD. By using this multiparametric analysis, we expected different connectivity metrics may reflect additional or complementary information regarding the topological changes in brain networks in MCI or AD. In our study, a total of 73 subjects participated in this study and underwent the magnetic resonance imaging scans. For the structural network, we compared commonly used connectivity metrics, including fractional anisotropy and normalized streamline count, with multiple diffusivity-based metrics. We compared Pearson correlation and covariance by investigating their sensitivities to functional network topology. Significant disruption of structural network topology in MCI and AD was found predominantly in regions within the limbic system, prefrontal and occipital regions, in addition to widespread alterations of local efficiency. At a global scale, our results showed that the disruption of the structural network was consistent across different edge definitions and global network metrics from the MCI to AD stages. Significant changes in connectivity and tract-specific diffusivity were also found in several limbic connections. Our findings suggest that tract-specific metrics (e.g., fractional anisotropy and diffusivity) provide more sensitive and interpretable measurements than does metrics based on streamline count. Besides, the use of inversed radial diffusivity provided additional information for understanding alterations in network topology caused by AD progression and its possible origins. Use of this proposed multiparametric network analysis framework may facilitate early MCI diagnosis and AD prevention. Keywords: Alzheimer's disease, Mild cognitive impairment, Diffusion tensor imaging, Resting-state functional MRI, Brain network, Structural connectivity, Functional connectivity, Graph theoretical analysis
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- 2019
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71. Cancer and mTOR inhibitors in kidney transplantation recipients
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Chih-Chin Kao, Jia-Sin Liu, Yu-Kang Chang, Ming-Huang Lin, Yen-Chung Lin, Hsi-Hsien Chen, Wei-Chiao Chang, Chih-Cheng Hsu, and Mai-Szu Wu
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Chronic kidney disease ,Cancer ,Kidney transplantation ,Mortality ,mTOR inhibitors ,Medicine ,Biology (General) ,QH301-705.5 - Abstract
Background Previous studies show that mTOR inhibitors decrease the risk of cancer development after kidney transplantation. However, the effect of cumulative doses of mTOR inhibitors on cancer after kidney transplantation is not well known. Methods In the current study, patients were registered into a national database in Taiwan. Between year 2000 and 2013, 4,563 patients received kidney transplantation. They were divided into two groups, according to mTOR inhibitors usage. The cumulative dose of mTOR inhibitors was recorded. Patients were followed-up until de novo cancer development, death, or the end of 2014. Results Patients were divided into two groups: mTOR inhibitors users (study group, n = 828) and mTOR inhibitors non-users (control group, n = 3,735). The median follow-up duration was 7.8 years. The risk of de novo cancer (hazards ratio (HR) 0.80, 95% CI [0.60–1.09], p = 0.16) and risk of death (HR 1.14, 95% CI [0.82–1.60], p = 0.43) was not different between mTOR inhibitor user and non-user groups. Neither high- nor low-dose exposure to mTOR inhibitors was associated with increased risk of cancer or mortality. Analysis of cancer subtypes showed no influence by mTOR inhibitors. In addition, the cause of mortality was not significantly different between the two groups. Discussion We could not find the association of mTOR inhibitors use and risk of de novo cancer development or mortality in patients with kidney transplantation in Chinese patients. Cumulative exposure to mTOR inhibitors did not change the results.
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- 2018
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72. Dietary Inflammatory Patterns Are Associated With Serum TGs and Insulin in Adults: A Community-Based Study in Taiwan
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Shu-Chun Chuang, I-Chien Wu, Chao Agnes Hsiung, Huei-Ting Chan, Chiu-Wen Cheng, Hui-Ling Chen, Yen-Feng Chiu, Marion M. Lee, Hsing-Yi Chang, and Chih-Cheng Hsu
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Nutrition and Dietetics ,Medicine (miscellaneous) - Published
- 2023
73. Reduced risk of pneumonia and influenza infection after bariatric surgery: a retrospective cohort study among patients with nondiabetic obesity in Taiwan
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Pei-Yun Chen, Chia-Wen Lu, Yi-Hsuan Lee, Chi-Ting Huang, Chih-Cheng Hsu, and Kuo-Chin Huang
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Surgery - Published
- 2023
74. Living Alone and Loneliness in Predicting Health-Related Quality of Life: Results from the Healthy Aging Longitudinal Study in Taiwan (HALST)
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Han-Yun Tseng, Chun-Yi Lee, Chi-Shin Wu, I-Chien Wu, Hsing-Yi Chang, Chih-Cheng Hsu, and Chao Agnes Hsiung
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Purpose. This study examined two related but distinct features of social isolation – living alone and loneliness – concerning their unique and joint effects on predicting health-related quality of life (HRQoL). In addition, we examined the moderating and mediating role of loneliness in the associations between living alone and HRQoL. Method. Analyses were with a nationally representative sample of 5,012 community-residing adults aged 55 and older (Mage = 59.3, SD = 8.1) and with their follow-up data 3.2 years later. Results. At baseline, 9% (n = 508) reported living alone, and 10.3% (n = 586) reported feeling lonely. 2.5% (n = 130) reported both living alone and feeling lonely. A series of regression showed that loneliness was consistently associated with lower physical (PCS) and mental (MCS) components of HRQoL, concurrently and longitudinally, whereas living alone was only associated with lower PCS 3.2 years later. Moderation analysis showed compounded effects of loneliness and living alone in predicting lower MCS. Mediation analyses revealed a cascading effect where living alone was associated with concurrent and subsequent loneliness, which, in turn, was associated with lower PCS and MCS 3.2 years later. Conclusion. Loneliness appeared to be a more potent predictor of lower HRQoL in later life. Nevertheless, living alone could indirectly worsen adults’ HRQoL by either exacerbating the negative impacts of loneliness or triggering a sense of prolonged loneliness predicting lower HRQoL. For practice, programs and policies to improve adults’ HRQoL should pay special attention to older adults who report loneliness, especially those who live alone.
