ABSTRACT
Objective@#To investigate the effects of parental feeding practices on anemia in children aged 0-6 years in the minority area of the plateau, and to provide evidence for anemia intervention.@*Methods@#A total of 1 726 children aged 0-6 years in 4 counties of Gannan Tibetan Autonomous Prefecture were selected by stratified random cluster sampling to measure hemoglobin level. Parental feeding practices were evaluated.@*Results@#The anemia prevalence rate among children aged 0-6 years was 50.3%. The prevalence of anemia was higher in those with younger age, Tibetan ethnic, rural residence, low parents education level and family income(χ2=156.95，899.51，148.17，8.18，16.36，11.03，P<0.05). Parentl awareness rates on feeding knowledge were 10.0%-53.7%. The report rates of distraction and force-feeding were 51.4% and 36.1%, respectively. Logistic regression analysis showed that parents incorrect feeding knowledge and compulsive feeding behaviors were positively associated with anemia in children(P<0.05).@*Conclusion@#Improvement of parents health literacy and feeding behavior is an important intervention to reduce anemia in children aged 0-6 years.
ABSTRACT
Objective@#To analyze the characteristics of perioperative mortality (POM) in oral maxillofacial head and neck cancer patients.@*Methods@#A retrospective study was adapted for head and neck cancer patients who were treated and had POM in the department of oral maxillofacial & head and neck oncology in Shanghai Ninth People′s Hospital from Jan 1999 to Dec 2019. Demographic information, disease characteristic and clinical records were collected. The factors of POM were classified into surgical complication, medical complication, mixed complication (surgical and medical) and personal complication. SPSS 17.0 software was used to analyze the cause composition for POM under different condition.@*Results @# 55 patients were included: 39 were male, and 16 were female. A total of 12 patients had a smoking history. Furthermore, 28 patients had general comorbidities. 20 underwent preoperative radiotherapy and 9 received preoperative chemotherapy. Squamous cell carcinoma was the most frequent pathological diagnosis in 37 patients. A total of 9 patients had tumors in the maxilla and skull base. In addtition, 4 patients had POM preoperatively, 1 patient had POM within the operation, and 50 patients had POM postoperatively. The leading causes of death were as follows: rupture of the carotid artery was the most frequent (8), and the surgical complication of pulmonary infection was the main medical complication (6). Pulmonary infection and hemorrhage were regarded as the main mixed complication (4). Two patients had POM due to personal complications. The higher the American Society of Anesthesiologists (ASA) score, the higher the proportion of medical factors in POM (P=0.039).@*Conclusion@#The composition of POM in oral maxillofacial- head and neck cancer (OMHNC) patients was complicated. Carotid artery rupture was the most common and fatal surgical complication, especially for those who underwent preoperative radiotherapy. Pulmonary infection was the most frequent medical complication, and those who had a higher ASA grade tended to have more complication.
ABSTRACT
Objective@#To investigate the epidemiology of iron-deficiency anemia among children aged 0-6 years in plateau area,and to provide a basis for the formulation of prevention and treatment measures for anemia.@*Methods@#A total of 1 512 children aged 0-6 years were randomly selected from 4 counties in plateau area by stratified and cluster sampling. Blood hemoglobin level was tested. Child dietary behaviors were collected from their parents.@*Results@#There were significant differences in the prevalence of children with different age, family location, education level of main dependants, occupation of main dependants and per capita income of family(χ2=12.83,39.48,27.05,44.26,32.45, P<0.05).No significant difference for anemia prevalence in gender and nationality was found. The prevalence of anemia among children aged 0-6 years was 67.0%, and the prevalence was highest among children aged 1 years while decreased with age.Univariate analysis of variance showed that the prevalence anemia was 74.0% in rural children, which was significantly higher than children in urban area 58.6%(χ2=39.48,P<0.05). Low education and income level of caregiver, husbandry in the family, no exclusive breastfeeding under 6 months, and picky eaters positively associated with high prevalence of anemia. The prevalence rate of anemia in 0-6 months old infants fed with mixed feeding and artificial feeding (73.1%, 75.0%) was higher than that of breast feeding (48.9%) (χ2=6.78, P<0.05). Picky eating can lead to a high incidence of anemia in children.@*Conclusion@#Promoting healthy diets and correcting unhealthy dietary pattern through nutrition education to parents might be effective ways to lower the prevalence of anemia among children in plateau areas.
