• Title/Summary/Keyword: 95% confidence interval

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The Prevalence of Metabolic Syndrome and Related Risk Factors Based on the KNHANES V 2010 (제 5기 국민건강영양조사로 추정한 한국 성인의 대사증후군 유병률과 관련 요인)

  • Park, Eunok;Choi, Su Jung;Lee, Hyo Young
    • Journal of agricultural medicine and community health
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    • v.38 no.1
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    • pp.1-13
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    • 2013
  • Objectives: This study is to investigate the prevalence and related factors of metabolic syndrome among Korean adults aged 20 years and above. Methods: From the database of the $5^{th}$ Korea National Health and Nutrition Examination Survey (KNHANES V) conducted in 2010, data of 5,670 adults who responded to all the questionnaires of health interview and had metabolic syndrome in the health examination were included in this analysis. SAS 9.2 was used for statistical analysis with complex sample survey modules and commands. Results: The prevalence rate of metabolic syndrome based on the criteria proposed by International Diabetes Federation (IDF) was 18.8%. The prevalence of metabolic syndrome in each group was: 20.7% of women, 43.1% among elderly over 70 years old, 40.6% of the divorced or the separated, 27.6% of recipients of economic support from the government, 23.6% of people who had alcohol dependency problem, and 43.7% of overweight or obese adults. Independent risk factors based on the multiple logistic regression analysis revealed that prevalence of metabolic syndrome was associated with female (odds ratio 1.59 [95% confidence interval 1.20-2.11]), age (50s 3.95 [2.11-7.37], 60s 5.62 [2.98-10.61], 70s 10.56 [5.25-21.25]), high school education (0.52 [0.37-0.74]), clerk occupation (2.14 [1.27-3.60]), divorced marital status (1.72 [1.15-2.59]), alcohol dependency (1.86 [1.16-2.98]), higher BMI (14.08 [10.60-18.70]). Conclusions: The metabolic syndrome is prevalent among Korean adult population according to IDF criteria. Several demographic characteristics and potentially modifiable factors are associated with metabolic syndrome. Identification of this high-risk group and management of these modifiable factors are warranted to reduce the prevalence of metabolic syndrome.

Effectiveness of statin treatment for recurrent stroke according to stroke subtypes (뇌졸중 재발에 대한 스타틴 치료의 뇌졸중 아형에 따른 효과성)

  • Min-Surk Kye;Do Yeon Kim;Dong-Wan Kang;Baik Kyun Kim;Jung Hyun Park;Hyung Seok Guk;Nakhoon Kim;Sang-Won Choi;Dongje Lee;Yoona Ko;Jun Yup Kim;Jihoon Kang;Beom Joon Kim;Moon-Ku Han;Hee-Joon Bae
    • Journal of Medicine and Life Science
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    • v.21 no.2
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    • pp.40-48
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    • 2024
  • Understanding the effectiveness of statin treatment is essential for developing tailored stroke prevention strategies. We aimed to evaluate the efficacy of statin treatment in preventing recurrent stroke among patients with various ischemic stroke subtypes. Using data from the Clinical Research Collaboration for Stroke-Korea-National Institute for Health (CRCS-K-NIH) registry, we included patients with acute ischemic stroke admitted between January 2011 and July 2020. To evaluate the differential effects of statin treatment based on the ischemic stroke subtype, we analyzed patients with large artery atherosclerosis (LAA), cardio-embolism (CE), and small vessel occlusion (SVO). The primary outcomes were recurrent ischemic stroke and recurrent stroke events. The hazard ratio for outcomes between statin users and nonusers was compared using a Cox proportional hazards model adjusted for covariates. A total of 46,630 patients who met the inclusion criteria were analyzed. Statins were prescribed to 92%, 93%, and 78% of patients with LAA, SVO, and CE subtypes, respectively. The hazards of recurrent ischemic stroke and recurrent stroke in statin users were reduced to 0.79 (95% confidence interval [CI], 0.63-0.99) and 0.77 (95% CI, 0.62-0.95) in the LAA subtype and 0.63 (95% CI, 0.52-0.76) and 0.63 (95% CI, 0.53-0.75) in CE subtype compared to nonusers. However, the hazards of these outcomes did not significantly decrease in the SVO subtype. The effectiveness of statin treatment in reducing the risk of recurrent stroke in patients with LAA and CE subtypes has been suggested. Nonetheless, no significant effect was observed in the SVO subtype, suggesting a differential effect of statins on different stroke subtypes.