- Published
- 2023
75. Power optimization for clock network with clock gate cloning and flip-flop merging.
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Shih-Chuan Lo, Chih-Cheng Hsu, and Mark Po-Hung Lin
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- 2014
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76. A visualized data analysis for bogus business entity detection.
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Hilary Cheng, Yi-Chuan Lu, and Chih-Cheng Hsu
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- 2014
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77. GreenGlue: Power Optimization for Data Centers through Resource-Guaranteed VM Placement.
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Ming-Te Chen, Chih-Cheng Hsu, Ming-Shing Kuo, Yu-Jung Cheng, and Cheng-Fu Chou
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- 2014
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78. A prediction model with lifestyle factors improves the predictive ability for renal replacement therapy: a cohort of 442 714 Asian adults
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Min-Kuang Tsai, Wayne Gao, Kuo-Liong Chien, Chih-Cheng Hsu, and Chi-Pang Wen
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Transplantation ,Nephrology - Abstract
Background There are limited renal replacement therapy (RRT) prediction models with good performance in the general population. We developed a model that includes lifestyle factors to improve predictive ability for RRT in the population at large. Methods We used data collected between 1996 and 2017 from a medical screening in a cohort comprising 442 714 participants aged 20 years or over. After a median follow-up of 13 years, we identified 2212 individuals with end-stage renal disease (RRT, n: 2091; kidney transplantation, n: 121). We built three models for comparison: model 1: basic model, Kidney Failure Risk Equation with four variables (age, sex, estimated glomerular filtration rate and proteinuria); model 2: basic model + medical history + lifestyle risk factors; and model 3: model 2 + all significant clinical variables. We used the Cox proportional hazards model to construct a points-based model and applied the C statistic. Results Adding lifestyle factors to the basic model, the C statistic improved in model 2 from 0.91 to 0.94 (95% confidence interval: 0.94, 0.95). Model 3 showed even better C statistic value i.e., 0.95 (0.95, 0.96). With a cut-off score of 33, model 3 identified 3% of individuals with RRT risk in 10 years. This model detected over half of individuals progressing to RRT, which was higher than the sensitivity of cohort participants with stage 3 or higher chronic kidney disease (0.53 versus 0.48). Conclusions Our prediction model including medical history and lifestyle factors improved the predictive ability for end-stage renal disease in the general population in addition to chronic kidney disease population.
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- 2022
79. Factors associated with burden among male caregivers for people with dementia
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Chia-Fen Tsai, Mao-Hsuan Huang, Jun-Jun Lee, Kai-Ming Jhang, Ling-Chun Huang, Li-Kai Huang, Wei-Ju Lee, Pi-Shan Sung, Yi-Chien Liu, Wen-Chen Ouyang, Chih-Ming Cheng, Chih-Cheng Hsu, and Jong-Ling Fuh
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Male ,Asia ,Caregivers ,Cost of Illness ,Activities of Daily Living ,Caregiver Burden ,Humans ,Dementia ,General Medicine - Abstract
There is a dearth of information on male dementia caregivers in Asia and, in particular, on the factors relating to caregiver burden. We aimed to identify factors that may be associated with burden among male caregivers of people with dementia (PWD).Data were collected from a national dementia registration survey. The caregiver burden was measured with the short version of the Zarit Burden Interview (ZBI). We analyzed the correlation between ZBI scores and variables, such as demographic data of PWD and their male caregivers, caregivers' monthly income, the relationship between PWD and caregivers, the severity of dementia, physical comorbidities and activities of daily living (ADL) of PWD, and neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory (NPI).A total of 509 PWD and their male caregivers were included. The majority of caregivers were sons (72.1%) and husbands (22.0%). Sons had higher ZBI scores than husbands (28.5 ± 15.2 vs 22.0 ± 17.0; p0.001). Multivariable linear regression showed that sons as caregivers (β = 7.44, p = 0.034), ADL (β = 0.52, p = 0.002), and NPI_severity subscore of apathy (β = 2.74, p = 0.001) were positively associated with ZBI scores.Poor ADL and apathy in PWD and being a patient's son were associated with higher levels of burden among male dementia caregivers. Effective interventions are needed to assist male caregivers in accomplishing their caregiving role and at the same time to alleviate their caregiver burden.
