Increased prevalence of peripheral vestibular disorder among patients with Fabry disease.

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

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

BACKGROUND: This study aimed to provide an updated prevalence of hearing loss, tinnitus, vertigo and sudden deafness on patients with Sjögren's syndrome and matched comparison patients. METHODS: Data for this study were retrieved from the Taiwan Longitudinal Health Insurance Database and Taiwan's registered catastrophic illness dataset. This study included 20 266 patients with Sjögren's syndrome as the study group and 60 798 propensity score-matched comparison patients as the comparison group. We used multivariable logistic regressions to estimate the ORs and 95% CI for tinnitus, hearing loss, vertigo and sudden deafness among Sjögren's syndrome patients versus comparison patients. RESULTS: χ2 tests showed there were statistically significant differences between the study group and comparison group in the prevalence of tinnitus (10.1% vs 6.3%, p<0.001), hearing loss (5.6% vs 3.3%, p<0.001), vertigo (4.6% vs 3.2%, p<0.001) and sudden deafness (0.8% vs 0.6%, p<0.001). Multiple logistic regression revealed that patients with Sjögren's syndrome had a greater tendency to have tinnitus (OR=1.690, 95% CI 1.596-1.788), sudden deafness (OR=1.368, 95% CI 1.137-1.647), hearing loss (OR=1.724, 95% CI 1.598-1.859) and vertigo (OR=1.473, 95% CI 1.360-1.597) relative to comparison patients after adjusting for age, income, geographic location, residential urbanisation level, diabetes, hypertension, hyperlipidaemia and rheumatoid arthritis. CONCLUSIONS: We found higher prevalence of hearing loss, vertigo, tinnitus and sudden deafness among patients with Sjögren's syndrome relative to comparison patients. Findings may provide guidance to physicians in counselling patients with Sjögren's syndrome regarding a higher risk of hearing loss, tinnitus, sudden deafness and vertigo.

Association of thyroid cancer with human papillomavirus infections.

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

Optimizing age-related hearing risk predictions: an advanced machine learning integration with HHIE-S.

OBJECTIVES: The elderly are disproportionately affected by age-related hearing loss (ARHL). Despite being a well-known tool for ARHL evaluation, the Hearing Handicap Inventory for the Elderly Screening version (HHIE-S) has only traditionally been used for direct screening using self-reported outcomes. This work uses a novel integration of machine learning approaches to improve the predicted accuracy of the HHIE-S tool for ARHL in older adults. METHODS: We employed a dataset that was gathered between 2016 and 2018 and included 1,526 senior citizens from several Taipei City Hospital branches. 80% of the data were used for training (n = 1220) and 20% were used for testing (n = 356). XGBoost, Gradient Boosting, and LightGBM were among the machine learning models that were only used and assessed on the training set. In order to prevent data leakage and overfitting, the Light Gradient Boosting Machine (LGBM) model-which had the greatest AUC of 0.83 (95% CI 0.81-0.85)-was then only used on the holdout testing data. RESULTS: On the testing set, the LGBM model showed a strong AUC of 0.82 (95% CI 0.79-0.86), far outperforming conventional techniques. Notably, several HHIE-S items and age were found to be significant characteristics. In contrast to traditional HHIE research, which concentrates on the psychological effects of hearing loss, this study combines cutting-edge machine learning techniques-specifically, the LGBM classifier-with the HHIE-S tool. The incorporation of SHAP values enhances the interpretability of the model's predictions and provides a more comprehensive comprehension of the significance of various aspects. CONCLUSIONS: Our methodology highlights the great potential that arises from combining machine learning with validated hearing evaluation instruments such as the HHIE-S. Healthcare practitioners can anticipate ARHL more accurately thanks to this integration, which makes it easier to intervene quickly and precisely.

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

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

Associations of Head and Neck Cancer with Hepatitis B Virus and Hepatitis C Virus Infection.

