Purpose: To analyze risk factors for postmenopausal breast cancer. Methods: The present case-control study included 600 women treated at a cancer center reference hospital in a municipality in the South of Brazil. Results: Totals of 100 patients and 500 control subjects were evaluated. The mean age of the women was $52.5{\pm}11.9$ years; the average was $57.4{\pm}11.8$ years, and the average age of the control subjects was $51.5{\pm}11.7$ years. The risk factors for breast cancer that were considered included an age ${\geq}40$ years, postmenopausal status, a body mass index $(BMI){\geq}30kg/m^2$, and reduced physical activity. Variables like postmenopausal status and an obese BMI were associated with cases of breast cancer. Women who were postmenopausal or obese were 3.80 or 1.80 times more likely to develop breast cancer, respectively, and physically inactive women were 1.72 times more likely to develop breast cancer. Conclusions: Obesity and postmenopausal status are associated with the occurrence of breast cancer in this population. Being over 40 years of age was also a statistically significant factor for postmenopausal women.
Geopolitics or Political Geography is an essential academic field that should be studied carefully for a more comprehensive analysis of international security relations. However, because of its tarnished image as an ideology that supported the NAZI German expansion and aggression, geopolitics has not been regarded as a pure academic field and was rejected and expelled from the academic communities starting from the Cold War years in 1945. During the Cold War, ideology, rather than geography, was considered more important in conducting and analyzing international relations. However, after the end of the Cold War and with the beginning of a new era in which territorial and religious confrontations are taking place among nations - including sub national tribal political organizations such as the Al Quaeda and other terrorist organizations - geopolitical analysis again is in vogue among the scholars and analysts on international security affairs. Most of the conflicts in international relations that is occurring now in the post-Cold War years can be explained more effectively with geopolitical concepts. The post - Cold War international relations among East Asian countries are especially better explained with geopolitical concepts. Unlike Europe, where peaceful development took place after the Cold War, China, Japan, Korea, the United States, Taiwan and Vietnam are feeling more insecure in the post-Cold War years. Most of the East Asian nations' economies have burgeoned during the Cold War years under the protection of the international security structure provided by the two superpowers. However, after the Cold War years, the international security structure has not been stable in East Asia and thus most of the East Asian nations began to build up stronger military forces of their own. Because most of the East Asian nations' national security and economy depend on the oceans, these nations desire to obtain more powerful navies and try to occupy islands, islets, or even rocks that may seem like a strategic asset for their economy and security. In this regard, the western Pacific Ocean is becoming a place of confrontation among the East Asian nations. As Robert Kaplan, an eminent international analyst, mentioned, East Asia is a Seascape while Europe is a Landscape. The possibility of international conflict on the waters of East Asia is higher than in any other period in East Asia's international history.
Purpose: This study was performed to assess the lifestyle-related behaviors of patients with gastric cancer (GC) and to investigate the associations between the time since GC diagnosis and these behaviors. Materials and Methods: This study included 29,478 adults (including 338 patients with GC) aged ≥ 40 years who participated in the Korea National Health and Nutrition Examination Survey 2014-2021. Multiple logistic regression analysis explored the associations between the time since GC diagnosis (patients diagnosed with GC less than 5 years ago [<5 years group] and those diagnosed with GC 5 or more than years ago [≥5 years group]) and lifestyle factors. Subgroup analyses were conducted based on age and sex. Results: The current smoking rate was not lower in the GC group than in the healthy group, regardless of time since diagnosis. Compared to the healthy controls, monthly alcohol intake was lower in the <5 years group (odds ratio [OR], 0.450; 95% confidence interval [CI], 0.275-0.736). The ≥5 years group showed a lower rate of strength training (OR, 0.548; CI, 0.359-0.838), compared with the healthy control group. Subgroup analysis focusing on the ≥5 years group revealed a significantly lower rate of strength training, particularly in patients aged ≥65 years and male patients (OR, 0.519 and 0.553; CI, 0.302-0.890 and 0.340-0.901, respectively). Conclusions: Clinicians should continue educating patients on lifestyle behavior modifications, particularly alcohol abstinence, even beyond 5 years after GC diagnosis. Education on strength training is especially important for patients ≥65 years or male patients.