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- 2022
80. Trends in the incidence and prevalence of end-stage kidney disease requiring dialysis in Taiwan: 2010–2018
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Tai-Shuan Lai, Chih-Cheng Hsu, Ming-Huang Lin, Vin-Cent Wu, and Yung-Ming Chen
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Adult ,Male ,Renal Dialysis ,Incidence ,Prevalence ,Taiwan ,Humans ,Kidney Failure, Chronic ,General Medicine ,Middle Aged ,Aged - Abstract
Taiwan has the highest incidence and prevalence of end-stage kidney disease (ESKD) worldwide. However, the epidemiologic features of ESKD requiring dialysis in Taiwan are unclear.Our study population included all patients undergoing chronic dialysis (i.e., receiving dialysis treatment for at least three successive months) from the National Health Insurance Research Database from 2010 to 2018. Dialysis was defined using ICD-9-CM order codes for dialysis treatment. The age-standardized incidence and prevalence rates were calculated based on the World Health Organization standard population.The mean age was 47.7 ± 15.4 years at dialysis initiation. The incidence of ESKD requiring dialysis increased steadily during the study period, whereas the age-standardized incidence rate remained constant. The increased rate was particularly prevalent in men aged 65-74 and 75+ years. Additionally, the percentage of patients with estimated glomerular filtration rates10 mL/min/1.73 mThe annual incidence and prevalence of dialysis increased steadily from 2010 to 2018, whereas the age-standardized incidence and prevalence of dialysis remained stable. The increased numbers of patients undergoing incident and prevalent dialysis were mostly elderly, especially men aged ≥65 years. Age-based prevention strategies and multidisciplinary care should be implemented to target the elderly population at risk of developing ESKD.
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- 2022
81. Healthcare utilization and expenditure among individuals with end-stage kidney disease in Taiwan
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Chia-Chun Lee, Chih-Cheng Hsu, Ming-Huang Lin, Junne-Ming Sung, and Te-Hui Kuo
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National Health Programs ,Taiwan ,Humans ,Kidney Failure, Chronic ,General Medicine ,Health Expenditures ,Patient Acceptance of Health Care - Abstract
The prevalence of end-stage kidney disease (ESKD) in Taiwan has been increasing in recent decades. ESKD care and medical expenditures constitute an important part of the entire healthcare system.This study analyzed data collected from the National Health Insurance (NHI) Research Database from 2010 to 2018.The annual medical cost increased by approximately 4% both in the entire Taiwanese population and in its ESKD population. The total medical expenditure in the ESKD population from 2010 to 2018 increased from 48.03 to 65.65 billion reimbursement points, with dialysis treatments costing higher than non-dialysis treatments. ESKD outpatient and inpatient costs accounted for 10.4%-11.1% and 4.8%-5.6% of the entire NHI expenditure, respectively. The leading cause of inpatient costs was circulatory diseases, accounting for 29.3% of the total ESKD inpatient costs in 2018. Furthermore, percutaneous coronary intervention had the highest cost followed by simple percutaneous transluminal angioplasty. In 2018, the hemodialysis population had the highest average monthly cost of 73 thousand points per person, while the kidney transplant population had the lowest average monthly cost of 39 thousand points per person.Medical expenditure, including both inpatient and outpatient costs, of the ESKD population continued to grow from 2010 to 2018. The non-dialysis cost in the ESKD population was mainly for cardiovascular disease management and vascular access care, for which prevention will always be challenging.