CT Examinations for COVID-19: A Systematic Review of Protocols, Radiation Dose, and Numbers Needed to Diagnose and Predict (COVID-19 진단을 위한 CT 검사: 프로토콜, 방사선량에 대한 체계적 문헌고찰 및 진단을 위한 CT 검사량)

  • Jong Hyuk Lee;Hyunsook Hong;Hyungjin Kim;Chang Hyun Lee;Jin Mo Goo;Soon Ho Yoon
    • Journal of the Korean Society of Radiology
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    • v.82 no.6
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    • pp.1505-1523
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    • 2021
  • Purpose Although chest CT has been discussed as a first-line test for coronavirus disease 2019 (COVID-19), little research has explored the implications of CT exposure in the population. To review chest CT protocols and radiation doses in COVID-19 publications and explore the number needed to diagnose (NND) and the number needed to predict (NNP) if CT is used as a first-line test. Materials and Methods We searched nine highly cited radiology journals to identify studies discussing the CT-based diagnosis of COVID-19 pneumonia. Study-level information on the CT protocol and radiation dose was collected, and the doses were compared with each national diagnostic reference level (DRL). The NND and NNP, which depends on the test positive rate (TPR), were calculated, given a CT sensitivity of 94% (95% confidence interval [CI]: 91%-96%) and specificity of 37% (95% CI: 26%-50%), and applied to the early outbreak in Wuhan, New York, and Italy. Results From 86 studies, the CT protocol and radiation dose were reported in 81 (94.2%) and 17 studies (19.8%), respectively. Low-dose chest CT was used more than twice as often as standard-dose chest CT (39.5% vs.18.6%), while the remaining studies (44.2%) did not provide relevant information. The radiation doses were lower than the national DRLs in 15 of the 17 studies (88.2%) that reported doses. The NND was 3.2 scans (95% CI: 2.2-6.0). The NNPs at TPRs of 50%, 25%, 10%, and 5% were 2.2, 3.6, 8.0, 15.5 scans, respectively. In Wuhan, 35418 (TPR, 58%; 95% CI: 27710-56755) to 44840 (TPR, 38%; 95% CI: 35161-68164) individuals were estimated to have undergone CT examinations to diagnose 17365 patients. During the early surge in New York and Italy, daily NNDs changed up to 5.4 and 10.9 times, respectively, within 10 weeks. Conclusion Low-dose CT protocols were described in less than half of COVID-19 publications, and radiation doses were frequently lacking. The number of populations involved in a first-line diagnostic CT test could vary dynamically according to daily TPR; therefore, caution is required in future planning.

Association between Sleep Duration, Dental Caries, and Periodontitis in Korean Adults: The Korea National Health and Nutrition Examination Survey, 2013~2014 (한국 성인에서 수면시간과 영구치 우식증 및 치주질환과의 관련성: 2013~2014 국민건강영양조사)

  • Lee, Da-Hyun;Lee, Young-Hoon
    • Journal of dental hygiene science
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    • v.17 no.1
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    • pp.38-45
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    • 2017
  • We evaluated the association between sleep duration, dental caries, and periodontitis by using representative nationwide data. We examined 8,356 subjects aged ${\geq}19$ years who participated in the sixth Korea National Health and Nutrition Examination Survey (2013~2014). Sleep duration were grouped into ${\leq}5$, 6, 7, 8, and ${\geq}9$ hours. Presence of dental caries was defined as caries in ${\geq}1$ permanent tooth on dental examination. Periodontal status was assessed by using the community periodontal index (CPI), and a CPI code of ${\geq}3$ was defined as periodontitis. A chi-square test and multiple logistic regression analysis were used to determine statistical significance. Model 1 was adjusted for age and sex, model 2 for household income, educational level, and marital status plus model 1, and model 3 for smoking status, alcohol consumption, blood pressure level, fasting blood glucose level, total cholesterol level, and body mass index plus model 2. The prevalence of dental caries according to sleep duration showed a U-shaped curve of 33.4%, 29.4%, 28.4%, 29.4%, and 31.8% with ${\leq}5$, 6, 7, 8, and ${\geq}9$ hours of sleep, respectively. In the fully adjusted model 3, the risk of developing dental caries was significantly higher with ${\leq}5$ than with 7 hours of sleep (odds ratio, 1.23; 95% confidence interval, 1.06~1.43). The prevalence of periodontitis according to sleep duration showed a U-shaped curve of 34.4%, 28.6%, 28.1%, 31.3%, and 32.5%, respectively. The risk of periodontitis was significantly higher with ${\geq}9$ than with 7 hours of sleep in models 1 and 2, whereas the significant association disappeared in model 3. In a nationally representative sample, sleep duration was significantly associated with dental caries formation and weakly associated with periodontitis. Adequate sleep is required to prevent oral diseases such as dental caries and periodontitis.

