ObjectivesTo determine whether anti-rheumatic drug usage is associated with risk of coronary artery diseases (CAD) in incident Rheumatoid Arthritis (RA) patients.MethodsData were obtained from the Taiwan National Health Insurance Research Database. The study cohort comprised 6260 patients who were newly diagnosed with RA between 2001–2010. The study endpoint was occurrence of CAD according to the ICD-9-CM codes. We used the WHO Defined Daily Dose (DDD) as a tool to assess the drugs exposure. The Cox proportional hazards regression model was used to estimate the hazard ratio (HR) of disease after controlling for demographic and other co-morbidities. When the proportionality assumption is violated, a spline curve of the Scaled Schoenfeld residuals is fitted to demonstrate the estimated effect on CAD over time for drug usage.ResultsAmong RA patients, use of celecoxib, and etoricoxib was associated with significantly decreased incidence of CAD. The adjusted HR(95% CI) of CAD for low-dose celecoxib (DDD≦1) and high-dose user were 0.47(0.34, 0.65) and 0.37(0.24, 0.58) during the 4 year follow-up time; however, it became 0.98(0.70, 1.37) and1.29(0.85, 1.95). Adjusted HR(95% CI) of CAD for etoricoxib users remained 0.47(0.26, 0.84).ConclusionsThis study revealed association of decreased CAD risk in RA patients taking 2 different kinds of COX-2i in comparison with nonusers. The effect might be changed over time, after about 4 years.

ObjectiveTo investigate whether Sjogren’s syndrome would have an influence on the development of Parkinson’s disease.MethodsA population-based case-control study was conducted. Participants consisted of 7716 subjects with newly diagnosed Parkinson’s disease and a population of 75129 matched control subjects between 2000 and 2010. We measured the risk of Parkinson’s disease in association with Sjogren’s syndrome by using adjusted odds ratios.ResultsA total of 143 Parkinson’s disease subjects (1.9%) and 893 control subjects (1.2%) suffered from Sjogren’s syndrome (p < 0.001). The crude odds ratio for Parkinson’s disease among subjects with Sjogren’s syndrome was 1.56 (95% CI 1.30–1.86; p < 0.01). After adjustment for potential confounders which have been proposed that would increase the risk of development of Parkinson’s disease, Sjogren’s syndrome was found to be significantly associated with the risk of Parkinson’s disease with an odds ratio of 1.37 (95% CI 1.15–1.65; p < 0.01).ConclusionThis study preliminarily proposed that Sjogren’s syndrome was significant associated with an increased risk of Parkinson’s disease.

At a dosage of > 0.5 defined daily dose, short-term methotrexate might decrease ischemic stroke risk in RA patients, while hydroxychloroquine and sulfasalazine were neutral.

Healthcare providers should not only focus on the patients' physiological needs, but should determine and address their other needs in various aspects in order to improve the quality and efficacy of the dialysis care process.

This paper considers the analysis of multivariate survival data where the marginal distributions are specified by semiparametric transformation models, a general class including the Cox model and the proportional odds model as special cases. First, consideration is given to the situation where the joint distribution of all failure times within the same cluster is specified by the Clayton-Oakes model (Clayton, Biometrika 65:141-151, l978; Oakes, J R Stat Soc B 44:412-422, 1982). A two-stage estimation procedure is adopted by first estimating the marginal parameters under the independence working assumption, and then the association parameter is estimated from the maximization of the full likelihood function with the estimators of the marginal parameters plugged in. The asymptotic properties of all estimators in the semiparametric model are derived. For the second situation, the third and higher order dependency structures are left unspecified, and interest focuses on the pairwise correlation between any two failure times. Thus, the pairwise association estimate can be obtained in the second stage by maximizing the pairwise likelihood function. Large sample properties for the pairwise association are also derived. Simulation studies show that the proposed approach is appropriate for practical use. To illustrate, a subset of the data from the Diabetic Retinopathy Study is used.