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- 2022
82. Clinical characteristics and outcomes of patients requiring incident dialysis in Taiwan
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Yen-Chung, Lin, Chia-Te, Liao, Cai-Mei, Zheng, Ming-Huang, Lin, Chih-Cheng, Hsu, Yung-Ho, Hsu, and Mai-Szu, Wu
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Renal Dialysis ,Incidence ,Taiwan ,Humans ,Kidney Failure, Chronic ,General Medicine ,Renal Insufficiency, Chronic ,Aged - Abstract
Despite having a well-established pre-end-stage kidney disease (pre-ESKD) care program, Taiwan has a high incidence of ESKD. Unrecovered incident dialysis may lead to the maintenance of dialysis. Contrast medium (CM) or general anesthesia (GA) may also induce dialysis. We aimed to examine the trends for incident dialysis, use of CM or GA, and its long-term trajectory outcomes.Patients who received at least one dialysis intervention between 2010 and 2017 were identified using the National Health Insurance Research Database. We collected information on age, sex, comorbidities, causes of dialysis in outpatient or inpatient settings, use of CM or GA or pre-ESKD program enrolment before incident dialysis, and trajectory outcomes.Incident dialysis occurred more frequently in elderly inpatients with infectious diseases or previous chronic kidney disease (CKD). The number of patients who had a pre-ESKD care plan before incident dialysis increased from 25% in 2010 to 41% in 2017 (P 0.001). In general, CM or GA exposure related with a higher mortality rate. Over the five-year longitudinal follow-up, patients without a history of CKD had a higher mortality rate than those with a history of CKD.Enrolment in the pre-ESKD care program increased, and inpatient incident dialysis decreased. The long-term survival of patients with CKD was higher than that of non-CKD patients after incident dialysis. CM or GA exposure appears to be related to dialysis-induced mortality, and further investigations are warranted.
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- 2022
83. Multidisciplinary care program in pre-end-stage kidney disease from 2010 to 2018 in Taiwan
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Ming-Yen Lin, Min-Yu Chang, Pei-Yu Wu, Ping-Hsun Wu, Ming-Huang Lin, Chih-Cheng Hsu, Jer-Ming Chang, Shang-Jyh Hwang, and Yi-Wen Chiu
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Male ,National Health Programs ,Renal Dialysis ,Taiwan ,Humans ,Kidney Failure, Chronic ,Female ,General Medicine ,Reimbursement, Incentive ,Aged - Abstract
The Taiwanese government launched a universal pay-for-performance (P4P) program in 2006 to promote multidisciplinary care for patients with stage 3b-5 chronic kidney disease (CKD). This study aimed to understand the enrollments, care processes, and outcomes of the P4P program between 2010 and 2018.We conducted a population-based study using the Taiwan National Health Insurance Research Data. We divided the incident dialysis population into joining and not joining P4P groups based on whether patients had joined the pre-ESRD program before dialysis or not. Trends in the medications prescribed, anemia correction, vascular access preparation before dialysis initiation, and cumulative survival rate were compared.The program included more than 100,000 patients with late-stage CKD. Enrollment increased by almost 100% from 2010 to 2018, with increases seen in those over 75 years old (127.5%), male (96.7%), and earlier CKD stages (≥35% stage 3b in 2018). Females were more likely to stay being enrolled. The joining P4P group was prescribed more appropriate medications, such as erythropoietin-stimulating agents and statins. However, a high number of patients were still prescribed metformin (≥40%) and non-steroidal anti-inflammatory drugs (≥20%). Compared to the not joining P4P group, the patients in the P4P group had better anemia management, dialysis preparation, and post-dialysis survival.The patients in the joining P4P program group were delivered more appropriate CKD care and were associated with better survival outcomes. Polices and action plans are needed to extend the coverage of and enrollment in the P4P program.
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- 2022
84. Mortality rate of end-stage kidney disease patients in Taiwan
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Bo-Sheng Wu, Chia-Ling Helen Wei, Chih-Yu Yang, Ming-Huang Lin, Chih-Cheng Hsu, Yu-Juei Hsu, Shih-Hua Lin, and Der-Cherng Tarng
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Survival Rate ,Renal Dialysis ,Taiwan ,Humans ,Kidney Failure, Chronic ,General Medicine ,Retrospective Studies - Abstract
End-stage kidney disease (ESKD) is a global burden that reflects each country's unique condition. We used the National Health Insurance Research Database (NHIRD) of Taiwan to decipher changes in the mortality and international survival rates and to determine the effectiveness of the pre-end-stage renal disease care program (pre-ESRD care program) to guide future health policies for ESKD.We conducted a retrospective cohort analysis of the NHIRD data along with records from the catastrophic illness certificate program of ESKD patients from 2010 to 2018.From 2010 to 2018, the annual dialysis-related mortality rate in Taiwan increased from 10.6 to 11.8 deaths per hundred patient-years. The mortality rate for patients below 40 years appears to be decreasing, reflecting the improved quality of care for ESKD patients. Patients above 75 years showed increasing mortality, indicating the prolonged survival and aging of the ESKD population. Patients undergoing dialysis who participated in the pre-ESRD care program had a higher post-dialysis initiation life expectancy than those who did not participate. Among the program enrollees, the post-dialysis initiation life expectancy was higher in patients who had participated for more than one year. Taiwan has one of the highest ESKD patient survival rates globally.From 2010 to 2018, the reduced mortality in young patients and aging of the ESKD population might indicate that the quality of care in Taiwan for ESKD has improved. Furthermore, a better survival rate after dialysis initiation was observed in the pre-ESRD care program participants.