Risk Factors for Hearing Loss in Very Low Birth Weight Infants: Results of Hearing Test in Infants <1,500 g (극소 저체중 출생아에서 청력 손상에 영향을 미치는 요인: 1,500 g미만의 청력 검사 결과)

  • Sung, Min-Jung;Han, Young-Mi;Park, Kyung-Hee;Lee, Il-Woo;Byun, Shin-Yun
    • Neonatal Medicine
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    • v.18 no.2
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    • pp.328-336
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    • 2011
  • Purpose: An association between very low birth weight infants(VLBWI) and hearing loss has long been recognized. Early identification and intervention for hearing loss benefits language and speech/cognitive development. We investigated the risk factors and clinical outcomes of hearing loss among VLBWI. Methods: We analyzed the results of auditory brainstem response (ABR) testing of VLBWI. These infants were admitted to the neonatal intensive care unit (NICU) of Pusan National University Yangsan Hospital between December 2008 and February 2011. A follow-up was conducted subsequently. Results: ABR evaluations were performed on 65 infants, and 31 showed abnormal results (47.7%). Among the 31 infants, 10 were classified with moderate/severe/profound hearing loss (15.4%). The infants with abnormal ABR had a higher incidence of low birth weight, prolonged ventilator care, cumulative dose of furosemide, and the lowest $PaO_2$ (P<0.05). Those with moderate/severe/profound hearing loss had a higher incidence of low Apgar scores at 5 minutes (odds ratio[OR],0.34; 95% confidence interval[CI],0.13-0.89), prolonged ventilator care (OR,1.06; 95% CI,1.01-1.12), and mild hearing loss compared to those without profound hearing loss. Follow-up evaluations on eight infants with ABR reveled improvements 5.6${\pm}$3.9 months later. One infant, who had profound hearing loss in both ears, used a hearing aid. Conclusion: Factors influencing hearing loss at the first VLBWI hearing screening test included lower Apgar scores at 5 min and prolonged use of a ventilator. Most VLBWI with hearing losses were expected to recover after several months of follow-up.

The Analysis of Blood Glucose Level Difference According to the Exact Use of Blood Glucose Measurement Test Strips in $^{18}F$-FDG Wholebody PET ($^{18}F$-FDG를 이용한 전신 PET 검사에서 혈당 측정 검사지의 정확한 사용에 따른 혈당 수치의 차이 분석)

  • Park, Soon-Ki;Lee, Nam-Ki;NamGung, Chang-Kyung;Jung, Woo-Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.100-103
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    • 2010
  • Purpose: $^{18}F$-FDG wholebody PET is to evaluate the tumor using glucose metabolism. The blood glucose level is important factor that affects on a result of examination. High glucose levels may interfere with tumor targeting due to competitive inhibition of FDG uptake by D-glucose. The blood glucose level measurement test strips used in the blood glucose measurement are classified into the capillary blood measurement test strips and general purpose measurement test strips that can measure the venous blood and capillary blood altogether depends on cases. The purpose of the study was to compare the blood glucose measurements between simultaneously obtained capillary and venous blood samples using the capillary blood measurement test strips, general purpose measurement test strips. Materials and Methods: A total of 46 subjects (32 males, 14 females) with a mean age of $57.3{\pm}12.3$ years were enrolled. The blood glucose estimation was performed with a Optium Xceed Glucometer (Abbott). Simultaneous capillary and venous blood samples were obtained from each subject. The blood glucose levels were measured using the capillary blood measurement test strips and general purpose measurement test strips. The capillary and venous measurements were compared using a pared t-test. Results: The mean capillary and venous glucose values using the general purpose measurement test strips were $95.2{\pm}12.4$ mg/dL and $104.1{\pm}14.4$ mg/dL, giving a statistically significant difference (p<0.001) between the mean values for the capillary and venous glucose samples (9.0 mg/dL; 95% confidence interval (CI) -11.2 to -6.7). The mean capillary and venous glucose values using the capillary blood measurement test strips were $91.5{\pm}13.6$ mg/dL and $108.6{\pm}16.2$ mg/dL, giving a statistically significant difference (p<0.001) between the mean values for the capillary and venous glucose samples (16.6 mg/dL; 95% CI -20.2 to -13.0). Conclusion: When measuring the blood glucose level before $^{18}F$-FDG PET examination, since the incorrect blood glucose level can be measured, it should note to measure the blood glucose level of the venous blood by the capillary blood measurement test strips. Therefore the measurement variation can be reduced to fulfill the standardized measurement procedure with the suitable measurement test strips, the preparation of the PET examination will be able to be clearly confirmed. In addition, the standardized procedure of the following measurement on the area which is same at all times the blood area in the blood glucose measurement among a capillary or a vein will be needed.