ABSTRACT
OBJECTIVE: To estimate the incidence and prevalence of thromboangiitis obliterans in Taiwan in the period spanning from 2002 to 2011. METHODS: We identified all incident and prevalent cases with a diagnosis of thromboangiitis obliterans (International Classification of Diseases, Ninth Revision code 443.1) in the period spanning from 2002 to 2011 using Taiwan’s National Health Insurance Research Database. We calculated the age- and sex-specific incidence and prevalence rates of thromboangiitis obliterans during the study period. RESULTS: From 2002 to 2011, 158 patients were diagnosed with thromboangiitis obliterans; of these, 76% were men. Most (63%) of the patients were <50 years old when they were first diagnosed. After reaching 20 years of age, the incidence rate increased with age and peaked among those aged ≥60 years. The average incidence rate of thromboangiitis obliterans during the 2002–2011 period was 0.068 per 105 years. The incidence of thromboangiitis obliterans decreased with time, from 0.10 per 105 years in 2002 to 0.04 per 105 years in 2011. The prevalence increased from 0.26 × 10−5 in 2002 to 0.65 × 10−5 in 2011. CONCLUSION: This is the first epidemiologic study of thromboangiitis obliterans using claims data from a general population in Taiwan. This nationwide, population-based study found that the incidence and prevalence of thromboangiitis obliterans in Taiwan in the 2002–2011 period were lower than those in other countries before 2000. This study also revealed a trend of decreasing incidence with simultaneous increasing prevalence of thromboangiitis obliterans in Taiwan from 2002 to 2011.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , Thromboangiitis Obliterans/epidemiology , Age Distribution , Age Factors , Catastrophic Illness/epidemiology , Incidence , Prevalence , Retrospective Studies , Sex Distribution , Taiwan/epidemiology , Time FactorsABSTRACT
Objetivo: Examinar se uma história de periodontite (PD) antes do tratamento antidiabético está associada a risco de ocorrência de artrite reumatoide (AR) em pacientes com diabetes melittus (DM) tratados de novo. Métodos: Fizemos um estudo retrospectivo populacional com os dados de reivindicações do National Health Insurance (NHI) de 1997-2009 referentes a um milhão de indivíduos representativos da totalidade de matriculados. Adultos com DM (≥ 20 anos) que iniciaram o tratamento antidiabético durante 2001-2009 foram classificados como pacientes DM tratados de novo. Identificamos 7.097 indivíduos DM com história de PD em um intervalo de um ano antes do tratamento antidiabético (data-índice). Na equiparação desses 7.097 indivíduos para idade por ocasião da data-índice, gênero e ano da data-índice, extraímos aleatoriamente 14.194 pacientes DM sem história de PD em um intervalo de um ano antes do tratamento antidiabético. As razões de risco ajustadas (aRR) com um intervalo de confiança (IC) de 95% foram calculadas mediante a aplicação do modelo de riscos proporcionais de Cox com o objetivo de quantificar a associação entre história de PD e risco de AR. Resultados: Em comparação com pacientes DM sem exposição à PD no intervalo de um ano antes do tratamento antidiabético, RR bruta e RR ajustada para AR entre pacientes DM e com exposição à PD no intervalo de um ano antes do tratamento antidiabético foram, respectivamente, 4,51 (IC 95%, 1,39-14,64) e 3,77 (IC 95%, 1,48-9,60). Conclusão: A exposição à PD no intervalo de um ano antes do tratamento antidiabético foi associada a maior risco de AR em pacientes DM tratados de novo. A ausência do status de tabagismo em nível individual é importante ...
Objective: To examine whether a history of periodontitis (PD) before anti-diabetic treatment is associated with risk of rheumatoid arthritis (RA) development in newly-treated diabetes mellitus (DM) patients. Methods: We conducted a population-based retrospective cohort study using the 1997-2009 National Health Insurance (NHI) claims data of one million representative individuals from all NHI enrollees. Adults with DM (aged ≥20 years) starting anti-diabetic treatment during 2001-2009 were classified as newly-treated DM patients. We identified 7097 DM subjects with PD history within one year before initiating anti-diabetes treatment (index date). By matching these 7097 subjects for age on the index date, sex, and year of the index date, we randomly extracted 14,194 DM subjects without PD history within one year before antidiabetic treatment. Adjusted hazard ratios (aHRs) with a 95% confidence interval (CI) were calculated by applying Cox proportional hazards models to quantify the association between PD history and RA risk. Results: Compared with DM patients without PD exposure within one year before anti-diabetic treatment, crude HR and adjusted HR of RA among DM patients with PD exposure within one year before anti-diabetic treatment were 4.51 (95% CI, 1.39-14.64) and 3.77 (95% CI, 1.48-9.60). Conclusion: PD exposure within one year before anti-diabetic treatment was associated with increased RA risk in newly treated DM patients. The lack of knowledge about individual smoking status is a major limitation of this study. .