This case-control study investigates the associations between head and neck cancer (HNC), hepatitis B virus (HBV), and hepatitis C virus (HCV) infection. We included 5603 patients who had received a diagnosis of HNC as cases and 16,809 propensity score matching controls. We employed multivariate logistic regression models to evaluate the association of HNC with HBV and HCV infection after taking sociodemographic characteristics and diabetes, hypertension, hyperlipidemia, HPV infection, tobacco use disorder, and alcohol abuse/alcohol dependence syndrome into considerations. Results show that 7.9% of the total sample had been previously diagnosed with HBV infection, with 9.0% prevalence among cases and 7.6% among controls (p < 0.001). The chi-squared test suggests a significant difference in the prevalence of HCV infection between cases and controls (3.3% vs. 2.7%, p = 0.019). The covariate-adjusted odds ratio (OR) of HBV infection in patients with HNC relative to controls was 1.219 (95% CI = 1.093~1.359). Additionally, the adjusted OR of HCV infection in patients with HNC was 1.221 (95% CI = 1.023~1.457) compared to controls. Furthermore, patients with oropharyngeal cancer were more likely to have HCV infection than controls (adjusted OR = 2.142, 95% CI = 1.171~3.918). Our study provides evidence that suggests a potential association between HBV and HCV infections and the risk of HNC.

Association of Nasopharynx Cancer with Human Papillomavirus Infections.

This population-based study aims to examine the association between nasopharyngeal carcinoma and human papillomavirus infections. This study included 2747 individuals aged 20 years and older who were diagnosed with nasopharynx cancer as cases and 13,735 propensity-score-matching controls. Multivariate logistic regression models were employed to quantitatively assess the association of nasopharynx cancer with human papillomavirus infections while considering age, sex, monthly income, geographic location, and urbanization level of the patient's residence as well as diabetes, hypertension, and hyperlipidemia. Our chi-squared test indicated a significant dissimilarity in previous human papillomavirus infection rates between nasopharynx cancer patients and controls (12.7% vs. 7.2%, p < 0.001). The adjusted odds ratio (OR) for prior human papillomavirus infections was found to be significantly higher for nasopharyngeal carcinoma cases compared to controls at a value of 1.869 with confidence interval ranging from 1.640 to 2.128. Among female participants, compared to controls, the adjusted OR of prior human papillomavirus infections was 2.150 (95% CI = 1.763-2.626) in patients with nasopharynx cancer. In male participants sampled in this study, we observed a statistically significant association between prior human papillomavirus infections and nasopharynx cancer (adjusted OR = 1.689; 95% CI = 1.421-2.008). Our study indicates a noteworthy association between previous human papillomavirus infections and nasopharyngeal carcinoma.

Does peripheral vestibular disorder increase the risk of attempted suicide: A retrospective cohort study.

BACKGROUND: This study aimed to investigate the risk of attempted suicide in the population of patients diagnosed with peripheral vestibular disorders (PVD). METHODS: We conducted a retrospective cohort study. We extracted data on patients diagnosed with PVD (72,569 study patients) and a 3:1 ratio of propensity-score matched comparison patients without PVD (217,707 patients) from Taiwan's Longitudinal Health Insurance Database 2010. The claims records of sampled patients were tracked for a one-year period from their index date to identify claims showing a diagnosis of suicide attempt. Cox proportional hazards regression analyses were performed to calculate the one-year hazard ratio (HR) of suicide attempt following the PVD diagnosis among PVD patients relative to comparison patients. RESULTS: Of total 290,276 sampled patients, the rate of attempted suicide was 0.158 per 100 person-years, being 0.460 and 0.057, respectively, among PVD patients and comparison patients. Cox proportional hazard analysis showed that PVD patients had a high relative hazard of suicide attempt (adjusted HR = 7.622, 95 % CI = 6.196-9.376) during one-year follow-up relative to comparison patients. We also found that subcategories of PVD, showed similar adjusted hazard ratios as all PVDs: Meniere's disease (HR = 7.608, 95 % CI = 4.350-13.305), benign paroxysmal positional vertigo (HR = 8.201, 95 % CI = 4.716-14.260), and vestibular neuritis (HR = 9.399, 95 % CI = 5.036-17.544). LIMITATIONS: The incidence of suicide attempts could be underestimated in both the study group and comparison group, if the suicide attempt did not cause a medical emergency and the patient did not seek medical assistance. CONCLUSIONS: We found a high magnitude of association between PVD and subsequent suicide attempt.