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- 2022
85. Innovative Head-Mounted System Based on Inertial Sensors and Magnetometer for Detecting Falling Movements.
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Chih-Lung Lin, Wen-Ching Chiu, Ting-Ching Chu, Yuan-Hao Ho, Fu-Hsing Chen, Chih-Cheng Hsu, Ping-Hsiao Hsieh, Chien-Hsu Chen, Chou-Ching K. Lin, Pi-Shan Sung, and Peng-Ting Chen
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- 2020
- Full Text
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86. Association of anemia and iron parameters with mortality among prevalent peritoneal dialysis patients in Taiwan: the AIM-PD study
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Ko-Lin Kuo, Jia-Sin Liu, Ming-Huang Lin, Chih-Cheng Hsu, Der-Cherng Tarng, and the Taiwan Society of Nephrology Renal Registry Data System Research Group
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Science ,Medicine - Abstract
In 1996, the National Health Insurance Administration of Taiwan applied a restrictive reimbursement criteria for erythropoiesis-stimulating agents (ESAs) use in patients with chronic kidney disease. The maximal ESAs dosage allowed by insurance is capped at 20,000 U of epoetin per month. Nephrologists avoided the use of high ESA dosages to achieve a hemoglobin level of 10–11 g/dL using iron supplementation. We assessed the association of anemia and iron parameters with mortality among peritoneal dialysis (AIM-PD) patients. A retrospective cohort study was conducted based on the Taiwan Renal Registry Data System. From January 1, 2000 to December 31, 2008, we enrolled 4356 well-nourished PD patients who were older than 20 years and had been receiving PD for more than 12 months. All patients were divided into subgroups according to different hemoglobin, ferritin and transferrin saturation (TSAT) values. Patients were followed until death or December 31, 2008. In a median 2.9-year study period, 694 (15.9%) patients died. By multivariate adjustment, a hemoglobin level lower than 10 g/dL was significantly associated with a higher risk for all-cause and cardiovascular deaths. Moreover, a serum ferritin level higher than 800 ng/mL was associated with a higher risk for all-cause deaths, and a TSAT value between 20 and 50% was associated with the lowest all-cause mortality. In conclusions, we recommend avoiding a low hemoglobin level and a serum ferritin level of more than 800 ng/mL and maintaining a TSAT value between 20 and 50%, as these conditions were associated with lower risks of all-cause mortality in the AIM-PD study.
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- 2022
87. Early Antiplatelet Resumption and the Risks of Major Bleeding After Intracerebral Hemorrhage
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Chi-Hung Liu, Yi-Ling Wu, Chih-Cheng Hsu, and Tsong-Hai Lee
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Advanced and Specialized Nursing ,Neurology (clinical) ,Cardiology and Cardiovascular Medicine - Abstract
Background: The appropriate timing of resuming antithrombotic therapy after intracerebral hemorrhage (ICH) remains unclear. The aim of this study was to compare the risks of major bleeding between early and late antiplatelet resumption in ICH survivors. Methods: Between 2008 and 2017, ICH patients were available in the National Health Insurance Research Database. Patients with a medication possession ratio of antiplatelet treatment ≥50% before ICH and after antiplatelet resumption were screened. We excluded patients with atrial fibrillation, heart failure, under anticoagulant or hemodialysis treatment, and developed cerebrovascular events or died before antiplatelet resumption. Finally, 1584 eligible patients were divided into EARLY (≤30 days) and LATE groups (31–365 days after the index ICH) based on the timing of antiplatelet resumption. Patients were followed until the occurrence of a clinical outcome, end of 1-year follow-up, death, or until December 31, 2018. The primary outcome was recurrent ICH. The secondary outcomes included all-cause mortality, major hemorrhagic events, major occlusive vascular events, and ischemic stroke. Cox proportional hazard model after matching was used for comparison between the 2 groups. Results: Both the EARLY and LATE groups had a similar risk of 1-year recurrent ICH (EARLY versus LATE: 3.12% versus 3.27%; adjusted hazard ratio [AHR], 0.967 [95% CI, 0.522–1.791]) after matching. Both groups also had a similar risk of each secondary outcome at 1-year follow-up. Subgroup analyses disclosed early antiplatelet resumption in the patients without prior cerebrovascular disease were associated with lower risks of all-cause mortality (AHR, 0.199 [95% CI, 0.054–0.739]) and major hemorrhagic events (AHR, 0.090 [95% CI, 0.010–0.797]), while early antiplatelet resumption in the patients with chronic kidney disease were associated with a lower risk of ischemic stroke (AHR, 0.065 [95% CI, 0.012–0.364]). Conclusions: Early resumption of antiplatelet was as safe as delayed antiplatelet resumption in ICH patients. Besides, those without prior cerebrovascular disease or with chronic kidney disease may benefit more from early antiplatelet resumption.