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Arthritis, Rheumatoid/etiology , Diabetes Complications/complications , Periodontitis/complications , Arthritis, Rheumatoid/epidemiology , Cohort Studies , Diabetes Mellitus/drug therapy , Hypoglycemic Agents/therapeutic use , Retrospective Studies , Risk Assessment , Time FactorsABSTRACT
BACKGROUND: Ankylosing spondylitis (AS) is one of the most common rheumatic diseases with gender differences in prevalence and clinical presentation. This study aimed to examine whether such gender differences are correlated with cumulative healthcare utilization in Taiwan. METHODS: The National Health Insurance Research Database supplied claim records of one million individuals from 1996 to 2007. Selected cases included patients aged >16 years. Certified rheumatologists diagnosed the patients in three or more visits and gave prescriptions for AS. Multivariate adjusted logistic regression analyses were used to calculate the influence of gender on cumulative healthcare utilization associated with AS. RESULTS: The study included 228 women and 636 men. After adjustment for potential confounding factors, men had more cumulative outpatient visits associated with AS (odds ratio, 1.59; 95 percent confidence interval, 1.13 -2.23; p = 0.008). Men also exhibited a trend for higher frequency of AS-related hospitalization (p = 0.054). CONCLUSION: Men are more likely to have high cumulative AS-associated healthcare utilization than women. Further investigation of the causal factors is warranted.
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Health Services Needs and Demand/statistics & numerical data , Spondylitis, Ankylosing/epidemiology , Epidemiologic Methods , Hospitalization/statistics & numerical data , Sex Distribution , Sex Factors , Taiwan/epidemiologyABSTRACT
OBJECTIVE: The goal of the present study was to estimate the risk ratio of herpes zoster among systemic lupus erythematosus patients after disease onset compared with a cohort of patients without systemic lupus erythematosus over a three-year period. METHODS: A nationwide population-based cohort study using the National Health Insurance Research Database identified 10,337 new cases of systemic lupus erythematosus as the study cohort. In addition, 62,022 patients without systemic lupus erythematosus, who were matched for age, gender, and date of systemic lupus erythematosus diagnosis, were used as the comparison cohort. These cohorts were followed-up for three years. A Cox proportional hazard regression was performed to estimate the risk ratio of herpes zoster, with adjustments for age, gender, level of insurance, urbanization level, geographic region, comorbid medical conditions, average daily dosage of corticosteroids, and the use of immune-modulation agents. RESULTS: Compared to patients without systemic lupus erythematosus, the crude risk ratio and adjusted risk ratio of herpes zoster among systemic lupus erythematosus patients were 7.37 (95 percent confidence interval 6.75-8.04) and 2.45 (95 percent confidence interval 1.77-3.40), respectively. Stratified by gender, the adjusted risk ratio of herpes zoster was 2.10 (95 percent confidence interval 1.45-2.99) in women and 7.51 (95 percent confidence interval 2.89-19.52) in men. Stratified by age, the adjusted risk ratio peaked in systemic lupus erythematosus patients who were aged 18 to 24 years (risk ratio 8.78, 95 percent confidence interval 3.08-24.97). CONCLUSION: Based on nationwide population-based data, there is an increased risk of herpes zoster in systemic lupus erythematosus patients compared with non-systemic lupus erythematosus patients, particularly among males and patients aged 18 to 24 years. Further research on the associated risk factors for herpes zoster in systemic lupus erythematosus patients is needed.
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Herpes Zoster/etiology , Lupus Erythematosus, Systemic/complications , Age Factors , Age of Onset , Epidemiologic Methods , Herpes Zoster/epidemiology , Sex Factors , Taiwan/epidemiologyABSTRACT
OBJECTIVES: To investigate the association of body cell mass loss with disease activity and disability in rheumatoid arthritis patients. INTRODUCTION: Rheumatoid cachexia, defined as the loss of body cell mass, is important but under-recognized and contributes to morbidity and mortality in patients with rheumatoid arthritis. METHODS: One hundred forty-nine rheumatoid arthritis patients and 53 healthy, non-rheumatoid arthritis control subjects underwent anthropometric measurements of body mass index and waist and hip circumferences. Bioelectrical impedance analysis was used to determine the subjects' body compositions, including fat mass, skeletal lean mass, and body cell mass. The disease activity of rheumatoid arthritis was assessed using C-reactive protein serum, the erythrocyte sedimentation rate and the 28-joint disease activity score, while disability was evaluated using a health assessment questionnaire. RESULTS: Rheumatoid arthritis patients had lower waist-to-hip ratio (0.86 ± 0.07 vs. 0.95 ± 0.06; p<0.001) and lower skeletal lean mass indexes (14.44 ±1.52 vs. 15.18 ± 1.35; p = 0.002) than those in the healthy control group. Compared with rheumatoid arthritis patients with higher body cell masses, those with body cell masses lower than median had higher erythrocyte sedimentation rates (40.10 ± 27.33 vs. 25.09 ± 14.85; p<0.001), higher disease activity scores (5.36 ± 3.79 vs. 4.23 ± 1.21; p = 0.022) and greater disability as measured by health assessment questionnaire scores (1.26 ± 0.79 vs. 0.87 ± 0.79; p = 0.004). CONCLUSIONS: The loss of body cell mass is associated with higher disease activity and greater disability in rheumatoid arthritis patients. Body composition determined by bioelectrical impedance analysis can provide valuable information for a rheumatologist to more rapidly recognize rheumatoid cachexia in rheumatoid arthritis patients.