Association of Chronic Otitis Media with Sjogren's Syndrome: A Case-Control Study.

There is a paucity of large-scale population-based study whether patients with Sjögren's syndrome are at higher risk of chronic otitis media. This study aimed to investigate the association of chronic otitis media with Sjögren's syndrome by utilizing the representative dataset of the Taiwanese population. We identified 9473 patients with chronic otitis media as cases. We used propensity score matching to select 28,419 controls. We used multiple logistic regression analysis to examine the association of chronic otitis media with prior Sjögren's syndrome after adjusting for age, sex, monthly income category, geographic location and urbanization level of the patient's residence, allergic rhinitis, chronic rhinosinusitis and tonsillitis and adenoiditis. Chi-square tests showed a statistically significant difference in Sjögren's syndrome between patients with chronic otitis media and controls (4.89% vs. 2.93%, p < 0.001). In addition, we found patients with chronic otitis media were more likely to have Sjögren's syndrome (OR = 1.698, 95% CI = 1.509~1.910) relative to controls after adjusting for age, income, geographic location, residential urbanization level, allergic rhinitis, chronic rhinosinusitis and tonsillitis and adenoiditis. We also found that of the male patients, patients with chronic otitis media had a greater tendency to Sjögren's syndrome than controls (adjusted OR = 1.982, 95% CI = 1.584~2.481). Similarly, a statistically significant association between Sjögren's syndrome and chronic otitis media remains in female sampled patients (adjusted OR = 1.604, 95% CI = 1.396~1.842). We found that patients with Sjögren's syndrome were associated with the occurrence of chronic otitis media. It may guide physicians as they counsel patients with Sjögren's syndrome on the possibility of chronic otitis media occurrence.

Trends in the incidence of head and neck cancer: A nationwide population-based study.

OBJECTIVE: This study aimed to demonstrate the temporal trend in incidence of head and neck cancer (HNC) in Taiwan. MATERIALS AND METHODS: Patients with a HNC were retrieved from the Taiwan's Health Insurance Database. We identified 16,894 patients aged ≥20 years who had received a first-time diagnosis of cancer of the oral cavity, oropharynx, larynx, hypopharynx, nasopharynx, sinonasal, salivary gland or thyroid gland between 2010 and 2018. We calculated the annual incidence rate per 100,000 population, overall, and classified by gender and cancer type. We also used the annual percent change (APC) to characterize trends in head and neck cancer rates over time. RESULTS: The incidence rate showed a gradual decline during this period from 2010 to 2018 with an APC of -2.81% (p < 0.001). Within gender groups, the decline was not statistically significant among females (APC = -1.69, 95% CI = -3.58 âˆ¼ 0.23, p = 0.080). Within cancer types, strikingly high magnitude and statistically significant declines were observed in respect of cancer of the nasopharynx (APC = -7.89%, 95% CI = -9.43%∼-6.31%, p < 0.001), sinonasal cancer (APC = -10.08%, 95% CI = -16.66%∼-2.99%, p = 0.012) and oropharyneal cancer (APC = -9.47%, 95% CI = -15.15%∼-3.42%, p = 0.013) over the study period. In contrast, there was a statistically significant increase in incidence on thyroid cancer over the study period with an APC of 4.75% (95% CI = -2.81%∼6.75%, p < 0.001). CONCLUSIONS: HNCs in Taiwan are showing a decreasing trend, led by the upper respiratory and oropharyngeal cancers. However, there was a concurrent increasing trend of the incidence on thyroid cancer. These trends may be attributable to changing lifestyles and behavioral choices in Taiwan.

Evaluating auditory brainstem response to a level-dependent chirp designed based on derived-band latencies.