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- 2023
88. Associations of Prolonged Occupational Sitting with the Spectrum of Kidney Disease: Results from a Cohort of a Half-Million Asian Adults
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Min-Kuang Tsai, Wayne Gao, Kuo-Liong Chien, Chin-Kun Baw, Chih-Cheng Hsu, and Chi-Pang Wen
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Physical Therapy, Sports Therapy and Rehabilitation ,Orthopedics and Sports Medicine - Abstract
Background Kidney diseases are viewed as continuously progressing diseases from microalbuminuria and chronic kidney disease (CKD), to end-stage renal disease (ESRD) and its mortality including deaths. The report on the association between prolonged sitting and kidney diseases is limited. Methods We examined a cohort of 455,506 participants in a screening program in Taiwan conducted between 1996 and 2017. Data on occupational sedentary behavior and physical activity were collected with a standardized questionnaire. The outcomes of ESRD and death were identified by linking with the Catastrophic Illness Dataset and Cause of Death Data. The association between prolonged sitting and CKD, the incidence of ESRD, and death were assessed using logistic regression models to compute odds ratios (ORs) and Cox proportional hazards models for hazard ratios (HRs). Results More than half of the participants, i.e., 265,948 (58.4%), were categorized as “prolonged sitting” during their work. During a median of 13 years of follow-up, we identified 2227 individuals undergoing dialysis and 25,671 deaths. Prolonged occupational sitting was significantly associated with a higher risk of CKD (OR: 1.26, 95% confidence interval: 1.21, 1.31), ESRD (HR: 1.19, 95% CI 1.03, 1.38), and kidney-specific mortality (HR: 1.43, 95% CI 1.07, 1.91) compared to mostly standing participants after controlling for physical activity and other risk factors. Inactive prolonged sitting carries a significantly higher risk of ESRD than physically active mostly standing participants (HR: 1.34, 95% CI 1.04, 1.73). However, active prolonged sitting decreased the risk of ESRD (HR: 1.03, 95% CI 0.79, 1.34) compared to inactive prolonged sitting. Conclusion The results suggest that prolonged occupational sitting is associated with a greater risk of the spectrum of kidney disease, proteinuria, CKD, dialysis (ESRD), and mortality for all causes and kidney diseases. Physical activity, even at a minimal level of 15 min/day (90 min/week) of moderate-intensity exercise, was associated with a reduction in these risks.
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- 2022
89. Sulfonylurea Use in Patients with Type 2 Diabetes and COPD: A Nationwide Population-Based Cohort Study
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Fu-Shun Yen, James Cheng-Chung Wei, Teng-Shun Yu, Chung Y. Hsu, Chih-Cheng Hsu, and Chii-Min Hwu
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Cohort Studies ,Pulmonary Disease, Chronic Obstructive ,Sulfonylurea Compounds ,Diabetes Mellitus, Type 2 ,Cardiovascular Diseases ,Health, Toxicology and Mutagenesis ,Public Health, Environmental and Occupational Health ,Humans ,all-cause mortality ,major adverse cardiovascular events ,non-invasive positive pressure ventilation ,invasive mechanical ventilation ,bacterial pneumonia ,lung cancer ,Retrospective Studies - Abstract
We conducted this study to investigate the long-term outcomes of sulfonylurea (SU) use in patients with chronic obstructive pulmonary disease (COPD) and type 2 diabetes (T2D). We used propensity-score matching to identify 6008 pairs of SU users and nonusers from Taiwan’s National Health Insurance Research Database from 1 January 2000 to 31 December 2017. Cox proportional hazard models were used to compare the risks of mortality, cardiovascular events, non-invasive positive pressure ventilation, invasive mechanical ventilation, bacterial pneumonia, lung cancer, and hypoglycemia between SU users and nonusers. In the matched cohorts, the mean follow-up time for SU users and nonusers was 6.57 and 5.48 years, respectively. Compared with nonusers, SU users showed significantly lower risks of mortality [aHR 0.53(0.48–0.58)], cardiovascular events [aHR 0.88(0.81–0.96)], non-invasive positive pressure ventilation [aHR 0.74(0.6–0.92)], invasive mechanical ventilation [aHR 0.57(0.5–0.66)], and bacterial pneumonia [aHR 0.78(0.7–0.87)]. A longer cumulative duration of SU use was associated with a lower risk of these outcomes. This nationwide cohort study demonstrated that SU use was associated with significantly lower risks of cardiovascular events, ventilation use, bacterial pneumonia, and mortality in patients with COPD and T2D. SU may be a suitable option for diabetes management in these patients.