Objectives : The aim of this study was to investigate the changes of attitude toward the oriental medicine for 10 years. Methods : A questionnaire was done about general characteristic of patient, the decision-maker of use and the reason of choice or alteration for oriental medicine hospital. Results : The results of this survey are as follows: For 10 years, sex ratio of outpatients is similar, but age distribution is even at all ages. The choice for oriental medicine is more determined by oneself than by others. The recommenders are more variable increasingly. The most common cause of moving from western medicine is to get the more effective treatment. The more the concomitant users are increasing, the more the patients that did not give notice to the western doctor about the dual therapies is increasing, also. The most frequent reason without a notice is "being afraid of western doctor's bias". Conclusions : The appropriate transfer system between oriental and western clinic must be constructed and the proper recognition about dual therapies will be needed among patients and especially dual doctors.
Kim, Jae-Yeong;Jeong, Seon-Yeong;Park, Sam-Min;Hwang, Dong-Gyu;Kho, Young Tak
Journal of Oriental Neuropsychiatry
/
v.26
no.3
/
pp.225-234
/
2015
Objectives: We aimed to evaluate the use of Korean medicine in patients with dizziness or vertigo, since such study has not been performed previously. Methods: In the current study, we included 3 diagnoses i.e., Disorders of vestibular function (H81), Vertiginous syndromes in diseases classified elsewhere (H82), and Dizziness and giddiness (R42) from the Health Insurance Review and Assessment Service (HIRAS) database for 4 years. We analyzed the database and compared treatment with Korean vs. Western medicine. Results: 1. Korean medical visits and cost have been increasing for 4 years, except 2011. Western medical visits are 11.9 times higher than Korean medical visits. 2. The number of women who received Korean medicine was 2.6 times higher than that of men. 3. Among all ages, the 70~79 years group were the most frequent users of Korean medicine. The older age was correlated with more patients' visits. 4. The comparative number of visits by patient care type for 4 years indicated that outpatients had more visits than hospitalization. Furthermore, outpatient visits have been increasing for 4 years. 5. The comparative number of visits by hospital type for 4 years indicated that visits to the Korean medical clinic were the highest. In primary care, patients used more Korean medicine than Western medicine. In tertiary care, patients used more Western medicine than Korean medicine. 6. Korean medical cost per patient by patient care type for 4 years was a total 89,000 won, hospitalization 449,000 won and outpatient 83,000 won. Costs of all patient care types have been increasing. 7. Korean medical cost per patient by hospital type for 4 years was 156,000 won for Korean medical hospital, 83,000 won for local clinic and 127,000 won for miscellaneous facilities. Costs of all types have been increasing. Conclusions: This study provided objective information about epidemiologic characteristics of Korean medicine in patients with dizziness or vertigo. Furthermore, it provides an understanding of the recent status and forms the basis for further expansion of demand for Korean medicine among patients with dizziness or vertigo.
Purpose: This study was conducted to compare the cumulative survival rates (CSRs) and the incidence of postloading complications (PLCs) between a bone-level internal connection system (ICS-BL) and an external connection system (ECS). Methods: The medical records of patients treated with either a ICS-BL or ECS between 2007 and 2010 at Asan Medical Center were reviewed. PLCs were divided into two categories: biological and technical. Biological complications included >4 mm of probing pocket depth, thread exposure in radiographs, and soft tissue complications, whereas technical complications included chipping of the veneering material, fracture of the implant, fracture of the crown, loosening or fracture of the abutment or screw, loss of retention, and loss of access hole filling material. CSRs were determined by a life-table analysis and compared using the log-rank chi-square test. The incidence of PLC was compared with the Pearson chi-squared test. Results: A total of 2,651 implants in 1,074 patients (1,167 ICS-BLs in 551 patients and 1,484 ECSs in 523 patients) were analyzed. The average observation periods were 3.4 years for the ICS-BLs and 3.1 years for the ECSs. The six-year CSR of all implants was 96.1% (94.9% for the ICS-BLs and 97.1% for the ECSs, P=0.619). Soft tissue complications were more frequent with the ECSs (P=0.005) and loosening or fracture of the abutment or screw occurred more frequently with the ICS-BLs (P<0.001). Conclusions: Within the limitations of this study, the ICS-BL was more prone to technical complications while the ECS was more vulnerable to biological complications.