The best cochlear-neural delay model for designing a chirp that can produce the largest auditory brainstem response (ABR) has not been established. This study comprised two experiments. Experiment I aimed to estimate the delay model by measuring derived-band ABR latencies at different levels. The results demonstrated that, as the level decreased, the delay between the center frequencies of 0.7 and 5.7 kHz increased. The aim of experiment II was to compare ABRs generated by three stimuli: (1) a level-dependent derived-band (DB)-Chirp, designed based on the model in experiment I; (2) a level-dependent level specific (LS)-Chirp from Kristensen and Elberling [(2012). J. Am. Acad. Audiol. 23, 712-721]; and (3) a click. The results demonstrated that the DB-Chirp produced significantly larger wave V than the LS-Chirp at 45 dB normal hearing level (nHL); however, no differences were observed at other levels. The wave I generated by the DB-Chirp and LS-Chirp were significantly larger than those evoked by the click at 45 and 60 dB nHL and at 30 and 45 dB nHL, respectively; however, at all levels, no differences between these two chirps were observed. The DB-Chirp may be a valuable stimulus for producing ABRs for clinical applications such as assessing cochlear synaptopathy and estimating hearing sensitivity.

Increased Risk of Major Depressive Disorder Following Tinnitus: A Population-Based Study.

Background and Purpose: In this study, we aimed to evaluate the relationship between tinnitus and a subsequent diagnosis of major depressive disorder (MDD) by studying the incidence of both entities. Design: A retrospective cohort study. Methods: Data for this observational follow-up study were retrieved from the Taiwan's National Health Insurance Dataset. A total of 375,272 patients with newly diagnosed tinnitus (study group) were retrieved. The date of first diagnosis of tinnitus was assigned as their index date. Comparison patients were selected by propensity score matching (one per case, n = 375,272 controls) from the same dataset, with their index date being the date of their first health service claim in the year of diagnosis of their matched index case. We tracked each patient's claims records for 1 year from the index date to identify those who received a diagnosis of MDD. Cox proportional hazards regression was performed to calculate the MDD hazard ratio for cases vs. controls. Results: We found that the overall incidence rate for MDD was 0.78 (95% CI = 0.76~0.80) per 100 person-years, being 1.17 (95% CI = 1.14~1.21) among the study cohorts and 0.38 (95% CI = 0.36~0.40) among the comparison cohorts. The log-rank test revealed that the patients in the study cohort had significantly lower one-year MDD-free survival when compared to the comparison cohort (p < 0.001). Cox proportional hazards analysis showed that the patients in the study cohort had a higher hazard of developing MDD than the patients in the comparison cohort (adjusted HR = 3.08, 95% CI = 2.90~3.27). Conclusions: In this study, we demonstrate that tinnitus is associated with an increased hazard of subsequent MDD in Taiwan.

Prognostic determinants of hearing outcomes in children with congenital cytomegalovirus infection.

Congenital cytomegalovirus (cCMV) infection is the most prevalent cause of non-genetic sensorineural hearing loss (SNHL) in children. However, the prognostic determinants of SNHL remain unclear. Children with cCMV infection in a tertiary hospital were enrolled. The presence of cCMV-related symptoms at birth, the newborn hearing screening (NHS) results, and the blood viral loads were ascertained. Audiologic outcomes and initial blood viral loads were compared between different groups. Of the 39 children enrolled, 16 developed SNHL. SNHL developed in 60% of children who were initially symptomatic, and in 34.5% of those who were initially asymptomatic with normal hearing or isolated hearing loss, respectively. Failuire in NHS was a reliable tool for early detection of SNHL. The initial viral loads were higher in children who were symptomatic at birth, those who failed NHS, and those who developed SNHL. We observed SNHL deterioration in a patient after CMV DNAemia clearance was achieved, and in another patient with the flare-up of viral load. The presence of cCMV-related symptoms at birth, failure in NHS, and blood viral load might be the prognostic factors for hearing outcomes. Regular audiologic examinations are necessary in all children with cCMV infection even after CMV DNAemia clearance.

Association of hearing loss with land transport accidents: a nationwide population-based study.

OBJECTIVE: This study aimed to investigate the association of prior hearing loss with land transport accidents using a nationwide population-based dataset. DESIGN: A case-control study. STUDY SAMPLE: Data for this study were obtained from Taiwan's National Health Insurance Dataset. We retrieved data on 2066 patients who had received a diagnosis of a land transport accident as cases. We used a propensity score-matched method to select 6198 controls. RESULTS: A Chi-squared test revealed that there was a significant difference in the prevalence of prior hearing loss between cases and controls (6.8% vs. 5.6%, p = 0.046). The odds ratio (OR) of prior hearing loss for cases was 1.128 (95% confidence interval [CI]: 1.003 ∼ 1.503) compared to controls. After adjusting for demographic variables and comorbidities, the OR of hearing loss for cases was 1.238 (95% CI: 1.008 ∼ 1.522) that of controls. CONCLUSIONS: Our finding suggests that pre-existing hearing loss may be associated with land transport accidents among adults aged 50 years and older. Further study is needed to elucidate the mechanism(s) through which hearing loss may contribute to land transport accidents and examine how the use of hearing rehabilitation devices, for example, hearing aids impacts the observed associations.