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- 2022
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90. The Risk of Severe Hypoglycemia and Mortality in Patients with Type 2 Diabetes and Discharged with Acute Liver Injury
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Fu-Shun Yen, Ming-Chih Hou, Chun-Wei Pan, Jia-Sin Liu, Chih-Cheng Hsu, and Chii-Min Hwu
- Subjects
Advanced and Specialized Nursing ,Endocrinology, Diabetes and Metabolism ,Internal Medicine - Abstract
OBJECTIVE To compare the risks of severe hypoglycemia and mortality between patients with type 2 diabetes (T2D) and discharged with and without acute liver injury. RESEARCH DESIGN AND METHODS From 1 January 2000 to 31 December 2010, we identified patients with T2D and hospitalization for acute liver injury and hospitalization for other causes from the National Health Insurance Research Database of Taiwan. Multivariable-adjusted Cox proportional hazards models were used to compare the risks of severe hypoglycemia and mortality between the study and control groups. RESULTS The incidence rates and adjusted hazard ratios (aHRs) for severe hypoglycemia within 90 days and 365 days after discharge were 12.28 and 5.59/1,000 person-years (aHR 1.92 [1.30–2.85]) and 7.35 and 2.9/1,000 person-years (aHR 1.98 [1.52–2.58]) for patients discharged with and without acute liver injury, respectively. The incidence rates and aHRs for mortality within 90 days and 365 days after discharge were 82.4 and 27.54/1,000 person-years (aHR 1.73 [1.46–2.05]) and 36.8 and 9.3/1,000 person-years (aHR 1.94 [1.69–2.24]) for patients discharged with and without acute liver injury, respectively. The subgroup analysis of hypoglycemia risk in patients discharged with acute liver injury revealed no significant interaction in risk factors of age, chronic kidney disease, and medications, except for sex difference, which has significant interaction. CONCLUSIONS This cohort study demonstrated that patients with T2D and discharged with acute liver injury showed significantly higher risks of severe hypoglycemia and mortality within 90 days and 365 days after discharge than patients discharged with other causes.
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- 2022
91. Clock-Tree Aware Multibit Flip-Flop Generation During Placement for Power Optimization.
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Mark Po-Hung Lin, Chih-Cheng Hsu, and Yu-Chuan Chen
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- 2015
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92. Crosstalk-aware multi-bit flip-flop generation for power optimization.
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Chih-Cheng Hsu, Mark Po-Hung Lin, and Yao-Tsung Chang
- Published
- 2015
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93. In-placement clock-tree aware multi-bit flip-flop generation for power optimization.
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Chih-Cheng Hsu, Yu-Chuan Chen, and Mark Po-Hung Lin
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- 2013
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94. Distributed flexible channel assignment in WLANs.
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Chih-Cheng Hsu, Yi-An Liang, Jose Luis Garcia Gomez, Cheng-Fu Chou, and Ching-Ju Lin
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- 2013
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95. Correction to: Individualized home-based exercise and nutrition interventions improve frailty in older adults: a randomized controlled trial
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Tsung-Jen Hsieh, Shin-Chang Su, Chun-Wei Chen, Yaw-Wen Kang, Ming-Hsia Hu, Li-Lin Hsu, Szu-Yun Wu, Likwang Chen, Hsing-Yi Chang, Shao-Yuan Chuang, Wen-Harn Pan, and Chih-Cheng Hsu
- Subjects
Nutritional diseases. Deficiency diseases ,RC620-627 ,Public aspects of medicine ,RA1-1270 - Abstract
Following publication of the original article [1], the author reported that an abbreviation was incorrect in the original article;
- Published
- 2019
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96. Association of Anemia and Iron Parameters With Mortality Among Patients Undergoing Prevalent Hemodialysis in Taiwan: The AIM‐HD Study
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Ko‐Lin Kuo, Szu‐Chun Hung, Wei‐Cheng Tseng, Ming‐Tsun Tsai, Jia‐Sin Liu, Ming‐Huang Lin, Chih‐Cheng Hsu, and Der‐Cherng Tarng
- Subjects
anemia ,erythropoietin ,hemodialysis ,hemoglobin ,iron ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The Taiwan Health Insurance Bureau has conducted a bundled payment system for hemodialysis reimbursement since 1995. The maximum dose of erythropoiesis‐stimulating agents allowed by insurance is capped at 20 000 U of epoetin or 100 μg of darbepoetin alfa per month. Nephrologists have avoided the use of high dosages of erythropoiesis‐stimulating agents to achieve a hemoglobin level of 10 to 11 g/dL by iron supplementation. The clinical impact of these policies on patients’ outcomes is unknown. The authors aimed to assess the AIM‐HD (Association of Anemia, Iron parameters, and Mortality among the prevalent Hemodialysis patients) Study in Taiwan. Methods and Results The AIM‐HD study was conducted based on the Taiwan Renal Registry Data System. From 2001 to 2008, the authors enrolled 42 230 patients undergoing hemodialysis who were older than 20 years and had received hemodialysis for more than 12 months. Patient follow‐ups occurred until death or December 31, 2008. During a study period of 8 years, 12 653 (30.0%) patients died. After multivariate adjustment, the authors found that a hemoglobin level
- Published
- 2018
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97. Crosstalk-aware power optimization with multi-bit flip-flops.