Purpose: The purpose of this study is to investigate the association between unmet healthcare needs due to financial reasons and catastrophic health expenditures. Methods: This study used secondary data from the 2014~2015 Korean Health Panel survey. The subjects of this study were 21,495 people aged 20 or older, and of them, there were 16,227 people aged 20 to 64 and 5,268 people aged 65 or older, which were surveyed between 2014 and 2015. The association between unmet healthcare needs due to financial reasons and catastrophic health expenditures was analyzed through logistic regression. Results: In 2015, 1.7% of people aged 20~64 years and 7.9% of those aged 65 or older experienced unmet healthcare needs due to financial reasons. In the 20~64 age group, people who repeatedly experienced catastrophic health expenditures (=10%,=20%) were less likely to experience unmet healthcare needs due to financial reasons than those who did not experience catastrophic health expenditures for two years (OR=0.50, OR=0.41). However, in the 65-or-older group, people who repeatedly experienced catastrophic health expenditures (=20%) were more likely to experience unmet healthcare needs due to financial reasons than those who did not experience catastrophic health expenditures for two years (OR=1.68). Conclusion: A greater percentage of the elderly repeatedly faced both catastrophic health expenditures and unmet healthcare needs due to financial reasons compared to the non-elderly.
Objective: Older persons with diabetes mellitus (DM) are particularly more likely to have fallen in the previous year than those without DM. The purpose of this study was to investigate the relationship between the risk of falls and type 2 DM in older adults who are 65 years of age or above. Design: A systematic review. Methods: PubMed and other two databases were searched up to August 2, 2018. Observational and cohort studies evaluating fall risk in people who are 65 years of age or above with DM were included. This review extracted the following information from each study selected: first author's surname, year of publication, country, average follow-up period, sex, age at enrollment, study population, measurement variables, relative risk, 95% confidence intervals and controlled variables. Results: This review involved nine cohort studies with 3,765 older adults with DM and 12,989 older adults without DM. Six studies compared with or without DM and two studies compared fallers with non-fallers with DM. Risk factors for falls included impaired cognitive function, diabetes-related complications (peripheral nerve dysfunction, visual impairment), and physical function (balance, gait velocity, muscle strength, and severity of physical activities). Conclusions: People who are 65 years of age or above with DM have increased risk of falling caused by impaired cognitive function, peripheral nerve dysfunction, visual impairment, and physical function in community-dwellers. For adults who are 65 years of age or older with DM, research fields and clinical settings should consider therapeutic approaches to improve these risk factors for falls.
Background: Breast cancer is mostly the disease of postmenopausal women but very young affected women are seen more than occasionally in developing countries. We reviewed our cases of very young breast cancer in order to help in better understanding of such cases. Materials and Methods: The records of patients 25 years of age or less who had been admitted for breast cancer surgery in the Cancer Institute of Tehran from 1979 to 2012 were reviewed and relevant data were extracted. Results: From 5,265 cases of breast cancer, 62 patients had 25 years of age or less. There were 55 cases of breast adenocarcinoma, all female. More than 78% of the patients had presented with a palpable mass, the family history was positive in 2% of cases, and about 94% of the histologies were invasive ductal carcinoma. Gestational breast cancer constituted 10% of the cancers; another 10%were bilateral. The median size of the tumors was 5.72 centimeters, 63.2% of them had axillary lymphatic involvement, and more than half were negative for hormone receptors. Conclusions: Our study shows an incidence of 1.17% for very young breast cancer and a 10% rate of bilaterality which probably warrants special guidelines for contralateral screening. Cancer stage and features were poor in comparison with breast cancer in all ages.
In the 7th curriculum revision, Home Economics and Technology are combined into one subject, Practical Arts(Technology Home Economic), from 5th to 10th grades. The purpose of this study was to ewamine what perspectives home economics teachers and technology teachers have on curriculum. A questionnaire survey was carried out to the 297 middle school home economics teachers and technology teachers across the nation, to find out the differences of their perspectives on curriculum by independent variables. The findings of this study were as follows: 1) Both groups of home economics teachers and technology teachers supported interpretive, emancipators, and technical perspective on curriculum in the order named. 2) Teachers who have teaching experience of 21 years or more showed higher orientation toward technical perspective than those who have teaching experience of 10 years or less in assumptions on society, educational goal, Knowledge, and teaching-loaming method. 3) Public school teachers showed stronger orientation toward technical perspective in assumptions on teaching-learning method, and toward emancipatory perspective in assumptions on society. 4) Teachers who majored in or took charge of Technology generally had strong orientation toward technical perspective, whereas those who majored in or took charge of Home Economics oriented more toward interpretive or emancipatory than technical perspective.
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