Diagnostic Validity of Self-Reported Hearing Loss in Elderly Taiwanese Individuals: Diagnostic Performance of a Hearing Self-Assessment Questionnaire on Audiometry.

KEY POINTS: Question: Can the traditional Chinese version of the hearing handicap inventory for elderly screening (HHIE-S) checklist screen for age-related hearing loss (ARHL) in elderly individuals? FINDINGS: In this cross-sectional study of 1696 Taiwanese patients who underwent annual government-funded geriatric health checkups, the Chinese version of the HHIE-S had a sensitivity of 76.9% and a specificity of 79.8% with a cutoff score greater than 6 for identifying patients with disabled hearing loss (defined as a PTA > 40 dB). Meaning: The traditional Chinese version of the HHIE-S is an effective test to detect ARHL and can improve the feasibility of large-scale hearing screening among elderly individuals. PURPOSE: The traditional Chinese version of the hearing handicap inventory for elderly screening (TC-HHIE-S) was translated from English and is intended for use with people whose native language is traditional Chinese, but its effectiveness and diagnostic performance are still unclear. The purpose of this study was to evaluate the validity and reliability of the traditional Chinese version of the HHIE-S for screening for age-related hearing loss (ARHL). METHODS: A total of 1696 elderly people underwent the government's annual geriatric medical examination at community hospitals. In this cross-sectional study, we recorded average conducted pure-tone averages (PTA) (0.5 kHz, 1 kHz, 2 kHz, 4 kHz), age, sex, and HHIE-S data. Receiver operating characteristic (ROC) curve analysis was used to identify the best critical point for detecting hearing impairment, and the validity of the structure was verified by the agreement between the TC-HHIE-S and PTA results. RESULTS: The HHIE-S scores were correlated with the better-ear pure-tone threshold averages (PTAs) at 0.5-4 kHz (correlation coefficient r = 0.45). The internal consistency of the total HHIE-S score was excellent (Cronbach's alpha = 0.901), and the test-retest reliability was also excellent (Spearman's correlation coefficient = 0.60, intraclass correlation coefficient = 0.75). In detecting disabled hearing loss (i.e., PTA at 0.5-4 kHz > 40 dB), the HHIE-S cutoff score of > 6 had a sensitivity of 76.9% and a specificity of 79.8%. CONCLUSIONS: The traditional Chinese version of the HHIE-S is a valid, reliable, and efficient tool for large-scale screening for ARHL.

A Nationwide Population-Based Study on the Association between Land Transport Accident and Peripheral Vestibular Disorders.

This case-control study aimed to investigate the association of peripheral vestibular disorders (PVD) with subsequent land transport accidents. Data for this study were obtained from Taiwan's National Health Insurance (NHI) dataset. We retrieved 8704 subjects who were newly found to have land transport accidents as cases. Their diagnosis date was used as their index date. Controls were identified by propensity score matching (one per case, n = 8704 controls) from the NHI dataset with their index date being the date of their first health service claim in 2017. Multiple logistic regressions were performed to calculate the prior PVD odds ratio of cases vs. controls. We found that 2.36% of the sampled patients had been diagnosed with PVD before the index date, 3.37% among cases and 1.36% among controls. Chi-square test revealed that there was a significant association between land transport accident and PVD (p < 0.001). Furthermore, multiple logistic regression analysis suggested that cases were more likely to have had a prior PVD diagnosis when compared to controls (OR = 2.533; 95% CI = 2.041-3.143; p < 0.001). After adjusting for age, gender, hypertension, diabetes, coronary heart disease, and hyperlipidemia, cases had a greater tendency to have a prior diagnosis of PVD than controls (OR = 3.001, 95% CI = 2.410-3.741, p < 0.001). We conclude that patients with PVD are at twofold higher odds for land transport accidents.

