This study aimed to evaluate the systemic impact of periodontitis, previously considered a local disease, on cancer occurrence. We enrolled 683,854 participants, comparing cancer incidence among those with and without periodontitis and assessing the impact of periodontal treatment on cancer risk. Regardless of gender, age, Charlson comorbidity index, or the use of non-steroidal anti-inflammatory drugs, periodontitis patients had a lower overall cancer risk than controls. However, men with periodontitis had a higher risk of prostate cancer (adjusted hazard ratio [aHR] = 1.22; 95% confidence interval [CI] = 1.10–1.35), and both men and women had a higher risk of thyroid cancer (women: aHR = 1.20, 95%CI = 1.04–1.38; men: aHR = 1.51, 95% CI = 1.15–1.99). Patients with periodontitis who received treatment showed a reduced cancer risk (aHR = 0.41; 95% CI = 0.38–0.44) compared to untreated patients. Proper treatment for periodontitis may lower an individual’s cancer risk more than if they did not have the disease at all, suggesting that periodontitis is a modifiable risk factor for cancer.

Rationale: Patients with chronic obstructive pulmonary disease (COPD) are susceptible to acute exacerbations, cardiovascular disease, and premature death. Objectives: To compare the risk of COPD exacerbation, cardiovascular diseases, and mortality between SGLT-2 (sodium-glucose cotransporter-2) inhibitor use and nonuse in patients with type 2 diabetes mellitus (T2DM) and COPD. Methods: The study included 299,168 patients with diagnoses of T2DM and COPD in the National Health Insurance Research Database from January 1, 2009, to December 31, 2020. Cox proportional hazards models were used to examine the relative hazard of the primary outcome (a composite of hospitalization for COPD, noninvasive positive-pressure ventilation [NIPPV], invasive mechanical ventilation, and all-cause mortality) and secondary outcomes: major adverse cardiovascular events, hospitalization for COPD, NIPPV, invasive mechanical ventilation, lung cancer, and mortality between SGLT-2 inhibitor users and nonusers. We used propensity score matching to select 1,288 pairs of SGLT-2 inhibitor users and nonusers. Results: In the matched cohorts, SGLT-2 inhibitor use was associated with a significantly lower risk of the primary outcome (multivariable-adjusted hazard ratio [aHR], 0.79 [95% confidence interval (CI), 0.67–0.93]), NIPPV (aHR, 0.48 [95% CI, 0.27–0.87]), hospitalization for COPD (aHR, 0.82 [95% CI, 0.69–0.98]), and mortality (aHR, 0.64 [95% CI, 0.43–0.95]), than SGLT-2 inhibitor nonuse. Subgroup and dose–response analyses showed that SGLT-2 inhibitor use was associated with a significantly lower risk of mortality, NIPPV, and hospitalization for COPD (P < 0.05) than nonuse of SGLT-2 inhibitors. Conclusions: This population-based cohort study showed that SGLT-2 inhibitor use was associated with a lower risk of the primary outcome, COPD exacerbations, ventilator support, and mortality than SGLT-2 inhibitor nonuse in patients with T2DM and COPD. SGLT-2 inhibitors may have a role in treating patients with COPD and diabetes.

Background: Pulmonary tuberculosis (TB), a global health problem, is typically caused by the bacterium Mycobacterium tuberculosis. Herpes zoster (HZ) is caused by the reactivation of the varicella-zoster virus (VZV). The reactivation of VZV can be caused by stress. We investigated whether pulmonary TB increases the risk of HZ development. Methods: This study used data that sampled a population of 2 million people in 2000 from the National Health Insurance Research Database. This cohort study observed Taiwanese patients aged 20–100 years with pulmonary TB from 2000 to 2017 (tracked to 2018). Pulmonary TB was defined as having two or more outpatient diagnoses or at least one admission record. To address potential bias caused by confounding factors, the control cohort and pulmonary TB cohort were matched 1:1 by age, gender, index year, and comorbidities. Patients with HZ before the index date were excluded. Results: A total of 30,805 patients were in the pulmonary TB and control cohorts. The incidence rate of HZ in pulmonary TB and control cohorts were 12.00 and 9.66 per 1000 person-years, respectively. The risk of HZ in the pulmonary TB cohort (adjusted hazard ratios = 1.23; 95% confidence interval = 1.16–1.30) was significantly higher than that of in control cohort. Among patients without comorbidities, the patients with TB were 1.28-fold more likely to have HZ than those without TB. Conclusion: Patients with TB should be well treated to avoid the potential risk of HZ occurrence. Although we identified the association between pulmonary TB and HZ, further studies are needed to confirm the result.