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Understanding the Occurrence of Lung Cancer in Foundry Workers through Health Insurance Data (의료보험 전산자료 주상병명으로 파악한 주물공장 근로자들의 폐암)

  • Song, Jae-Seok;Kang, Seong-Kyu;Chung, Ho-Keun;Ahn, Yeon-Soon
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.3
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    • pp.299-305
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    • 2000
  • Objectives : To investigate the difference in the occurrence of lung cancer between foundry workers and non-foundry workers by comparing the number of workers diagnosed with lung cancer through health insurance data. Methods : The study population was comprised of 28,884 workers who had undergone at least one general or special medical examination between January 1995 and December 1997 at the occupational health center. All of the subjects had health insurance during this period. We combined the medical examination data with the health insurance data to compare the number of foundry workers diagnosed with lung cancer and the number of non-foundry workers diagnosed with lung cancer. Results : Seven workers were diagnosed with lung cancer among the 1,591 foundry workers, compared to twelve workers among the 27,293 non-foundry workers (odds ratio: 10.04, 95% confidence interval: 3.95-25.55). The seven foundry workers diagnosed with lung cancer were all exposed to dust, and six out these seven workers were engaged in finishing or shake-out processes. Conclusions : Although the information for this study was obtained from health insurance data, which has limitations such as accuracy and completeness, the number of foundry workers diagnosed with lung cancer was significantly higher than that of non-foundry workers. Therefore, a well-designed cohort study should be followed to confirm the higher lung cancer rates in foundry workers.

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Association between the Number of Existing Permanent Teeth and Chronic Obstructive Pulmonary Disease (현존자연치아수와 만성폐쇄성폐질환과의 연관성)

  • Shin, Hye-Sun;Ahn, Yong-Soon;Lim, Do-Seon
    • Journal of dental hygiene science
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    • v.16 no.3
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    • pp.217-224
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    • 2016
  • The aim of this study was to evaluate whether the number of existing permanent teeth is associated with chronic obstructive pulmonary disease (COPD) in a representative sample of Korean adults. Data from 3,107 subjects who participated in the 2009 Korea National Health and Nutrition Examination Survey were examined. The dependent variable was COPD and the independent variable was the number of existing permanent teeth. Spirometry results were classified into three groups (normal pattern, restrictive pattern, and obstructive pattern) by trained technicians. We used dichotomized COPD variables (no vs. yes). The number of existing permanent teeth was evaluated by oral examination and divided into 3 groups (0~19, 20~27, and 28). Demographic factors (age group and sex group), socioeconomic status (education and income), health behaviors (smoking and drinking), oral health and behavior (frequency of toothbrushing; periodontitis; decayed, missing, filled, permanent teeth index; and denture status), and general health status (body mass index, diabetes mellitus, and hypertension) were included as confounders in the analysis. Bivariate analysis and multivariate logistic regression analyses including confounders were applied, and all analyses considered a complex sampling design. Stratified analysis was performed by smoking status. After controlling for various confounders, there was a significant association between the number of existing permanent teeth and COPD (odds ratio [OR], 1.90; 95% confidence interval [CI], 1.20~3.00 for the 20~27 group; OR, 3.93; 95% CI, 1.75~8.84 for the 0~19 group). The association was more significant in current smokers (OR, 8.90; 95% CI, 2.53~31.33). Our data indicate that the number of existing permanent teeth was independently associated with COPD, especially in current smokers. Further longitudinal research is needed to determine whether oral health promotion plays a role in the improvement of lung function and prevention of COPD.