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Chih-Cheng Hsu, Yao-Tsung Chang, and Mark Po-Hung Lin
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- 2012
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98. Epidemiological characteristics of diabetic kidney disease in Taiwan
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Kun-Der Lin, Jun-Sing Wang, Chih-Cheng Hsu, Yueh-Han Hsu, Fu-Shun Yen, and Shyi-Jang Shin
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Adult ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Population ,Taiwan ,Review Article ,Type 2 diabetes ,Prognostic factors ,Diseases of the endocrine glands. Clinical endocrinology ,End stage renal disease ,Young Adult ,Renal Dialysis ,Internal medicine ,Diabetes mellitus ,Prevalence ,Internal Medicine ,medicine ,Humans ,Diabetic Nephropathies ,Diabetic kidney disease ,Family history ,education ,Dialysis ,Aged ,Type 1 diabetes ,education.field_of_study ,business.industry ,Incidence ,General Medicine ,Middle Aged ,RC648-665 ,medicine.disease ,Diabetes Mellitus, Type 1 ,Diabetes Mellitus, Type 2 ,Risk factors ,Kidney Failure, Chronic ,Female ,business ,Dyslipidemia - Abstract
Diabetic kidney disease (DKD) is a critical microvascular complication of diabetes. With the continuous increase in the prevalence of diabetes since 2000, the prevalence of DKD has also been increasing in past years. The prevalence of DKD among individuals with type 2 diabetes in Taiwan increased from 13.32% in 2000 to 17.92% in 2014. The cumulative incidence of DKD among individuals with type 1 diabetes in Taiwan was higher than 30% during 1999–2012. DKD is the leading cause of end‐stage renal disease (ESRD), with a prevalence of approximately 45% in a population on chronic dialysis in Taiwan. Among individuals with type 2 diabetes, the prevalence of ESRD in the receipt of dialysis also increased from 1.32% in 2005 to 1.47% in 2014. Risk factors for DKD development are age, race, family history, hyperglycemia, hypertension, dyslipidemia, dietary patterns, and lifestyles. Prognostic factors that aggravate DKD progression include age, family history, sex, glycemic control, blood pressure (BP), microvascular complications, and atherosclerosis. This review summarizes updated information on the onset and progression of DKD, particularly in the Taiwanese population. Translating these epidemiological features is essential to optimizing the kidney care and improving the prognosis of DKD in Asian populations., This review summarizes updated information on the onset and progression of DKD, particularly in Taiwan. Translating these epidemiological features is essential to optimizing kidney care and improving the prognosis of DKD in Asian populations.
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- 2021
99. Bulldozer: A Cooperative P2P-Based Distribution Platform for User-Centric Content Dissemination.
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Chih-Cheng Hsu, Wei-Liang Shen, Kate Ching-Ju Lin, and Cheng-Fu Chou
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- 2011
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100. Metformin use and the risks of herpes zoster and postherpetic neuralgia in patients with type 2 diabetes
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Fu‐Shun Yen, James Cheng‐Chung Wei, Hei‐Tung Yip, Chih‐Cheng Hsu, and Chii‐Min Hwu
- Subjects
Infectious Diseases ,Virology - Abstract
Herpes zoster and postherpetic neuralgia cause substantial pain in patients. Persons with type 2 diabetes (T2D) are prone to zoster infection and postherpetic neuralgia due to compromised immunity. We conducted this study to evaluate the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers. Propensity score matching was utilized to select 47 472 pairs of metformin users and nonusers from Taiwan's National Health Insurance Research Database between January 1, 2000, and December 31, 2017. The Cox proportional hazards models were used for comparing the risks of herpes zoster and postherpetic neuralgia between metformin users and nonusers in patients with T2D. Compared with no-use of metformin, the adjusted hazard ratios (95% confidence interval) for metformin use in herpes zoster and postherpetic neuralgia were 0.70 (0.66, 0.75) and 0.510 (0.39, 0.68), respectively. A higher cumulative dose of metformin had further lower risks of herpes zoster and postherpetic neuralgia than metformin no-use. This nationwide cohort study demonstrated that metformin use was associated with a significantly lower risk of herpes zoster and postherpetic neuralgia than metformin no-use. Moreover, a higher cumulative dose of metformin was associated with further lower risks of these outcomes.
- Published
- 2022
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