The prevalence and demographic features of congenital cytomegalovirus infection in an urban area of East Asia: A population-based study.

Congenital cytomegalovirus (cCMV) infection is the leading environmental cause of childhood hearing impairment. However, its significance remains largely undocumented in many regions of the world. The purpose of this study was to investigate the prevalence and clinical features of cCMV infection in East Asia. Neonates born at a municipal hospital in Taipei were prospectively recruited and underwent concurrent hearing and CMV screenings. Those who failed the hearing screening or screened positive for CMV were subjected to a focused audiological and/or virological surveillance. The characteristics of the newborns and their mothers were compared between the CMV-positive and CMV-negative groups. Of the 1,532 newborns who underwent concurrent hearing and CMV screenings, seven (0.46%) were positive for cCMV infection. All seven CMV-positive newborns were asymptomatic at birth, and none of them developed hearing or other symptoms during a follow-up period of 14.4±6.3 months. The mothers of the CMV-positive newborns demonstrated higher gravidity (2.4 ± 1.4 vs. 2.1 ± 1.2) and parity (2.0 ± 1.2 vs. 1.6 ± 0.7) than those in the CMV-negative group; however, the difference did not reach statistical significance. The prevalence of cCMV infection in Taipei newborns was 0.46%, which is slightly lower than that of other populations and that of a previous report in the Taiwanese population. The relatively low prevalence in this study might be attributed to the improved public health system and decreased fertility rate in Taiwan.

Increased Risk of Injury Following a Diagnosis of Vertigo: A Population-based Study.

BACKGROUND: This study aimed to evaluate whether peripheral vestibular disorders (PVD) are associated with subsequent injury. METHODS: Data for this follow-up study were retrieved from the Taiwan's National Health Insurance (NHI) Dataset. A total of 251,355 patients with newly diagnosed PVD during January 2015 to December 2016 was identified as the study cohort, the diagnosis date being their index date. Comparison patients were identified by propensity score-matching (one per case, n = 251,355 controls) from the remaining NHI beneficiaries in 2015 with their index date being the date of their first health service claim in 2015. We tracked each subject's claims history for 1 year from the index date to identify those who suffered an injury. Cox proportional hazards regressions were performed to calculate the injury hazard ratio of cases versus controls. RESULTS: The incidence of injury during 1-year follow-up was 128.6 (95% CI = 127.6-129.5) per 1,000 person-years, 158.2 (95% CI = 156.8-159.6) and 97.5 (95% CI = 96.3-98.7) among the study and comparison cohorts, respectively. After adjusting for demographic variables, the hazard ratio (HR) for injury during 1-year was 1.663 (95% CI: 1.636-1.690) for cases relative to controls. CONCLUSIONS: Patients with PVD were at a higher risk for a wide range of injuries, most of all, joint dislocation and sprain. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:1633-1638, 2021.

A Nationwide Population-Based Study on the Incidence of Parapharyngeal and Retropharyngeal Abscess-A 10-Year Study.

This study aimed to investigate the annual incidence of parapharyngeal and retropharyngeal abscess (PRPA) based on 10-year population-based data. Patients with PRPA were identified from the Taiwan Health Insurance Research Database, a database of all medical claims of a randomly selected, population-representative sample of over two million enrollees of the National Health Insurance system that covers over 99% of Taiwan's citizens. During 2007-2016, 5779 patients received a diagnosis of PRPA. We calculated the population-wide incidence rates of PRPA by sex and age group (20-44, 45-64, and >64) as well as in-hospital mortality. The annual incidence rate of PRPA was 2.64 per 100,000 people. The gender-specific incidence rates per 100,000 people were 3.34 for males and 1.94 for females with a male:female gender ratio of 1.72. A slight increase in incidence rates among both genders over the study period was noted. Age-specific rates were lowest in the 20-44 age group with a mean annual incidence of 2.00 per 100,000 people, and the highest rates were noted in the age groups of 45-64 and >64 years with mean annual incidences of 3.21 and 3.20, respectively. We found that PRPA is common in Taiwan, males and older individuals are more susceptible to it, and incidence has increased in recent years.