Comparison of Efficacy of Overlapped Versus Long Eluting Stent in Acute Myocardial Infarction Patients with Diffuse Long Lesion (미만성 긴 병변이 있는 급성심근경색환자에서 긴 단일 용출 스텐트 시술과 중첩 스텐트 시술의 효과 비교)

  • Kim, Won Hyo;Kim, In Soo;Kong, Chang gi;Han, Jae Bok
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.319-336
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    • 2020
  • The purpose of this study was to compare the outcomes of two interventional methods, overlapping drug-eluting stents (DES) and long DES, for long-term clinical outcomes in patients with acute myocardial infarction (AMI). A total of 438 patients with AMI (65.9±11.0 years, 306 males) from June 2008 to March 2019 who had diffuse long coronary artery lesion, more than 30mm were divided into two groups; group I (overlapped DES group; n=140) and group II (long DES group; n=298). We compared the incidences of major adverse cardiac events [MACEs; cardiac death, myocardial infaction (MI), target lesion revascularization (TLR) and stent thrombosis (ST)] during 12 months between the two groups. Everolimus-eluting stent was more commonly used in group II than in group I (28.1% vs. 51.8% p<0.001). Mean lesion diameter was slightly longer in group II (3.1±0.3mm vs. 3.2±0.3mm, p=0.042), and prevalence of ACC/AHA lesion type C was higher in group I (41.7% vs. 25.4%, p<0.001). Incidences of MACEs during 12 months were higher in group I than group II (18.5% vs. 14.4%, p=0.034). The rates of cardiac death (2.1% vs. 4.4%, p=0.667), MI (5.0% vs. 2.7%, p=0.260) and stent thrombosis rate (0.7% vs. 1.7%, p=0.669) were similar between the two groups. However, TLR rate was higher in group I (10.7% vs. 5.6%, p=0.041). In multivariate logistic regression analysis, presence of diabetes mellitus [Hazard ratio (HR) 2.383, 95% confidence interval (CI) 1.332-4.260, p=0.003] and use of paclitaxel-eluting stent (HR) 2.367, 95% CI 1.371-4.086, p=0.002) were independent predictors of 12-month MACEs, without significant differences in prevalence between the two groups. In AMI patients with diffuse long lesion, TLR rate was higher in the overlapped DES group during 12-month follow-up. Presence of diabetes and use of paclitaxel-eluting stent were independent predictors of MACEs.

Performance effectiveness of pediatric index of mortality 2 (PIM2) and pediatricrisk of mortality III (PRISM III) in pediatric patients with intensive care in single institution: Retrospective study (단일 병원에서 소아 중환자의 예후인자 예측을 위한 PIM2 (pediatric index of mortality 2)와 PRIMS III (pediatric risk of mortality)의 유효성 평가 - 후향적 조사 -)

  • Hwang, Hui Seung;Lee, Na Young;Han, Seung Beom;Kwak, Ga Young;Lee, Soo Young;Chung, Seung Yun;Kang, Jin Han;Jeong, Dae Chul
    • Clinical and Experimental Pediatrics
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    • v.51 no.11
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    • pp.1158-1164
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    • 2008
  • Purpose : To investigate the discriminative ability of pediatric index of mortality 2 (PIM2) and pediatric risk of mortality III (PRISM III) in predicting mortality in children admitted into the intensive care unit (ICU). Methods : We retrospectively analyzed variables of PIM2 and PRISM III based on medical records with children cared for in a single hospital ICU from January 2003 to December 2007. Exclusions were children who died within 2 h of admission into ICU or hopeless discharge. We used Students t test and ANOVA for general characteristics and for correlation between survivors and non-survivors for variables of PIM2 and PRISM III. In addition, we performed multiple logistic regression analysis for Hosmer-Lemeshow goodness-of-fit, receiver operating characteristic curve (ROC) for discrimination, and calculated standardized mortality ratio (SMR) for estimation of prediction. Results : We collected 193 medical records but analyzed 190 events because three children died within 2 h of ICU admission. The variables of PIM2 correlated with survival, except for the presence of post-procedure and low risk. In PRISM III, there was a significant correlation for cardiovascular/neurologic signs, arterial blood gas analysis but not for biochemical and hematologic data. Discriminatory performance by ROC showed an area under the curve 0.858 (95% confidence interval; 0.779-0.938) for PIM2, 0.798 (95% CI; 0.686-0.891) for PRISM III, respectively. Further, SMR was calculated approximately as 1 for the 2 systems, and multiple logistic regression analysis showed ${\chi}^2(13)=14.986$, P=0.308 for PIM2, ${\chi}^2(13)=12.899$, P=0.456 for PRISM III in Hosmer-Lemeshow goodness-of-fit. However, PIM2 was significant for PRISM III in the likelihood ratio test (${\chi}^2(4)=55.3$, P<0.01). Conclusion : We identified two acceptable scoring systems (PRISM III, PIM2) for the prediction of mortality in children admitted into the ICU. PIM2 was more accurate and had a better fit than PRISM III on the model tested.