Chronic pancreatitis (CP) may induce systemic inflammation, potentially increasing cancer susceptibility. However, the link between CP and extra-pancreatic cancer remains underexplored. Employing Taiwanese National Health Insurance Database data from 2000 to 2017, we compared 5394 CP patients with 21,576 non-CP individuals through propensity score matching. CP patients exhibited a significantly higher cancer risk (adjusted hazard ratio (aHR) of 1.32 for females and 1.68 for males) and cumulative incidence (p < 0.001) compared to non-CP individuals. CP showed notable associations with pancreatic (aHR = 3.51), liver (aHR = 1.62), stomach (aHR = 2.01), and other cancers (aHR = 2.09). In terms of liver cancer, CP was significantly associated with patients without viral hepatitis, regardless of gender (aHR = 2.01 for women; aHR = 1.54 for men). No significant cancer occurrences were observed within the first year following CP diagnosis. Pancreatic or liver cancer developed in approximately half of CP patients within 2–3 years, while gastric cancer in male CP patients predominantly occurred around the fifth year after diagnosis. These findings inform potential cancer-screening plans for CP patients.

Background: Rickets is a growth disorder that imposes a global health burden and causes disability in affected children. However, issues related to the clinical epidemiology and mortality risk of nutritional versus hereditary rickets have not been fully investigated in large population studies, particularly in Asia.Purpose: This study aimed to investigate the nationwide incidence, demographic characteristics, and mortality-related risk factors of pediatric rickets stratified by nutritional and hereditary subtypes.Methods: This study utilized data of subjects aged 0–18 years taken from Taiwan’s National Health Insurance Research Database. The database includes records of 31,488,321 individuals from January 1, 2008, to December 31, 2018. We analyzed all cases and conducted subgroup analyses of nutritional and hereditary rickets to examine how different etiologies affect the risk of mortality (ROM).Results: Among the 1,551 patients with rickets, nutritional rickets accounted for twice as many cases as hereditary rickets. Nutritional rickets primarily affects preschoolers without sex-based differences, whereas hereditary rickets is often diagnosed later with a male predominance. ROM in rickets is associated with a low household income, anemia, chronic kidney disease (CKD), hyperparathyroidism secondary to renal tubulopathy, and a prolonged length of hospital stay (LOS). Between 2012 and 2018, the overall incidence of rickets increased and the mortality rates decreased.Conclusion: Increasing incidence and decreasing mortality rates of rickets were noted, suggesting improvements in clinical awareness and disease management. influencing ROM, such as family income, anemia, CKD, hyperparathyroidism secondary to renal tubulopathy, and LOS are important considerations in the clinical care of rickets.

Recent research has established an association between insomnia and an elevated risk of stroke. Given the severe global impact of stroke on public health, exploring nonpharmacological interventions, such as acupuncture, that can mitigate stroke risk among individuals with insomnia is crucial. In this retrospective cohort study, we used data from the Taiwan National Health Insurance Database (NHIRD) to examine the relationship between acupuncture and the risk of stroke among individuals who received a diagnosis of insomnia between 2000 and 2017. The study participants were divided into two cohorts: the acupuncture group that received acupuncture and a matched control group that did not. The primary outcome was the occurrence of stroke. Of the 217,356 patients included in the study, 3668 individuals in the acupuncture group and 4913 in the control group experienced stroke. The incidence rate of stroke was lower in the acupuncture group (4.51 per 1000 person-years) than in the control group (6.86 per 1000 person-years). After adjustment for various potential confounders, patients who received acupuncture exhibited a notably reduced risk of stroke, with an adjusted hazard ratio of 0.66 (95 % confidence interval [CI]: 0.63, 0.69). Furthermore, a dose–response relationship was evident, in that individuals who received 6–11 acupuncture sessions experienced a 24 % reduction in stroke risk, whereas those who received 12–17 sessions, 18–29 sessions, and ≥30 sessions exhibited reductions of 31 %, 34 %, and 42 %, respectively. Acupuncture treatment was significantly associated with a reduced risk of stroke among patients with insomnia.